The State of Mental Health in America report highlights the latest national data and provides state-level rankings on mental health and well-being in the U.S. Through this report, Mental Health America offers critical insights to drive policy, improve care, and support people living with mental health conditions across the country.
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 have a higher prevalence of mental illness and lower rates of access to care for youth.
The eight measures that make up the youth ranking include:
| Rank | State |
|---|---|
| 1 | District of Columbia |
| 2 | Vermont |
| 3 | New York |
| 4 | Massachusetts |
| 5 | Iowa |
| 6 | Pennsylvania |
| 7 | Hawaii |
| 8 | Illinois |
| 9 | New Jersey |
| 10 | Utah |
| 11 | Kansas |
| 12 | Wisconsin |
| 13 | Georgia |
| 14 | North Dakota |
| 15 | Ohio |
| 16 | Maine |
| 17 | Indiana |
| 18 | North Carolina |
| 19 | Texas |
| 20 | Michigan |
| 21 | Connecticut |
| 22 | Oklahoma |
| 23 | California |
| 24 | New Hampshire |
| 25 | South Dakota |
| 26 | Nebraska |
| 27 | Mississippi |
| 28 | Rhode Island |
| 29 | Missouri |
| 30 | Minnesota |
| 31 | Colorado |
| 32 | Virginia |
| 33 | West Virginia |
| 34 | Delaware |
| 35 | Wyoming |
| 36 | Kentucky |
| 37 | Alaska |
| 38 | Washington |
| 39 | Oregon |
| 40 | Maryland |
| 41 | Louisiana |
| 42 | Tennessee |
| 43 | South Carolina |
| 44 | Florida |
| 45 | Montana |
| 46 | Arkansas |
| 47 | New Mexico |
| 48 | Idaho |
| 49 | Arizona |
| 50 | Alabama |
| 51 | Nevada |
The percentage of youth (ages 12-17) who experienced a major depressive episode (MDE) in the past year decreased significantly between 2023 and 2024. In 2023, 18.10% of youth reported suffering from at least one MDE in the past year, compared to 15.40% in 2024.
In 2024, 11.30% of youth in the U.S. experienced a MDE with severe impairment, meaning it severely impacted their functioning at work, school, or home. That’s an estimated 2.8 million youth whose depression significantly impaired their functioning.
Alaska had the largest improvement in the percentage of youth with MDE, shifting from 21.72% in 2021-2022 to 17.27% in 2022-2023 (5% decrease). California, Indiana, New York, and Washington also had statistically significant decreases in the percentage of youth with MDE in the past year.
| Rank | State | Percentage | Count |
|---|---|---|---|
| 1 | Hawaii | 16.06% | 16,000 |
| 2 | District of Columbia | 16.10% | 6,000 |
| 3 | South Dakota | 16.67% | 13,000 |
| 4 | Utah | 16.68% | 56,000 |
| 5 | New York | 16.88% | 232,000 |
| 6 | Indiana | 17.01% | 95,000 |
| 7 | Georgia | 17.03% | 156,000 |
| 8 | Alaska | 17.27% | 10,000 |
| 9 | Texas | 17.30% | 457,000 |
| 10 | California | 17.53% | 534,000 |
| 11 | Wisconsin | 17.55% | 80,000 |
| 12 | Louisiana | 17.74% | 66,000 |
| 13 | South Carolina | 17.75% | 72,000 |
| 14 | Mississippi | 17.92% | 44,000 |
| 15 | Oklahoma | 18.10% | 61,000 |
| 16 | New Jersey | 18.28% | 130,000 |
| 17 | Massachusetts | 18.73% | 90,000 |
| 18 | North Dakota | 18.84% | 11,000 |
| 19 | Delaware | 18.86% | 14,000 |
| 20 | Iowa | 18.87% | 49,000 |
| 21 | Alabama | 18.91% | 75,000 |
| 22 | North Carolina | 19.14% | 158,000 |
| 23 | Pennsylvania | 19.15% | 179,000 |
| 24 | Michigan | 19.16% | 145,000 |
| 25 | Ohio | 19.17% | 174,000 |
| 26 | Kansas | 19.34% | 48,000 |
| 27 | Rhode Island | 19.61% | 14,000 |
| 28 | Florida | 19.62% | 301,000 |
| 29 | Montana | 19.63% | 16,000 |
| 30 | Arkansas | 19.65% | 49,000 |
| 31 | Connecticut | 19.66% | 53,000 |
| 32 | Tennessee | 19.87% | 108,000 |
| 33 | Vermont | 19.89% | 8,000 |
| 34 | Virginia | 19.93% | 131,000 |
| 35 | Wyoming | 20.14% | 10,000 |
| 36 | Washington | 20.15% | 116,000 |
| 37 | Nebraska | 20.20% | 34,000 |
