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Youth Ranking 2023

 
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States with rankings 1-13 have a lower prevalence of mental illness and higher rates of access to care for youth. States with rankings 39-51 indicate that youth have a higher prevalence of mental illness and lower rates of access to care.

The seven measures that make up the Youth Ranking include:

  1.  Youth with at Least One Major Depressive Episode (MDE) in the Past Year
  2.  Youth with Substance Use Disorder in the Past Year
  3.  Youth with Serious Thoughts of Suicide
  4.  Youth (Ages 6-17) Flourishing
  5.  Youth with MDE Who Did Not Receive Mental Health Services
  6.  Youth with Private Insurance That Did Not Cover Mental or Emotional Problems
  7.  Students (K+) Identified with Emotional Disturbance for an Individualized Education Program.
Rank Sort descending State
01 District of Columbia
02 Delaware
03 Wisconsin
04 Pennsylvania
05 Massachusetts
06 New Jersey
07 New Hampshire
08 Connecticut
09 Nevada
10 Oklahoma
11 Colorado
12 Rhode Island
13 Illinois
14 Maryland
15 Vermont
16 South Carolina
17 Wyoming
18 North Dakota
19 Mississippi
20 New York
21 Minnesota
22 Georgia
23 Indiana
24 North Carolina
25 South Dakota
26 Iowa
27 Ohio
28 California
29 Arizona
30 Utah
31 Kentucky
32 Maine
33 Florida
34 New Mexico
35 Michigan
36 Missouri
37 Alabama
38 Alaska
39 Montana
40 Washington
41 Tennessee
42 Louisiana
43 Hawaii
44 Arkansas
45 West Virginia
46 Texas
47 Idaho
48 Virginia
49 Nebraska
50 Kansas
51 Oregon

Youth with At Least One Major Depressive Episode (MDE) 2023

 
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Youth with at Least One Past Year Major Depressive Episode (MDE)

20.17% of youth (ages 12-17) reported suffering from at least one major depressive episode (MDE) in the past year.

15% of youth in the U.S. experienced an MDE with severe impairment, meaning it severely impacted their functioning at work, school, or home.

The state prevalence of youth with MDE ranges from 16.02% in the District of Columbia to 24.96% in Oregon.

 

Rank Sort descending State Percentage Number
01 New Jersey 12.57 84,000
02 South Carolina 13.41 51,000
03 Pennsylvania 14.04 127,000
04 Wisconsin 14.16 63,000
05 Delaware 14.24 10,000
06 Georgia 14.49 127,000
07 California 14.83 447,000
08 Kentucky 14.89 51,000
09 Arkansas 14.97 36,000
10 Mississippi 15.08 37,000
11 Maryland 15.37 69,000
12 Indiana 15.45 83,000
13 Florida 15.51 225,000
14 North Carolina 15.56 124,000
15 Connecticut 15.64 42,000
16 Rhode Island 15.90 11,000
17 Oklahoma 15.97 51,000
18 Michigan 15.99 119,000
19 Nevada 16.02 38,000
20 New York 16.03 214,000
21 Louisiana 16.18 58,000
22 District of Columbia 16.32 5,000
23 Wyoming 16.78 8,000
24 Missouri 16.84 79,000
25 Arizona 16.90 96,000
26 New Hampshire 17.02 16,000
27 Colorado 17.05 74,000
28 Texas 17.08 429,000
29 Iowa 17.10 42,000
30 Tennessee 17.32 89,000
31 Alabama 17.56 65,000
32 Massachusetts 17.74 84,000
33 North Dakota 17.77 10,000
34 West Virginia 17.92 22,000
35 Kansas 17.94 43,000
36 South Dakota 17.96 13,000
37 Illinois 18.10 177,000
38 Ohio 18.25 162,000
39 Alaska 18.36 10,000
40 Hawaii 18.36 17,000
41 Utah 19.08 61,000
42 New Mexico 19.32 32,000
43 Minnesota 19.39 86,000
44 Virginia 19.56 124,000
45 Washington 19.57 108,000
46 Maine 19.85 18,000
47 Nebraska 20.08 32,000
48 Montana 20.18 16,000
49 Vermont 20.64 8,000
50 Idaho 20.88 33,000
51 Oregon 21.13 63,000
52 National 16.39 4,087,000

Youth with Severe Major Depressive Episode 2023

 
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11.5% of youth (or over 2.7 million youth) are experiencing severe major depression.

