Nevada, Arizona and Alabama rank lowest in nation for mental health. Where your state lands
By Kristen Rogers, CNN
(CNN) — A new report ranks US states on rates of mental well-being and mental health care, and New York, Hawaii and New Jersey have outperformed the rest — in that order.
The 2025 State of Mental Health in America report sizes up how all 50 states and Washington, DC, fared on 17 measures of mental health in 2022 and 2023, according to Mental Health America, which published the report on Wednesday. The nonprofit promotes mental health and illness prevention through education, research and advocacy.
The 17 factors mainly concern adults and youth who experienced mental illness, suicidal thoughts or substance use disorder in the past year; adults and youth who didn’t receive necessary treatment, couldn’t afford it or were uninsured; people with insurance that didn’t cover mental or emotional problems; and the availability of mental health providers.
Nevada had the worst rating, followed by Arizona and Alabama — marking the second time Nevada and Arizona have ranked the lowest, “underscoring a high need for strategic investment in mental health in these states,” MHA said in a news release.
“We must also remember — and we really take this to heart at Mental Health America — that behind every data point here is a real person who deserves access to timely, quality, affordable mental health care,” Mary Giliberti, interim president and CEO of MHA, said in a Monday news briefing. “These are not just statistics. They are stories. And through sharing the data, we hope not only to raise awareness of these mental health topics and needs, but to turn that awareness into action.”
“The message from this year’s report is clear: We continue to face a persistent mental health crisis in this country,” Giliberti said.
About 23% of adults in the United States experienced mental health challenges in 2024, according to the report. In 2022 and 2023, 25% of adults with mental illness reported an unmet need for mental health treatment, about 77% of adults with substance use disorder didn’t receive help and around 9% of adults with mental illness were uninsured.
And there aren’t enough mental health professionals to serve the need. For every provider in the United States, there are 320 people, said Maddy Reinert, lead author of the report and senior director of population health at MHA, speaking in the news briefing.
The rates of depressive episodes and suicidal thoughts among kids ages 12 to 17 have improved, but nearly 3 million youth still said they had serious suicidal thoughts in 2024, the report found. Additionally, about 28% of youth didn’t have a preventive health care appointment in 2022 or 2023, representing a missed opportunity for screening and prevention.
“The data continue to show that the overall need for mental health care remains high, while access still falls short for too many,” Reinert said.
The report also discovered regional disparities, with people in the South or states with greater rural populations still facing inadequate access to care. Roughly 20% of adults in Tennessee, Mississippi and Texas were uninsured, compared with 4% in Vermont and Maryland. And around 40% of adults in Wisconsin, Utah and Wyoming reported not receiving the care they needed, compared with 13% in Maine and 16% in Arkansas.
The organization collected its data from several sources, including the US Substance Abuse and Mental Health Services Administration, the US Centers for Disease Control and Prevention, and the University of Wisconsin Population Health Institute.
“It’s unacceptable that access to mental health care is still a problem, more than 15 years after the passage of the (Mental Health Parity and Addiction Equity Act),” Dr. Marketa M. Wills, CEO and medical director of the American Psychiatric Association, said via email.
“Across states there should not be ‘haves’ and ‘have nots’ in terms of who gets to receive the care they need,” Wills, who wasn’t involved in the report, added. “We call upon policymakers at the state and federal levels to use the solutions that we know work, like telehealth and integrated care, to expand access and connect more people who need it with lifesaving treatments.”
The impact of supportive state policies
Over the years, a barrier to “improving mental health has been skepticism that policy changes would even help,” Giliberti said. This report challenges that mindset.
In 2018, “Maine and Virginia ranked 39th and 40th for adults with any mental illness who were uninsured,” Giliberti explained. “But after both states expanded Medicaid in 2019, their rankings have improved dramatically. In this report … Maine has climbed to 10th place. Virginia is now in 23rd, and it’s not a coincidence. It is a success story for mental health policy.”
That news comes as President Donald Trump’s “One Big Beautiful Bill Act” for domestic policy, which he signed into law in July, may cut federal Medicaid spending by roughly $800 billion over 10 years.
Regarding New York coming out on top, “since taking office, Governor Kathy Hochul has made mental health a top priority of her administration and has followed through with an unprecedented level of investment, securing nearly $2 billion to strengthen New York’s continuum of care,” a spokesperson for the governor said via email. “From adding inpatient capacity to dramatically expanding outpatient programs to creating thousands of new units of specialized housing and more, the state has taken bold measures to ensure all New Yorkers have access to these critical services.”
The spokesperson also noted Hochul’s efforts to improve youth mental health, including “legislative initiatives to address the harmful impacts of social media and to eliminate the use of smartphones by students in K-12 public schools.”
The positive ratings for Hawaii, the second-highest ranked state, “reflect our community’s collective efforts to expand access to care and support resilience for both adults and youth,” the State of Hawai’i Department of Health said via email.
“At the same time, the report highlights areas where we must continue to improve, particularly youth access to services,” the department said. “We remain committed to advancing mental health for all Hawai’i residents.”
Two factors that drove Nevada’s ranking down to last place were the highest rates of youth depression and youth who didn’t receive preventive care in the past year, suggesting a significant lack of services for that group, Reinert said.
“Addressing the state’s mental health crisis remains a top priority for Governor (Joe) Lombardo and policymakers in Nevada,” the Nevada Health Authority said via email. “The state is taking a comprehensive approach to tackling the state’s long-standing mental and behavioral health challenges by strengthening our crisis response system, expanding the behavioral health workforce through loan repayment incentives and telehealth in rural areas, reforming the forensic mental health system with new treatment facilities, and improving access to children’s behavioral health services through expanded community care and higher Medicaid reimbursements.”
“This includes investing more than $100 million annually to grow the provider network through expanded Medicaid coverage of services,” the department added.
Low-ranking states may also benefit from greater investment in public health services — promoting whole-person health and prevention of mental health conditions — that can be implemented in primary care offices, schools and other community settings, Reinert said.
CNN has contacted for comment the human services department for New Jersey, the third-highest ranked state, but did not get a response. The relevant government departments for Arizona, the second-lowest rated state, and Alabama, the third-lowest scored state, could not comment in time for publication.
What you can do
The MHA report is policy-focused, but all individuals can be advocates for mental health, Reinert said.
“Every person has the power to be able to tell not only your public health officials, but also your state legislators, what is happening in your state and what you would like to see change,” she added.
For anyone struggling with their own mental health, “we would also encourage you to take a mental health screen on Mental Health America’s website to see where your mental health is landing, access support and take care of yourself and the people around you as best that you can,” Reinert said.
For help with substance use issues, search the US Substance Abuse and Mental Health Administration’s treatment locator. Find psychologists near you via the American Psychological Association’s locator.
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