| 38 | Missouri | 20.20% | 98,000 |
| 39 | Illinois | 20.30% | 200,000 |
| 40 | Kentucky | 20.53% | 73,000 |
| 41 | Idaho | 20.58% | 35,000 |
| 42 | Maine | 20.59% | 19,000 |
| 43 | Minnesota | 20.94% | 96,000 |
| 44 | Arizona | 21.06% | 121,000 |
| 45 | New Mexico | 21.36% | 36,000 |
| 46 | West Virginia | 21.46% | 27,000 |
| 47 | Oregon | 21.90% | 66,000 |
| 48 | Colorado | 21.91% | 96,000 |
| 49 | Maryland | 22.30% | 106,000 |
| 50 | Nevada | 22.63% | 56,000 |
| 51 | New Hampshire | 22.71% | 21,000 |
| National | 18.82% | 4,860,000 |
The percentage of youth (ages 12-17) with substance use disorder (SUD) decreased significantly between 2021 and 2024. In 2021, 9.20% of youth in the U.S. had a SUD in the past year compared to 7.80% in 2024.
Youth substance use decreased during the COVID-19 pandemic and has remained low, even as youth have returned to school in-person. In 2024, the percentage of 8th-12th graders who reported abstaining from using alcohol, marijuana, or nicotine was the highest recorded since the question was introduced in 2017.3
Youth with depression and anxiety were more likely to use substances, especially illicit drugs, than their peers. The percentage of youth with a past year major depressive episode (MDE) who used illicit drugs was 21% higher than those without MDE. The percentage of youth with moderate to severe anxiety who use illicit drugs was 16% higher than those without anxiety symptoms. This indicates that while substance use may be declining among the general population, addressing youth mental health challenges is critical to sustaining those gains.
| Rank | State | Percentage | Count |
|---|---|---|---|
| 1 | Utah | 6.57% | 22,000 |
| 2 | Hawaii | 6.84% | 7,000 |
| 3 | Iowa | 7.09% | 18,000 |
| 4 | North Carolina | 7.58% | 63,000 |
| 5 | Mississippi | 7.58% | 19,000 |
| 6 | South Dakota | 7.70% | 6,000 |
| 7 | New Jersey | 7.79% | 55,000 |
| 8 | Nebraska | 7.86% | 13,000 |
| 9 | Kentucky | 7.90% | 28,000 |
| 10 | Wyoming | 8.00% | 4,000 |
| 11 | Michigan | 8.03% | 61,000 |
| 12 | West Virginia | 8.05% | 10,000 |
| 13 | Indiana | 8.07% | 45,000 |
| 14 | New Hampshire | 8.09% | 8,000 |
| 15 | New York | 8.17% | 112,000 |
| 16 | Texas | 8.17% | 216,000 |
| 17 | California | 8.18% | 249,000 |
| 18 | Oklahoma | 8.21% | 28,000 |
| 19 | Minnesota | 8.24% | 38,000 |
| 20 | Tennessee | 8.25% | 45,000 |
| 21 | Vermont | 8.33% | 4,000 |
| 22 | Alaska | 8.34% | 5,000 |
| 23 | North Dakota | 8.39% | 5,000 |
| 24 | Pennsylvania | 8.52% | 80,000 |
| 25 | Washington | 8.57% | 49,000 |
| 26 | Kansas | 8.61% | 21,000 |
| 27 | Ohio | 8.63% | 78,000 |
| 28 | Virginia | 8.69% | 57,000 |
| 29 | South Carolina | 8.77% | 36,000 |
| 30 | Arkansas | 8.79% | 22,000 |
| 31 | Maryland | 8.82% | 42,000 |
| 32 | Alabama | 8.86% | 35,000 |
| 33 | Missouri | 8.90% | 43,000 |
| 34 | Massachusetts | 8.95% | 43,000 |
| 35 | Georgia | 9.11% | 83,000 |
| 36 | District of Columbia | 9.13% | 3,000 |
| 37 | Florida | 9.16% | 141,000 |
| 38 | Wisconsin | 9.20% | 42,000 |
| 39 | Idaho | 9.24% | 16,000 |
| 40 | Rhode Island | 9.30% | 7,000 |
| 41 | Illinois | 9.32% | 92,000 |
| 42 | Montana | 9.35% | 8,000 |
| 43 | Louisiana | 9.52% | 35,000 |
| 44 | Maine | 9.57% | 9,000 |
| 45 | Connecticut | 9.72% | 26,000 |
| 46 | Colorado | 9.88% | 43,000 |
| 47 | Oregon | 10.02% | 30,000 |
| 48 | Nevada | 10.05% | 25,000 |
| 49 | Arizona | 10.15% | 58,000 |
| 50 | Delaware | 10.34% | 8,000 |
| 51 | New Mexico | 11.28% | 19,000 |
| National | 8.56% | 2,210,000 |
The national rate of youth (ages 12-17) reporting serious thoughts of suicide (suicidal ideation) has decreased significantly, from 12.30% of youth in 2023 to 10.10% of youth in 2024. Still, that totals nearly 3 million youth reporting suicidal ideation.
