A new report ranks US states on rates of mental well-being and mental health care, with New York, Hawaii, and New Jersey outperforming the rest — in that order.
The **2025 State of Mental Health in America** report evaluates how all 50 states and Washington, DC, fared on 17 measures of mental health in 2022 and 2023, according to Mental Health America (MHA), which published the report on Wednesday. The nonprofit promotes mental health and illness prevention through education, research, and advocacy.
### Key Metrics and Findings
The 17 factors primarily concern adults and youth who experienced mental illness, suicidal thoughts, or substance use disorder in the past year. They also examine:
– 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
– 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. MHA noted this “underscores a high need for strategic investment in mental health in these states.”
“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,” said Mary Giliberti, interim president and CEO of MHA, during 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.”
### Persistent Mental Health Crisis
“The message from this year’s report is clear: We continue to face a persistent mental health crisis in this country,” Giliberti added.
According to the report:
– About 23% of adults in the United States experienced mental health challenges in 2024.
– In 2022 and 2023, 25% of adults with mental illness reported an unmet need for mental health treatment.
– Approximately 77% of adults with substance use disorder didn’t receive help.
– Around 9% of adults with mental illness were uninsured.
Moreover, there aren’t enough mental health professionals to meet the demand. For every mental health provider in the US, there are 320 people, said Maddy Reinert, lead author of the report and senior director of population health at MHA.
### