10 US States that need to improve mental health care

(excerpt from The Worst States For Mental Health Care, Ranked)

Over 50 million Americans have a mental illness, but more than half (55%) of adults with a mental illness don’t receive treatment. In some states, accessing mental health care may be more challenging because of high costs, too few mental health treatment centers and lack of health insurance coverage.

To determine which states are worst for mental health care, Forbes Advisor compared all 50 states and Washington, D.C., across seven key metrics.

Key Takeaways

Texas tops the list of worst states for mental health care, while Vermont is the best state for mental health care.
Seven of the 10 worst states for mental health care are located in the South, including Texas, Mississippi, Alabama, Georgia, Florida, South Carolina, and Tennessee.

10 Worst States for Mental Health Care

1. Texas

Texas’s score: 100 out of 100

With the highest percentage of adults with any mental illness who are uninsured (21.5%), Texas is the worst state for mental health care.
Texas is home to the highest percentage of adults with a cognitive disability who could not see a doctor due to cost (40.65%), and the highest percentage of youth who had a major depressive episode in the past year and did not receive treatment (73.1%).
Texas has the fourth-highest percentage of children with private health insurance that does not cover mental or emotional problems (13.8%).
Texas has the fifth lowest number of mental health treatment centers in the nation (only 41.92 per 10,000 businesses).

2. Mississippi

Mississippi’s score: 88.96 out of 100

Mississippi is the second worst state in the nation for two of the metrics we considered: The number of mental health treatment centers (36.33 per 10,000 businesses) and the percentage of youth who had a major depressive episode in the past year and did not receive treatment (71.7%).
The state is also home to the fourth-highest percentage of adults with any mental illness who are uninsured (18.2%).

3. Alabama

Alabama’s score: 86.50 out of 100

Alabama has the second-highest percentage of adults with a mental illness who are uninsured (19.3%, tied with Missouri).
Alabama has the third lowest number of mental health treatment centers nationwide (38.33 per 10,000 businesses).
More than one-third (38.35%) of Alabama adults with a cognitive disability could not see a doctor in the past 12 months due to cost, the fourth highest percentage in the country.
Alabama has the sixth-highest percentage of children with private health insurance that does not cover mental or emotional problems (12.5%).

4. Georgia

Georgia’s score: 86.02 out of 100

Georgia tied with Florida for having the second-highest percentage of adults with a mental illness who did not receive mental health treatment in the past year (63.5%).
The state has the second-highest percentage of adults with a cognitive disability who could not see a doctor in the past 12 months due to cost (39.18%).
Georgia has the fifth-highest percentage of youth who had a major depressive episode in the past year and did not receive mental health treatment (67.8%).

5. Florida

Florida’s score: 81.48 out of 100

Florida tied with Georgia for having the second-highest percentage of adults with a mental illness who didn’t receive treatment in the past year (63.5%).
More than one-third (34.9%) of Florida adults with a cognitive disability could not see a doctor in the past 12 months due to cost, the fifth highest in the nation.
Florida is home to the sixth-highest percentage of adults with a mental illness who are uninsured (17.8%).

6. South Carolina

South Carolina’s score: 79.11 out of 100

South Carolina has the lowest number of mental health treatment centers compared to all other states (only 30.87 per 10,000 businesses).
South Carolina is home to the sixth-highest percentage of youth who had a major depressive episode in the past year who didn’t receive mental health services (67.6%).
The state had the seventh-highest percentage of children with private health insurance that does not cover mental or emotional problems (12.4%).

7. Arizona

Arizona’s score: 72.75 out of 100

Arizona performed poorly in two of our metrics that assessed access to mental health treatment for youth.
The state has the fourth-highest percentage of youth who had a major depressive episode in the past year who didn’t receive mental health treatment (70.1%).
Arizona also had the 10th highest percentage of children with private health insurance that doesn’t cover mental or emotional problems (10.2%).

8. Wyoming

Wyoming’s score: 71.58 out of 100

Wyoming is fifth worst in the nation for three of the metrics that we considered: Percentage of adults with any mental illness who did not receive mental health treatment in the past year (61.7%), percentage of adults with any mental illness who are uninsured (18%) and percentage of children with private health insurance that doesn’t cover mental or emotional problems (12.7%).
Wyoming is home to the eighth-highest percentage of adults with a cognitive disability who could not see a doctor in the past 12 months due to cost (32.94%).

9. Tennessee

Tennessee’s score: 68.06 out of 100

Tennessee has the eighth lowest rate of mental health treatment centers nationwide (50.6 per 10,000 businesses).
Tennessee ranks 10th worst in two of the metrics that we considered: The percentage of adults with any mental illness who are uninsured (15.3%) and the percentage of youth who had a major depressive episode in the past year and did not receive mental health treatment (66.5%).

10. Idaho

Idaho’s score: 67.29 out of 100

Idaho ranks eighth worst in the nation for two of our metrics that evaluated access to mental health treatment for youth: Percentage of youth who had a major depressive episode in the past year who didn’t receive mental health treatment (67.1%) and percentage of children with private health insurance that doesn’t cover mental or emotional problems (12.2%).

Of the 10 worst states for mental health care, two are also among the most expensive states for health insurance. Florida and Wyoming are in the top five list of the most expensive states for health insurance, based on Forbes Advisor’s analysis of health insurance costs by state.

Data for both metrics comes from the Substance Abuse and Mental Health Services Administration (2021). State population data comes from the U.S. Census Bureau (2022).