Rates of suicidal ideation and suicide decreased among even the highest risk populations in 2023. According to the 2023 Youth Risk Behavior Surveillance System (YRBSS), 41.00% of LGBTQ+ students in the U.S. reported seriously considering attempting suicide, a 4% decrease from 2021. However, rates of suicidal ideation were still 28% higher among LGBTQ+ youth than their cisgender and heterosexual peers.4
The decrease in youth suicidal ideation signifies substantial improvement in connecting youth to mental health and crisis resources, likely due in part to greater investment in 988 and crisis services from 2021 to 2023. To further decreases in youth suicide, states must continue to invest in both crisis care and upstream suicide prevention. This includes sustaining specialized services for the populations at greatest risk, including LGBTQ+ youth.
| Rank | State | Percentage | Count |
|---|---|---|---|
| 1 | New York | 11.30% | 155,000 |
| 2 | District of Columbia | 11.60% | 4,000 |
| 3 | Connecticut | 11.87% | 32,000 |
| 4 | Texas | 12.04% | 319,000 |
| 5 | Utah | 12.12% | 41,000 |
| 6 | Mississippi | 12.16% | 30,000 |
| 7 | Georgia | 12.17% | 111,000 |
| 8 | Michigan | 12.34% | 93,000 |
| 9 | California | 12.39% | 377,000 |
| 10 | Oklahoma | 12.39% | 42,000 |
| 11 | North Carolina | 12.51% | 103,000 |
| 12 | Kentucky | 12.58% | 45,000 |
| 13 | New Jersey | 12.59% | 89,000 |
| 14 | Massachusetts | 12.61% | 61,000 |
| 15 | North Dakota | 12.62% | 8,000 |
| 16 | Kansas | 12.62% | 31,000 |
| 17 | South Carolina | 12.66% | 51,000 |
| 18 | Iowa | 12.75% | 33,000 |
| 19 | Missouri | 12.88% | 62,000 |
| 20 | Washington | 12.92% | 74,000 |
| 21 | Hawaii | 12.92% | 13,000 |
| 22 | Wisconsin | 12.92% | 59,000 |
| 23 | Louisiana | 12.97% | 48,000 |
| 24 | Florida | 12.98% | 199,000 |
| 25 | Indiana | 13.10% | 73,000 |
| 26 | Delaware | 13.23% | 10,000 |
| 27 | Arizona | 13.37% | 77,000 |
| 28 | Pennsylvania | 13.38% | 125,000 |
| 29 | Alaska | 13.39% | 8,000 |
| 30 | Colorado | 13.45% | 59,000 |
| 31 | Alabama | 13.48% | 53,000 |
| 32 | Rhode Island | 13.52% | 10,000 |
| 33 | Ohio | 13.53% | 123,000 |
| 34 | Arkansas | 13.65% | 34,000 |
| 35 | Montana | 13.70% | 11,000 |
| 36 | Oregon | 13.72% | 42,000 |
| 37 | Virginia | 13.76% | 90,000 |
| 38 | Illinois | 13.79% | 136,000 |
| 39 | Minnesota | 13.98% | 64,000 |
| 40 | Nebraska | 14.06% | 23,000 |
| 41 | Idaho | 14.12% | 24,000 |
| 42 | New Hampshire | 14.19% | 13,000 |
| 43 | Nevada | 14.23% | 35,000 |
| 44 | Wyoming | 14.42% | 7,000 |
| 45 | Tennessee | 14.54% | 79,000 |
| 46 | West Virginia | 14.63% | 19,000 |
| 47 | Maryland | 14.66% | 70,000 |
| 48 | Vermont | 14.71% | 6,000 |
| 49 | New Mexico | 14.74% | 25,000 |
| 50 | South Dakota | 14.98% | 11,000 |
| 51 | Maine | 15.36% | 14,000 |
| National | 12.87% | 3,322,000 |
In 2022 and 2023, 60.40% of youth (ages 6-17) across the U.S. met all three criteria for flourishing.