Rates of a severe major depressive episode were highest among youth who identified as more than one race, at 16.5% (about 123,000 youth).

The percentage of youth with severe major depressive episode in South Dakota (ranked 51) is nearly four times the percentage of youth with severe MDE in South Carolina (ranked 1).

The state prevalence of youth with Severe MDE ranges from 5.2% in South Carolina to 19.9% in South Dakota.

Rank Sort descending State Percentage Number
01 South Carolina 5.20% 19,000
02 New Jersey 7.50% 48,000
03 Mississippi 8.10% 19,000
04 Wisconsin 8.50% 37,000
05 Massachusetts 8.80% 40,000
06 California 9.20% 269,000
07 Pennsylvania 9.20% 79,000
08 Kentucky 9.30% 30,000
09 Rhode Island 9.90% 7,000
10 Georgia 10.00% 85,000
11 Delaware 10.10% 7,000
12 Connecticut 10.20% 26,000
13 Oklahoma 10.30% 32,000
14 Arkansas 10.60% 25,000
15 District of Columbia 10.60% 3,000
16 North Carolina 10.60% 82,000
17 Tennessee 10.60% 54,000
18 Wyoming 10.70% 5,000
19 New York 10.80% 137,000
20 Texas 10.80% 261,000
21 Colorado 10.90% 46,000
22 Hawaii 10.90% 10,000
23 Indiana 11.20% 57,000
24 Michigan 11.30% 83,000
25 Florida 12.30% 174,000
26 Maryland 12.40% 55,000
27 New Mexico 12.80% 21,000
28 Kansas 13.00% 30,000
29 West Virginia 13.00% 16,000
30 Arizona 13.10% 72,000
31 Alabama 13.20% 48,000
32 New Hampshire 13.30% 12,000
33 Montana 13.40% 10,000
34 North Dakota 13.60% 7,000
35 Missouri 13.80% 64,000
36 Nevada 13.80% 32,000
37 Ohio 13.90% 119,000
38 Vermont 13.90% 5,000
39 Washington 14.00% 74,000
40 Illinois 14.40% 136,000
41 Alaska 14.80% 8,000
42 Iowa 15.00% 36,000
43 Minnesota 15.20% 64,000
44 Nebraska 15.70% 23,000
45 Virginia 15.70% 97,000
46 Maine 16.30% 14,000
47 Utah 16.40% 50,000
48 Louisiana 16.60% 59,000
49 Idaho 17.50% 27,000
50 Oregon 19.00% 55,000
51 South Dakota 19.90% 14,000
52 National 11.50% 2,782,000

Youth with Substance Use Disorder 2023

 
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6.34% of youth in the U.S. reported a substance use disorder in the past year.  

2.85% had an alcohol use disorder in the past year, while 4.85% had an illicit drug use disorder.

The state prevalence of youth with substance use disorder ranges from 3.94% in the District of Columbia to 9.05% in Kansas.

