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Home » Policy & Advocacy » The State of Mental Health in America » Ranking the States

Ranking the States

Ranking - Why We Ranked State Data on Mental Health

  • Using national survey data allows us to measure a community’s mental health needs, access to care, and outcomes regardless of the differences between the states and their varied mental health policies.
  • Rankings explore which states are more effective at addressing issues related to mental health and substance use.
  • Analysis may reveal similarities and differences among states in order to begin assessing how federal and state mental health policies result in more or less access to care.
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Overall Ranking

A high overall ranking indicates lower prevalence of mental illness and higher rates of access to care. A low overall ranking indicates higher prevalence of mental illness and lower rates of access to care. The combined scores of 13 measures make up the overall ranking. The overall ranking includes both adult and youth measures as well as prevalence and access to care measures.

The 13 measures that make up the overall ranking include:

  1. Adults with Any Mental Illness (AMI)
  2. Adults with Dependence or Abuse of Illicit Drugs or Alcohol
  3. Adults with Serious Thoughts of Suicide
  4. Adults with AMI who Did Not Receive Treatment
  5. Adults with AMI Reporting Unmet Need
  6. Adults with Disability who Could Not See a Doctor Due to Costs
  7. Youth with At Least One Past Year Major Depressive Episode (MDE)
  1. Youth with Dependence or Abuse of Illicit Drugs or Alcohol
  2. Youth with Severe MDE
  3. Youth with MDE who Did Not Receive Mental Health Services 
  4. Youth with Severe MDE who Received Some Consistent Treatment
  5. Students Identified with Emotional Disturbance for an Individualized Education Program
  6. Mental Health Workforce Availability

Because the most recent survey data comes from 2013, which is one year prior to implementation of the Affordable Care Act, the measures “Adults with AMI who are Uninsured” and “Children with Private Insurance that Did Not Cover Mental or Emotional Problems” were left out of calculations from the Overall Ranking.

States that rank in the top ten are in the Northeast and Midwest, while most states that rank in the bottom ten are in the South and the West.

Overall Ranking Compared to Other Positive Outcomes

Mental health, substance use, and suicidal thoughts are influenced by both biological and environmental factors. Environmental factors such as stress, poverty, homelessness, and exposure to interpersonal and community violence are linked to increased rates of mental health and substance use problems.

Top 10 states in the Overall Ranking also rank among the top 10 states in the following positive outcomes.

States with the lowest prevalence of mental illness and highest rates of access to care include:

  1. Minnesota
  2. Massachusetts
  3. Connecticut
  4. Vermont
  5. South Dakota
  1. New Jersey
  2. North Dakota
  3. Iowa
  4. Alaska
  5. New York

Overall Ranking Compared to Other Poor Outcomes

Mental health, substance use, and suicidal thoughts are influenced by both biological and environmental factors. Environmental factors such as stress, poverty, homelessness, and exposure to interpersonal and community violence are linked to increased rates of mental health and substance use problems.

Bottom 10 states in the Overall Ranking also rank among the bottom 10 states in the following poor outcomes. Among the bottom 10 states in the Overall Ranking, 8 states had correlations with poor outcomes – shown below.

States at the bottom 10 of the Overall Ranking with the highest prevalence of mental illness and lowest rates of access to care include:

  1. Virginia
  2. Louisiana
  3. Indiana
  4. Idaho
  5. Utah
  1. Washington
  2. Rhode Island
  3. Nevada
  4. Arizona
  5. Oregon

Adult Ranking

States with high rankings have lower prevalence of mental illness and higher rates of access to care for adults. Lower rankings indicate that adults have higher prevalence of mental illness and lower rates of access to care.

The 7 measures that make up the Adult Ranking include:

  1. Adults with Any Mental Illness (AMI)
  2. Adults with Dependence or Abuse of Illicit Drugs or Alcohol
  3. Adults with Serious Thoughts of Suicide
  4. Adults with AMI who Did Not Receive Treatment
  5. Adults with AMI Reporting Unmet Need
  6. Adults with AMI who are Uninsured
  7. Adults with Disability who Could Not See a Doctor Due to Costs.

Youth Ranking

States with high rankings have lower prevalence of mental illness and higher rates of access to care for youth. Lower rankings indicate that youth have higher prevalence of mental illness and lower rates of access to care.