The criteria for flourishing were designed by the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau to assess children and adolescents’ learning, resilience, and self-regulation.5 Youth who were flourishing were those who always or usually showed interest and curiosity in learning new things, work to finish tasks they started, and stayed calm and in control when faced with a challenge. These were established as high priority, baseline measures of flourishing that could be improved through investment in early interventions for parents and families – including social support, conflict resolution, and resources for families to meet basic needs.
To capture a more comprehensive picture of well-being, researchers have suggested covering five domains: physical health, mental well-being, social behavior, cognitive and academic development, and relationships.6
Studies using more holistic measures of well-being among adults have found that young adults reported lower well-being than they did in happiness studies in the early 2000s.7 These findings suggest that not only is adolescent and young adult mental health in crisis, but states need to take an earlier and more comprehensive approach to reducing rates of loneliness, supporting education and employment, and ensuring access to care for better physical and mental health for all.
| Rank | State | Percentage | Count |
|---|---|---|---|
| 1 | Illinois | 66.40% | 1,257,191 |
| 2 | New Jersey | 64.50% | 872,530 |
| 3 | Iowa | 63.50% | 315,473 |
| 4 | District of Columbia | 63.20% | 48,147 |
| 5 | Hawaii | 63.20% | 128,104 |
| 6 | Maryland | 63.00% | 574,530 |
| 7 | Georgia | 62.70% | 1,084,181 |
| 8 | New Mexico | 62.70% | 202,567 |
| 9 | Kansas | 62.50% | 298,652 |
| 10 | Nebraska | 62.00% | 200,414 |
| 11 | Delaware | 61.90% | 86,601 |
| 12 | Texas | 61.90% | 3,150,547 |
| 13 | Pennsylvania | 61.80% | 1,117,629 |
| 14 | Massachusetts | 61.70% | 571,082 |
| 15 | California | 61.60% | 3,653,991 |
| 16 | Mississippi | 61.30% | 288,459 |
| 17 | Ohio | 61.30% | 1,077,565 |
| 18 | Tennessee | 61.00% | 637,174 |
| 19 | South Carolina | 60.90% | 468,346 |
| 20 | New York | 60.70% | 1,632,381 |
| 21 | North Carolina | 60.60% | 961,401 |
| 22 | Wisconsin | 60.60% | 527,688 |
| 23 | Connecticut | 60.50% | 306,632 |
| 24 | South Dakota | 60.10% | 89,254 |
| 25 | Colorado | 59.60% | 507,133 |
| 26 | Florida | 59.30% | 1,741,248 |
| 27 | North Dakota | 59.30% | 71,727 |
| 28 | Arizona | 59.00% | 647,934 |
| 29 | Louisiana | 59.00% | 424,830 |
| 30 | Minnesota | 58.50% | 519,217 |
| 31 | Indiana | 58.20% | 625,538 |
| 32 | Nevada | 58.20% | 276,584 |
| 33 | Michigan | 58.10% | 847,457 |
| 34 | West Virginia | 57.90% | 143,534 |
| 35 | Wyoming | 57.80% | 53,508 |
| 36 | Idaho | 57.50% | 187,481 |
| 37 | Virginia | 57.50% | 737,372 |
| 38 | Oregon | 57.30% | 337,186 |
| 39 | Alaska | 57.00% | 67,663 |
| 40 | Alabama | 56.90% | 431,616 |
| 41 | Arkansas | 56.80% | 270,340 |
| 42 | Oklahoma | 56.70% | 365,276 |
| 43 | Vermont | 56.70% | 45,876 |
| 44 | New Hampshire | 56.60% | 100,732 |
| 45 | Rhode Island | 56.50% | 79,372 |
| 46 | Missouri | 56.40% | 523,722 |
| 47 | Maine | 55.00% | 93,943 |
| 48 | Washington | 54.50% | 618,487 |
| 49 | Kentucky | 54.10% | 370,934 |
| 50 | Utah | 54.00% | 350,275 |
| 51 | Montana | 53.90% | 87,728 |
| 60.40% | 30,077,252 |
In 2022-2023 combined data, 8.60% of youth (ages 12-17) had private health insurance that did not cover mental health treatment – totaling over 1 million youth in the U.S.