Rank Sort descending State Percentage Number
01 District of Columbia 3.94 1,000
02 Georgia 4.30 38,000
03 Nevada 4.65 11,000
04 Alaska 5.06 3,000
05 North Carolina 5.13 41,000
06 Delaware 5.13 4,000
07 South Carolina 5.26 20,000
08 Maryland 5.27 24,000
09 Wisconsin 5.66 25,000
10 Utah 5.70 18,000
11 Minnesota 5.73 25,000
12 Texas 5.79 146,000
13 Florida 5.99 87,000
14 Louisiana 6.00 22,000
15 Arizona 6.06 35,000
16 Oklahoma 6.07 20,000
17 Hawaii 6.08 6,000
18 Alabama 6.11 23,000
19 Tennessee 6.13 32,000
20 Washington 6.27 35,000
21 Arkansas 6.29 15,000
22 Colorado 6.37 28,000
23 Mississippi 6.48 16,000
24 New York 6.49 86,000
25 Indiana 6.49 35,000
26 Iowa 6.52 16,000
27 North Dakota 6.53 4,000
28 Kentucky 6.59 22,000
29 Rhode Island 6.60 5,000
30 California 6.64 200,000
31 Massachusetts 6.77 32,000
32 Ohio 6.81 60,000
33 Missouri 6.81 32,000
34 Pennsylvania 6.85 62,000
35 Wyoming 6.90 3,000
36 West Virginia 6.96 9,000
37 Virginia 6.99 44,000
38 Idaho 7.06 11,000
39 Nebraska 7.13 11,000
40 Michigan 7.14 53,000
41 Illinois 7.19 70,000
42 New Jersey 7.26 49,000
43 South Dakota 7.37 5,000
44 New Hampshire 7.46 7,000
45 Maine 7.46 7,000
46 Connecticut 7.50 20,000
47 New Mexico 7.75 13,000
48 Vermont 7.91 3,000
49 Oregon 7.97 24,000
50 Montana 8.60 7,000
51 Kansas 9.05 22,000
52 National 6.34 1,584,000

Youth with MDE Who Did Not Receive Mental Health Services 2023

 
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59.8% of youth with major depression did not receive any mental health treatment.

In Kentucky, Hawaii, and Texas, three-quarters of youth with major depression did not receive mental health treatment. In South Carolina, the lowest ranking state, nearly 8 in 10 youth with depression do not receive care.

The state prevalence of untreated youth with depression ranges from 32.6% in the District of Columbia to 77.1% in South Carolina.

Rank Sort descending State Percentage Number
1 Rhode Island 1.40% 1,000
10 Wyoming 7.10% 2,000
11 Kentucky 7.50% 13,000
12 New Jersey 7.60% 31,000
13 Tennessee 7.70% 20,000
14 Hawaii 8.10% 4,000
15 Iowa 8.10% 11,000
16 Arizona 8.20% 22,000
17 California 8.20% 114,000
18 Maryland 8.20% 20,000
19 New Hampshire 8.20% 5,000
2 Missouri 4.20% 11,000
20 Oregon 8.20% 14,000
21 Montana 8.40% 3,000
22 Ohio 8.40% 39,000
23 Pennsylvania 8.40% 38,000
24 Washington 8.60% 23,000
25 North Carolina 8.70% 33,000
26 Oklahoma 8.70% 11,000
27 Delaware 9.00% 3,000
28 Maine 9.10% 4,000
29 Alaska 9.60% 3,000
3 Illinois 5.30% 29,000
30 Michigan 9.60% 42,000
31 Minnesota 9.60% 25,000
32 Vermont 9.70% 2,000
33 West Virginia 9.70% 6,000
34 Wisconsin 9.90% 26,000
35 Louisiana 10.00% 16,000
36 Kansas 10.30% 10,000
37 Nebraska 10.90% 9,000
38 South Carolina 10.90% 20,000
39 New Mexico 11.20% 7,000
4 Massachusetts 5.70% 16,000
40 Florida 11.40% 68,000
41 New York 11.70% 78,000
42 Indiana 12.10% 35,000
43 Mississippi 12.10% 9,000
44 Georgia 13.20% 52,000
45 Idaho 13.40% 12,000
46 Alabama 13.80% 22,000
47 North Dakota 14.30% 5,000
48 Virginia 17.00% 61,000
49 Colorado 17.20% 40,000
5 Connecticut 5.90% 10,000
50 Texas 19.40% 205,000
51 Arkansas 23.20% 27,000
52 National 10.30% 1,281,000
6 Utah 5.90% 12,000
7 South Dakota 6.20% 3,000
8 District of Columbia 6.80% 1,000
9 Nevada 7.00% 10,000

Youth with Severe MDE Who Received Some Consistent Treatment 2023

 
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Nationally, only 28% of youth with severe depression receive some consistent treatment (7-25+ visits in a year). 

