Best and worst states for mental health prevalence and healthcare access

By Jules Murtha | Fact-checked by Barbara Bekiesz
Published September 2, 2022

Key Takeaways

  • Of American adults, two in five report experiencing symptoms associated with depression and anxiety. Additionally, more than half of American parents have concerns about their children’s mental health, according to the White House.

  • The five states which offer the greatest access to mental healthcare are Vermont, Massachusetts, Maine, Wisconsin, and Minnesota. Those with the least access are Texas, Alabama, Florida, Georgia, and Mississippi, as reported by Mental Health America.

  • Research suggests that affordability is the greatest barrier preventing Americans from accessing quality mental healthcare.

In May 2022, the White House published a statement about the “national mental health crisis” facing Americans.[] With more than 50% of American parents concerned for their children’s mental well-being, and 40% of adults experiencing symptoms of mental illness themselves, President Biden called for a comprehensive national strategy to tackle the crisis.

The prevalence of mental health problems and access to appropriate care differ depending on the state.

Doctors can familiarize themselves with the latest mental health state rankings, as well as the most common roadblocks that patients encounter when trying to access care.

Mental illness prevalence by state

Mental Health America (MHA) recently published 2022 data that rank each state based on mental illness prevalence among adults.[] There are seven measures that MHA used to guide the rankings, which included any mental illness, substance use disorder, thoughts of suicide, whether treatment was given, and insurance/affordability issues.

According to the 2022 adult rankings, the top five states with the lowest mental illness prevalence and highest access to care are New Jersey, Wisconsin, Massachusetts, Connecticut, and New York. Immediately following are Minnesota, Hawaii, Pennsylvania, Maryland, and Illinois.

Conversely, the states with the overall highest mental illness prevalence and lowest access to care are Colorado, Wyoming, Oregon, Utah, and Alabama. Alaska, District of Columbia, Missouri, Indiana, and Kansas trail right behind.

For youths, the states were ranked using criteria appropriate to that age group. Pennsylvania, Maine, and the District of Columbia are the states with the lowest prevalence of mental illness in the younger population. The highest include Nevada, Idaho, and Arizona.

Now that the where is established, let’s look at how easily (or not) people in each state access proper mental healthcare.

Which states have the greatest access to healthcare?

The White House statement declared that one of the Biden-Harris Administration’s goals is to connect more Americans to care.

But access, much like prevalence, is relative to the state in which one lives.

According to MHA data, Vermont, Massachusetts, Maine, Wisconsin, and Minnesota generally provide more access to insurance and mental healthcare.

Texas, Alabama, Florida, Georgia, and Mississippi fall on the other side of that spectrum, providing the least access.

These state rankings are not cast in stone, however. HealthCareInsider conducted its own research and came up with slightly different rankings.[] Using their own methodology and a point system (highest score = 33.3 points), they found that Vermont, Minnesota, and Colorado took the cake when it came to providing access to healthcare, earning access scores between 26.38 and 30.28. South Carolina, Mississippi, and Texas provided the least access, scoring between 4.03 and 8.39.

Ainsely Burke, PhD, Assistant Professor of Clinical Psychology at Columbia, noted the political trends associated with states’ differing access to healthcare in the HealthCareInsider.com article, stating, “More liberal states are doing a better job with mental healthcare than conservative states.”

"Mental health is more openly discussed in open-minded communities with less judgment."

Ainsely Burke, PhD

"Conservative laws and mandates, for example banning discussion of certain topics like sexual identity in schools, discourage people from talking about issues and seeking treatment," Dr. Burke added.

The economic barrier

There are other barriers to mental healthcare—namely, issues concerning affordability.

Affordability was the most prevalent reported barrier according to a study published in SSM - Population Health.[] For their study on barriers to healthcare access among US adults with and without mental health challenges, researchers used data from the 2017–2018 National Health Interview Survey.

This is a yearly survey given to 35,000 US households. It includes a detailed interview with one adult from each household, chosen randomly, which inquires about mental health status and healthcare access.

The investigators focused on three dimensions of access—approachability, availability, and affordability—and related barriers, such as not getting an appointment soon enough, waiting too long in the doctor’s office, and being worried about the cost of normal medical care and that for an illness or accident. They analyzed data from 50,103 adults.

Although the results clearly put affordability at the top of the access barrier list, the authors acknowledged that other social and environmental factors may play a role in who has access.

Further research is necessary to gain a clearer understanding of these mechanisms, which will hopefully provide you with the information you need to better treat your patients.

What this means for you

Americans are facing a national mental health crisis, and where patients live may determine their level of access to quality mental healthcare. States with the lowest rates of mental illness include New Jersey, Wisconsin, Massachusetts, Connecticut, and New York. The highest rates are found in Alabama, Utah, Oregon, Wyoming, and Colorado. The best access to mental healthcare occurs in Vermont, Massachusetts, Maine, Wisconsin, and Minnesota. Texas, Alabama, Florida, Georgia, and Mississippi rank the lowest. Affordability still remains the primary barrier facing patients who are seeking mental healthcare.

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