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires that insurance coverage of mental health and substance use disorder benefits be no more restrictive than coverage of benefits for medical or surgical care.22 However, people continue to have to pay more out-of-pocket for mental health care than physical health care. A 2021 study found that adults who were treated for depression or anxiety had almost twice the out-of-pocket spending as those who did not have a mental health condition.23 In 2024, the Biden Administration finalized new rules to strengthen and incentivize enforcement of MHPAEA, which were a supplement to the original rules finalized in 2013.24 However, in 2025, the Departments of Labor, Health and Human Services, and the Treasury announced that they would not be enforcing the new rules, and had plans to rescind or modify them, undermining access to behavioral health services for youth and adults across the U.S.25 Without enforcement from the federal government, states bear the primary responsibility to enforce MHPAEA.
| Rank | State | Percentage | Count |
|---|---|---|---|
| 1 | Maine | 3.00% | 2,000 |
| 2 | Kansas | 4.50% | 6,000 |
| 3 | District of Columbia | 4.80% | 1,000 |
| 4 | Oklahoma | 4.90% | 6,000 |
| 5 | Rhode Island | 5.00% | 2,000 |
| 6 | Connecticut | 5.30% | 8,000 |
| 7 | Ohio | 5.30% | 24,000 |
| 8 | Illinois | 6.00% | 32,000 |
| 9 | Minnesota | 6.00% | 18,000 |
| 10 | Vermont | 6.00% | 1,000 |
| 11 | New Hampshire | 6.10% | 3,000 |
| 12 | New Mexico | 6.10% | 4,000 |
| 13 | Wisconsin | 6.90% | 17,000 |
| 14 | Massachusetts | 7.20% | 22,000 |
| 15 | Washington | 7.20% | 23,000 |
| 16 | Pennsylvania | 7.30% | 35,000 |
| 17 | Virginia | 7.30% | 29,000 |
| 18 | California | 7.40% | 110,000 |
| 19 | New York | 7.40% | 47,000 |
| 20 | Colorado | 7.50% | 17,000 |
| 21 | Hawaii | 7.50% | 4,000 |
| 22 | South Dakota | 7.50% | 3,000 |
| 23 | Tennessee | 7.70% | 17,000 |
| 24 | Utah | 8.10% | 20,000 |
| 25 | Texas | 8.40% | 86,000 |
| 26 | Arkansas | 8.50% | 6,000 |
| 27 | Michigan | 8.60% | 34,000 |
| 28 | Oregon | 8.60% | 13,000 |
| 29 | New Jersey | 8.80% | 33,000 |
| 30 | Georgia | 8.90% | 34,000 |
| 31 | Montana | 8.90% | 4,000 |
| 32 | West Virginia | 9.20% | 5,000 |
| 33 | Nevada | 9.40% | 12,000 |
| 34 | North Dakota | 9.50% | 3,000 |
| 35 | Iowa | 10.20% | 14,000 |
| 36 | Maryland | 10.30% | 29,000 |
| 37 | Indiana | 10.40% | 29,000 |
| 38 | Florida | 10.50% | 73,000 |
| 39 | Wyoming | 10.50% | 3,000 |
| 40 | Missouri | 10.70% | 27,000 |
| 41 | Nebraska | 11.40% | 12,000 |
| 42 | North Carolina | 11.40% | 46,000 |
| 43 | Mississippi | 11.80% | 8,000 |
| 44 | Alaska | 11.90% | 3,000 |
| 45 | Delaware | 12.80% | 5,000 |
| 46 | Louisiana | 12.90% | 15,000 |
| 47 | Idaho | 13.00% | 12,000 |
| 48 | Arizona | 13.30% | 28,000 |
| 49 | Kentucky | 14.70% | 23,000 |
| 50 | South Carolina | 17.20% | 32,000 |
| 51 | Alabama | 18.00% | 29,000 |
| National | 8.60% | 1,070,000 |
In 2022-2023 combined data, over half (50.80%) of youth (ages 12-17) with a major depressive episode (MDE) did not receive any treatment or counseling for depression in the past year. That is a 5% improvement over 2021-2022 combined data. Still, over 2 million youth with depression are not receiving care. In Alabama (ranked 51) nearly two-thirds of youth with MDE did not receive treatment in 2022-2023.
