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Alexandria, VA – Today, for the eighth year in a row, Mental Health America (MHA) released its annual State of Mental Health in America report, which ranks all 50 states and the District of Columbia based on 15 mental health access and prevalence measures. This year, Massachusetts (#1), New Jersey (#2), and Pennsylvania (#3) were the top three ranking states. Arizona (#49), Idaho (#50), and Nevada (#51) were the three bottom-ranking states. Notably, Nevada has ranked last for six of the report’s eight years.

The state with the largest rise over last year’s overall ranking was South Carolina, jumping from #43 in 2021 to #30 this year. The state with the largest fall over last year’s overall ranking was Texas, dropping from #27 in 2021 to #44 this year. 

Most alarmingly, the data show an increase of 664,000 people from last year’s dataset reporting serious thoughts of suicide. The national rate of suicidal ideation among adults has increased year-over-year in every report, but this is a larger increase than seen in last year’s report and is a concerning trend.

The report also found an increase over last year’s dataset in the percentage of youth that experienced a major depressive episode in the past year -- nearly one in five youth ages 12-17 experienced a major depressive episode. On top of that, the data show that over 60% of youth with major depression do not receive any mental health treatment. Even in states with the greatest access, nearly one in three are going without treatment. In Texas, the bottom-ranked state, nearly three-quarters of youth with major depression did not receive mental health treatment. 

In addition, the data present a larger picture about the number of people living with a mental illness in the U.S. and their insurance coverage:

  • Nearly 50 million Americans – almost 20% -- are experiencing a mental illness.
  • Over half of adults with a mental illness do not receive treatment, totaling over 27 million adults in the U.S. who are going untreated. The percentage of adults with a mental illness who report an unmet need for treatment has increased every year since the inception of this report.
  • 11.1% of Americans with a mental illness are uninsured. There was a 0.3% increase from last year’s dataset, the second year in a row that this indicator increased since the passage of the Affordable Care Act (ACA).

“Our report illuminates the continuing crisis both in the prevalence of mental health conditions and in access to mental health services,” said Schroeder Stribling, President and CEO of Mental Health America. “It is clear that we must do more to ensure that Americans are able to lead mentally healthy lives. As policymakers, advocates, educators, and concerned citizens, we must continue to expand prevention, focus on early intervention, and improve access to mental health care for all in need. And we must do so with a specific emphasis on mental health equity – addressing the needs of marginalized and impoverished communities who face greater risk factors for mental health conditions as well as greater challenges in access to care.” 

In developing the report, MHA gathered the most current data reported by the states and available to the public. These data are from 2019. They are most useful in providing comparative baselines in the states for the needs and systems that were in place prior to the COVID-19 pandemic, as data reflective of the COVID-19 pandemic will not be made available until next year.

In releasing this report, MHA aims to provide a snapshot of mental health status among youth and adults for policy and program planning, analysis, and evaluation; to track changes in the prevalence of mental health issues and access to mental health care; to understand how changes in national data reflect the impact of legislation and policies; and to increase the dialogues and improve outcomes for individuals and families with mental health needs.

The full State of Mental Health in America report can be accessed here.


About Mental Health America

Mental Health America (MHA) is the nation’s leading community-based nonprofit dedicated to addressing the needs of those living with mental illness and promoting the overall mental health of all. MHA’s work is driven by its commitment to promote mental health as a critical part of overall wellness, including prevention services for all; early identification and intervention for those at risk; integrated care, services, and supports for those who need them; with recovery as the goal. Learn more at