14.7% of youth with severe MDE received 1-6 visits in the previous year. Most (57.3%) youth with severe depression do not receive any care.

The state prevalence of youth with severe depression who received some outpatient treatment ranges from 58.1% in South Dakota to 6.5% in Kansas.


High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes.

Rank Sort descending State Percentage Number
01 South Dakota 58.10% 8,000
02 Colorado 57.40% 27,000
03 North Dakota 51.20% 4,000
04 New Hampshire 46.80% 5,000
05 Massachusetts 46.30% 17,000
06 Delaware 45.30% 3,000
07 Illinois 44.70% 56,000
08 Oklahoma 44.70% 14,000
09 Alabama 44.60% 21,000
10 Maine 43.20% 6,000
11 New Mexico 43.20% 8,000
12 New Jersey 42.50% 18,000
13 Montana 39.70% 3,000
14 Vermont 39.60% 2,000
15 Ohio 38.60% 45,000
16 Pennsylvania 38.10% 25,000
17 Virginia 34.90% 33,000
18 Maryland 34.50% 18,000
19 Idaho 34.10% 9,000
20 District of Columbia 34.00% 1,000
21 New York 34.00% 45,000
22 Wyoming 33.30% 1,000
23 Nevada 33.00% 10,000
24 Utah 32.50% 14,000
25 Minnesota 30.70% 19,000
26 Washington 30.70% 21,000
27 Wisconsin 30.60% 10,000
28 Iowa 30.20% 10,000
29 Florida 26.50% 45,000
30 California 25.40% 68,000
31 Mississippi 24.30% 5,000
32 Arizona 24.20% 17,000
33 South Carolina 24.20% *
34 Michigan 23.60% 19,000
35 Connecticut 22.30% 6,000
36 Indiana 22.10% 12,000
37 Missouri 21.20% 13,000
38 Alaska 19.70% 2,000
39 North Carolina 19.70% 14,000
40 Arkansas 19.50% 4,000
41 West Virginia 18.00% 3,000
42 Georgia 17.40% 14,000
43 Kentucky 16.40% 5,000
44 Nebraska 16.00% 3,000
45 Rhode Island 13.90% 1,000
46 Tennessee 13.70% 7,000
47 Oregon 13.00% 7,000
48 Texas 12.70% 33,000
49 Louisiana 12.10% 4,000
50 Hawaii 11.40% 1,000
51 Kansas 6.50% 2,000
52 National 28.20% 737,000

Youth with Private Insurance that Did Not Cover Mental or Emotional Problems 2023

 
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Nationally, 1 in 10 youth who are covered under private insurance do not have coverage for mental or emotional difficulties – totaling over 1.2 million youth.

In Arkansas (ranked 51), nearly one-quarter of youth with private insurance do not have coverage for mental health care.

The state prevalence of youth lacking mental health coverage ranges from 1.4% in Rhode Island to 23.2% in Arkansas.