In 2023, 85.30% of youth reported not receiving care because they felt they should have been able to handle their mental health on their own. Nearly 3 in 5 (58.90%) youth reported being worried what people would think or say if they got treatment, and 58.20% were worried that the information they shared would not be kept private.26
Fear of involuntary treatment is also a major barrier to youth seeking mental health care. In 2023, nearly half (46.20%) of youth reported that they did not get treatment because they were afraid of being committed to a hospital or forced into treatment against their will.27
| Rank | State | Percentage | Count |
|---|---|---|---|
| 1 | Maine | 27.70% | 5,000 |
| 2 | Missouri | 37.70% | 38,000 |
| 3 | Vermont | 37.80% | 3,000 |
| 4 | Illinois | 38.20% | 78,000 |
| 5 | Iowa | 39.80% | 17,000 |
| 6 | Colorado | 40.00% | 42,000 |
| 7 | North Dakota | 41.50% | 5,000 |
| 8 | Utah | 41.50% | 21,000 |
| 9 | Oregon | 42.50% | 27,000 |
| 10 | Montana | 43.00% | 7,000 |
| 11 | Rhode Island | 43.30% | 6,000 |
| 12 | West Virginia | 44.40% | 11,000 |
| 13 | District of Columbia | 45.20% | 2,000 |
| 14 | Ohio | 45.60% | 77,000 |
| 15 | Kentucky | 45.70% | 34,000 |
| 16 | New York | 46.70% | 95,000 |
| 17 | Wisconsin | 46.80% | 27,000 |
| 18 | Michigan | 47.70% | 66,000 |
| 19 | Wyoming | 47.80% | 4,000 |
| 20 | Virginia | 47.90% | 63,000 |
| 21 | Massachusetts | 48.00% | 37,000 |
| 22 | Indiana | 48.30% | 39,000 |
| 23 | Maryland | 48.50% | 57,000 |
| 24 | Kansas | 49.10% | 24,000 |
| 25 | New Jersey | 49.10% | 59,000 |
| 26 | New Hampshire | 49.80% | 11,000 |
| 27 | North Carolina | 50.10% | 78,000 |
| 28 | Pennsylvania | 50.40% | 88,000 |
| 29 | Delaware | 50.80% | 7,000 |
| 30 | Georgia | 51.10% | 70,000 |
| 31 | Idaho | 51.10% | 20,000 |
| 32 | Nebraska | 52.10% | 19,000 |
| 33 | Texas | 52.20% | 216,000 |
| 34 | California | 52.40% | 267,000 |
| 35 | Louisiana | 52.70% | 34,000 |
| 36 | Oklahoma | 53.10% | 30,000 |
| 37 | Washington | 53.40% | 59,000 |
| 38 | Alaska | 55.00% | 5,000 |
| 39 | New Mexico | 56.70% | 22,000 |
| 40 | Florida | 57.10% | 166,000 |
| 41 | Hawaii | 57.10% | 6,000 |
| 42 | South Carolina | 57.80% | 38,000 |
| 43 | Arkansas | 59.00% | 29,000 |
| 44 | Nevada | 59.50% | 39,000 |
| 45 | South Dakota | 59.80% | 5,000 |
| 46 | Mississippi | 60.30% | 26,000 |
| 47 | Arizona | 61.50% | 81,000 |
| 48 | Connecticut | 61.90% | 26,000 |
| 49 | Tennessee | 63.70% | 61,000 |
| 50 | Minnesota | 64.10% | 67,000 |
| 51 | Alabama | 66.40% | 46,000 |
| National | 50.80% | 2,360,000 |
In 2022-2023 combined data, 28.60% of youth (ages 12-17) did not have a preventive health visit in the past year. That totaled over 7 million youth in the U.S. In Nevada (ranked 51), nearly 4 in 10 adolescents did not receive preventative care in 2023.
Despite being identified as a goal for improvement in Healthy People 2030, the percentage of adolescents who have never received preventive care has increased over time. In 2016-2017, the baseline years for measurement, 21.30% of adolescents had not received a preventive care visit.28
Several expert organizations and agencies, including the National Academy of Medicine and the Department of Health and Human Services, recommend that all adolescents receive an annual preventive health care visit.29,30 Preventive health care visits are especially critical during adolescence to promote wellness and identify physical and mental health problems as early as possible. Fifty percent of individuals with a mental health condition will show symptoms during their adolescent years.31 These preventive visits are often the only place adolescents receive necessary mental health screenings, including screenings for depression and substance use.