The 7 measures that make up the Youth Ranking include:

  1. Youth with At Least One Past Year Major Depressive Episode (MDE)
  2. Youth with Dependence or Abuse of Illicit Drugs or Alcohol
  3. Youth with Severe MDE
  4. Youth with MDE who Did Not Receive Mental Health Services
  5. Youth with Severe MDE who Received Some Consistent Treatment
  6. Children with Private Insurance that Did Not Cover Mental or Emotional Problems
  7. Students Identified with Emotional Disturbance for an Individualized Education Program.

Prevalence of Mental Illness Ranking

The Prevalence Ranking indicates how many people in the US have a mental heatlh or substance use problem.

The 6 measures that make up the Prevalence Ranking include:

  1. Adults with Any Mental Illness (AMI)
  2. Adults with Dependence or Abuse of Illicit Drugs or Alcohol
  3. Adults with Serious Thoughts of Suicide
  4. Youth with At Least One Past Year Major Depressive Episode (MDE)
  5. Youth with Dependence or Abuse of Illicit Drugs or Alcohol
  6. Youth with Severe MDE.

A high ranking on the Prevalence Ranking indicates a lower prevalence of mental health and substance use issues. States that rank 1-10 have lower rates of mental health and substance use problems compared to states that ranked 42-51.

Prevalence Ranking Compared to Other Positive Outcomes

Top 10 states in the Prevalence Ranking also rank among the top 10 states in the following positive outcomes. Among the top 10 states in the Prevalence Ranking, 9 states had correlations with positive outcomes – shown below.

Prevalence Ranking Compared to Other Poor Outcomes

Bottom 10 states in the Prevalence Ranking also rank among the bottom 10 states in the following poor outcomes. Among the bottom 10 states in the Prevalence Ranking, 6 states had correlations with poor outcomes – shown below.

Access to Care Ranking

The Access Ranking indicates how much access to mental health care exists within a state. The access measures include access to insurance, access to treatment, quality and cost of insurance, access to special education, and workforce availability. A high Access Ranking indicates that a state provides relatively more access to insurance and mental health treatment.

The 9 measures that make up the Access Ranking include:

  1. Adults with AMI who Did Not Receive Treatment
  2. Adults with AMI Reporting Unmet Need
  3. Adults with AMI who are Uninsured
  4. Adults with Disability who Could Not See a Doctor Due to Costs
  5. Youth with MDE who Did Not Receive Mental Health Services
  6. Youth with Severe MDE who Received Some Consistent Treatment
  7. Children with Private Insurance that Did Not Cover Mental or Emotional Problems
  8. Students Identified with Emotional Disturbance for an Individualized Education Program
  9. Mental Health Workforce Availability

In Georgia or Florida, despite having lower percentages of individuals who need mental health services, those who have problems are likely to face more difficulty obtaining treatment as compared to other states.

The opposite is true for states like Maine or Vermont, where there are more individuals with mental health and substance use issues and higher rates of access to care.

Among states that rank the poorest, like Arizona, Idaho and Montana, there are comparatively more individuals needing mental health and substance use care, yet lower rates of access to mental health care.

Access to Care Ranking Compared to Other Positive Outcomes

States that invest in care for individuals with mental illness are likely to provide better services overall. Due to their investment for those in need, the states in the top 10 in the Access to Care Ranking have comparatively stronger communities.

Top 10 states in the Access to Care Ranking also rank among the top 10 states in the following positive outcomes.

Access to Care Ranking Compared to Other Poor Outcomes

States that invest in care for individuals with mental illness are likely to provide better services overall. Due to their investment for those in need, the states in the bottom 10 in the Access to Care Ranking have communities that struggle more compared to those states that rank in the top 10.

Bottom 10 states in the Access to Care Ranking also rank among the bottom 10 states in the following poor outcomes.

Mental Health in America 2016 Links

The State of Mental Health in America - Home

Ranking Guidelines

Ranking the States -Results of Overall, Adult, Youth, Prevalence, and Access to Care Rankings

Adult Data - Adult Prevalence and Access Data

Youth Data - Youth Prevalence and Access Data

Prevalence Data - How many adults and youth have a mental health or substance use problem in America?

Access to Care Data - How many adults and youth have access to insurance and mental health treatment in America?

Prevention and Early Intervention in Mental Health - Issue Spotlight

Glossary and Citations - For Indicators & Positive and Poor Outcomes

Print Version of The State of Mental Health in America

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