Rank Sort descending State Percentage Number
1 Rhode Island 1.40% 1,000
10 Wyoming 7.10% 2,000
11 Kentucky 7.50% 13,000
12 New Jersey 7.60% 31,000
13 Tennessee 7.70% 20,000
14 Hawaii 8.10% 4,000
15 Iowa 8.10% 11,000
16 Arizona 8.20% 22,000
17 California 8.20% 114,000
18 Maryland 8.20% 20,000
19 New Hampshire 8.20% 5,000
2 Missouri 4.20% 11,000
20 Oregon 8.20% 14,000
21 Montana 8.40% 3,000
22 Ohio 8.40% 39,000
23 Pennsylvania 8.40% 38,000
24 Washington 8.60% 23,000
25 North Carolina 8.70% 33,000
26 Oklahoma 8.70% 11,000
27 Delaware 9.00% 3,000
28 Maine 9.10% 4,000
29 Alaska 9.60% 3,000
3 Illinois 5.30% 29,000
30 Michigan 9.60% 42,000
31 Minnesota 9.60% 25,000
32 Vermont 9.70% 2,000
33 West Virginia 9.70% 6,000
34 Wisconsin 9.90% 26,000
35 Louisiana 10.00% 16,000
36 Kansas 10.30% 10,000
37 Nebraska 10.90% 9,000
38 South Carolina 10.90% 20,000
39 New Mexico 11.20% 7,000
4 Massachusetts 5.70% 16,000
40 Florida 11.40% 68,000
41 New York 11.70% 78,000
42 Indiana 12.10% 35,000
43 Mississippi 12.10% 9,000
44 Georgia 13.20% 52,000
45 Idaho 13.40% 12,000
46 Alabama 13.80% 22,000
47 North Dakota 14.30% 5,000
48 Virginia 17.00% 61,000
49 Colorado 17.20% 40,000
5 Connecticut 5.90% 10,000
50 Texas 19.40% 205,000
51 Arkansas 23.20% 27,000
52 National 10.30% 1,281,000
6 Utah 5.90% 12,000
7 South Dakota 6.20% 3,000
8 District of Columbia 6.80% 1,000
9 Nevada 7.00% 10,000

Students (K+) Identified with Emotional Disturbance for An Individualized Education Program 2023

 
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Only .718% of students are identified as having an Emotional Disturbance (ED) for an Individualized Education Program (IEP).

For purposes of an IEP, the term “Emotional Disturbance” is used to define youth with a mental or behavioral health condition that is affecting their educational performance.

The rate for this measure is shown as a rate per 1,000 students.

The calculation was made this way for ease of reading. Unfortunately, doing so hides the fact that the percentages are significantly lower.

The state rate of students identified as having an emotional disturbance for an IEP ranges from 30.60 per 1,000 students in Vermont to 1.82 per 1,000 students in Alabama.


High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes

 

Rank Sort descending State Percentage Number
01 Vermont 30.60 2,317
02 Minnesota 19.80 16,848
03 Massachusetts 19.14 17,230
04 Pennsylvania 15.37 26,081
05 Wisconsin 14.78 11,575
06 Maine 14.57 2,444
07 Iowa 13.31 *
08 Indiana 12.03 12,236
09 New Hampshire 11.67 1,937
10 North Dakota 11.50 1,290
11 Connecticut 11.41 5,636
12 Rhode Island 11.29 1,546
13 Illinois 9.76 17,797
14 Oregon 9.67 5,425
15 Nebraska 9.39 2,881
16 District of Columbia 9.34 728
17 Ohio 9.14 14,768
18 South Dakota 8.67 1,182
19 Delaware 8.56 1,164
20 Missouri 8.25 7,056
21 New York 8.19 20,857
22 Virginia 7.73 9,463
23 Michigan 7.63 10,702
24 Texas 7.25 37,375
25 Kentucky 7.03 4,489
26 Mississippi 6.88 3,005
27 Arizona 6.87 7,547
28 Maryland 6.54 5,615
29 Colorado 6.29 5,390
30 Wyoming 6.26 577
31 Montana 5.92 857
32 New Mexico 5.90 1,821
33 Oklahoma 5.90 3,877
34 Georgia 5.77 9,731
35 Alaska 5.74 725
36 Hawaii 5.19 907
37 Washington 5.16 5,510
38 Kansas 5.14 2,377
39 New Jersey 5.13 6,760
40 Florida 4.70 12,875
41 Idaho 4.61 1,404
42 Nevada 4.39 2,077
43 California 4.06 24,370
44 West Virginia 3.97 956
45 Tennessee 3.41 3,272
46 North Carolina 3.33 4,976
47 South Carolina 2.81 2,098
48 Louisiana 2.74 *
49 Utah 2.66 1,776
50 Arkansas 2.28 1,080
51 Alabama 1.82 1,303
52 National 7.18 345,350