The Community Preventive Services Task Force for Healthy People 2030 recommends creating school-based health centers to increase access to preventive health services and meet youth with care where they are, especially in communities where access to primary care may be limited.32 Mental health screenings can also be implemented in schools in health classes, or as part of a ubiquitous mental health screening and education protocol outside of clinical settings.33 A 2025 survey of K-12 principals found that nearly one-third of U.S. public schools mandate mental health screenings for students, but many reported a lack of resources as a barrier to connecting students to care.34 Consistent state and federal funding for school mental health services is critical to ensure all youth have access to early identification and intervention for their mental health.
| Rank | State | Percentage | Count |
|---|---|---|---|
| 1 | New Hampshire | 14.70% | 13,370 |
| 2 | Maine | 15.50% | 13,647 |
| 3 | Vermont | 16.00% | 6,862 |
| 4 | North Carolina | 18.50% | 150,038 |
| 5 | Pennsylvania | 20.00% | 184,185 |
| 6 | District of Columbia | 21.00% | 6,945 |
| 7 | Massachusetts | 21.00% | 101,236 |
| 8 | West Virginia | 21.60% | 26,894 |
| 9 | Colorado | 22.50% | 97,950 |
| 10 | Connecticut | 22.50% | 60,457 |
| 11 | Illinois | 22.60% | 222,816 |
| 12 | New York | 23.20% | 322,332 |
| 13 | Ohio | 23.60% | 213,702 |
| 14 | Oregon | 24.20% | 74,314 |
| 15 | Kansas | 24.60% | 60,099 |
| 16 | Georgia | 24.90% | 227,348 |
| 17 | Kentucky | 25.00% | 87,763 |
| 18 | Iowa | 25.10% | 64,007 |
| 19 | Nebraska | 25.10% | 42,059 |
| 20 | Maryland | 25.90% | 119,784 |
| 21 | Indiana | 26.00% | 140,546 |
| 22 | North Dakota | 26.00% | 15,040 |
| 23 | Wisconsin | 26.50% | 120,309 |
| 24 | Tennessee | 26.60% | 142,677 |
| 25 | New Jersey | 26.90% | 190,970 |
| 26 | Delaware | 27.40% | 19,967 |
| 27 | Michigan | 27.60% | 208,251 |
| 28 | Missouri | 27.70% | 134,471 |
| 29 | Washington | 27.80% | 156,313 |
| 30 | Hawaii | 28.10% | 26,710 |
| 31 | Louisiana | 28.20% | 104,711 |
| 32 | Oklahoma | 28.30% | 94,969 |
| 33 | Utah | 28.40% | 94,461 |
| 34 | Wyoming | 28.50% | 13,653 |
| 35 | South Dakota | 29.10% | 21,790 |
| 36 | Alabama | 30.00% | 116,896 |
| 37 | Rhode Island | 30.20% | 22,465 |
| 38 | Minnesota | 30.40% | 134,995 |
| 39 | Arkansas | 30.90% | 74,780 |
| 40 | Virginia | 30.90% | 203,168 |
| 41 | South Carolina | 31.30% | 123,341 |
| 42 | Alaska | 32.10% | 18,604 |
| 43 | Montana | 32.10% | 26,709 |
| 44 | New Mexico | 32.90% | 54,653 |
| 45 | Florida | 33.00% | 504,058 |
| 46 | Arizona | 35.00% | 196,552 |
| 47 | Texas | 35.10% | 915,572 |
| 48 | Mississippi | 35.50% | 86,878 |
| 49 | California | 36.60% | 1,125,809 |
| 50 | Idaho | 37.10% | 60,642 |
| 51 | Nevada | 37.90% | 87,981 |
| National | 28.60% | 7,333,751 |
In the 2023-2024 school year, only 0.663% of students are identified as having an emotional disturbance (ED) for an individualized education program (IEP). Under the Individuals with Disabilities Education Act (IDEA), ED is one of the disability categories that can make a student eligible for special education services and an IEP. This number is critically low compared to the prevalence of severe mental health concerns among youth. For example, in 2023, 3.4 million youth reported experiencing MDE with severe impairment, compared to only 317,641 who were identified with ED for an IEP.
IEPs are critical for ensuring that youth with disabilities can receive the individualized services, supports, and accommodations to succeed in a school setting. However, schools continue to report problems with adequate funding and staffing to meet the behavioral health needs of their students. A 2024 survey of schools from the National Center for Education Statistics found that less than half (48%) of schools reported they could effectively provide mental health services to students who needed them. That was a 10% decrease from data collected during the 2021-2022 school year. Over half of schools reported that they were unable to meet students’ mental health needs due to a lack of staffing (55%) and funding (54%) in 2023.35 Despite emergency school funding following the COVID-19 pandemic and increased efforts to eliminate the teacher shortage in special education, there were still about 8 students with disabilities for every one certified or qualified teacher or paraprofessional in the U.S. in 2022. 36
Efforts by the Trump administration to dismantle the Department of Education and limit access to school mental health funds are jeopardizing schools’ ability to serve their students with mental health needs. While states are responsible for decisions regarding how they implement the Individuals with Disabilities Education Act (IDEA) and use funding, the Department of Education is responsible for IDEA enforcement and distribution of that funding to states. If states are not adequately providing students with disabilities with the supports or accommodations they need, the Department of Education can withhold federal funds.37 States already differ significantly in how they provide special education services, but without an agency to enforce IDEA compliance, those disparities will likely widen as states make difficult decisions about where to cut funding. Further, the federal government contributes about 12% of special education funding to states.38 If the federal government dismantles the Department of Education, it should assign enforcement of IDEA to another agency and continue providing funding for school mental health services. As states are given more jurisdiction over education policies, they must continue to invest in accommodations and supports for students with disabilities.
| Rank | State | Rate | Count |
|---|---|---|---|
| 1 | Vermont | 28.26 | 2,104 |
| 2 | Massachusetts | 19.41 | 17,133 |
| 3 | Minnesota | 18.98 | 16,032 |
| 4 | Pennsylvania | 15.73 | 26,467 |
| 5 | Maine | 13.96 | 2,320 |
| 6 | Wisconsin | 11.63 | 8,886 |
| 7 | Indiana | 11.16 | 11,260 |
| 8 | New Hampshire | 10.87 | 1,762 |
| 9 | Connecticut | 10.52 | 5,186 |
| 10 | North Dakota | 10.37 | 1,202 |
| 11 | South Dakota | 10.19 | 1,408 |
| 12 | Rhode Island | 9.74 | 1,294 |
| 13 | Nebraska | 9.05 | 2,801 |
| 14 | Illinois | 8.68 | 15,330 |
| 15 | Oregon | 8.62 | 4,721 |
| 16 | Delaware | 8.15 | 1,136 |
| 17 | Texas | 7.93 | 41,696 |
| 18 | Michigan | 7.49 | 10,316 |
| 19 | Ohio | 7.48 | 12,174 |
| 20 | Missouri | 7.46 | 6,385 |
| 21 | Virginia | 7.06 | 8,648 |
| 22 | Wyoming | 6.98 | 630 |
| 23 | New York | 6.6 | 16,246 |
| 24 | Mississippi | 6.25 | 2,672 |
| 25 | Kentucky | 6.1 | 3,856 |
| 26 | Arizona | 6.04 | 6,622 |
| 27 | Alaska | 5.87 | 751 |
| 28 | Oklahoma | 5.52 | 3,651 |
| 29 | Colorado | 5.52 | 4,600 |
| 30 | District of Columbia | 5.47 | 441 |
| 31 | Montana | 5.26 | 777 |
| 32 | Maryland | 5.22 | 4,485 |
| 33 | New Jersey | 5.1 | 6,672 |
| 34 | Georgia | 4.98 | 8,459 |
| 35 | Kansas | 4.8 | 2,204 |
| 36 | Washington | 4.64 | 4,960 |
| 37 | Hawaii | 4.15 | 696 |
| 38 | Idaho | 4.1 | 1,282 |
| 39 | Nevada | 3.8 | 1,769 |
| 40 | California | 3.73 | 21,757 |
| 41 | Florida | 3.7 | 10,371 |
| 42 | Tennessee | 3.25 | 3,159 |
| 43 | West Virginia | 3.22 | 746 |
| 44 | North Carolina | 2.97 | 4,509 |
| 45 | Utah | 2.42 | 1,629 |
| 46 | South Carolina | 2.33 | 1,783 |
| 47 | Louisiana | 2 | 1,367 |
| 48 | Arkansas | 1.92 | 912 |
| 49 | Alabama | 1.51 | 1,096 |
| New Mexico | * | * | |
| Iowa | * | * | |
| National | 6.63 | 317,641 |
Want more information about mental health?