The State of Mental Health in America

Mental Health America is committed to promoting mental health as a critical part of overall wellness. We advocate for prevention services for all, early identification and intervention for those at risk, integrated services, care and treatment for those who need it, and recovery as the goal. 

We believe that gathering and providing up-to-date data and information about disparities faced by individuals with mental health problems is a tool for change.

Mental Health in America 2016 Links

• Ranking Overview
• Key Findings
• Ranking Guidelines
• Ranking the States - Results of Overall, Adult, Youth, Prevlance, and Access to Care Rankings
• Adult Data - Adult Prevlance 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

The State of Mental Health in America

In the above links you will find a Collection of Data across all 50 states and the District of Columbia answering the following questions:

• How many adults and youth have mental health issues?
• How many adults and youth have substance use issues?
• How many adults and youth have access to insurance?
• How many adults and youth have access to adequate insurance?
• How many adults and youth have access to mental health care?
• Which states have higher barriers to accessing mental health care?

Our Goal:

• To provide a snapshot of mental health status among youth and adults for policy and program planning, analysis, and evaluation.
• To track changes in prevalence of mental health issues and access to mental health care.
• To understand how changes in national data reflect the impact of legislation like the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA).
• To increase dialogue and improve outcomes for individuals and families with mental health needs

Why Gather this Information?

• 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.

Key Findings

• Southern states have the lowest prevalence of addiction – around 7.5 percent.  States in the Mountain West region have the highest prevalence of addiction – around 10.0 percent.
• More youth are becoming depressed.  There was a 1.2 percent increase in youth with depression, and a 1.3 percent increase in youth with severe depression between 2010 and 2013.  States with the highest rates of depression have twice as many severely depressed youth compared to states with the lowest rates.
• Nationally, 57 percent of adults with mental illness receive no treatment, and in some states (Nevada and Hawaii), that number increases to 70 percent. Despite low utilization of treatment, individuals in Hawaii are the least likely to say that have unmet treatment needs, with  only 12 percent of adults in Hawaii reporting that they do not receive the treatment they need. This leads to the question of whether it is possible that individuals in Hawaii are trying to manage their mental health problems on their own, or perhaps the stigma surrounding mental illness is preventing individuals from acknowledging the need for help.
• In 2012-2013, 18 percent (1 in 5) of adults with a mental illness were uninsured. Individuals living in states with the highest percentage of uninsured adults with mental illness are 3 times more likely to be uninsured compared to those who live in the states with highest rates of insurance access. Individuals with mental illness living in Nevada (33.40 percent) are 10 times more likely to be uninsured compared to individuals in Massachusetts (3.30 percent).
• Cost is a barrier to treatment – 1 in 5 adults with a disability report difficulty getting care due to costs.
• 64 percent of youth with depression do not receive any treatment.  Even among those with severe depression, 63 percent do not receive any outpatient services.  Only 22 percent of youth with severe depression receive any kind of consistent outpatient treatment (7-25+ visits in a year).
• Youth with severe depression in Nevada (9.40 percent) are 4 times less likely to get consistent outpatient treatment compared to youth in South Dakota (39.50 percent).    
• Children with the least access to mental health insurance coverage are 3.5 times less likely to have coverage compared to those that live in states with the most coverage. In Hawaii (20 percent), children are 10 times more likely to be uninsured compared to children in Connecticut (2 percent).
• States in the Northeast are 5 times more likely to identify youth with Emotional Disturbance as compared to the rest of the nation. Youth who have a mental health problem are more likely to get better school-based supports in the Northeast.
• 250:1 vs 1,100:1 - In states with the greatest number of available mental health providers (Massachusetts, Maine, and Vermont), there are approximately 250 individuals for every one mental health provider. In states with the lowest number of available mental health providers (West Virginia, Texas, and Alabama), there are approximately 1,100 individuals for every one provider – that is more than 4 times less access to treatment providers in lower ranking states.

Overall Ranking

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.

Overall Ranking Compared to Other Poor Outcomes

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.

All heat maps, online and in this printed chart book, were created by HealthGrove.  HealthGrove’s mission is to simplify the process of sharing the world's knowledge by transforming complicated data sets into vivid and contextually-rich visualizations.  With dedicated teams of researchers and data scientists, their industry leading data visuals are based on the world's deepest and most interconnected knowledge graph, creating a web of data points and contextual information.  Learn more at https://www.graphiq.com/industry-health.

This publication was made possible by the generous support of our individual supporters, Eli Lilly and Company, and Otsuka America Pharmaceuticals Inc.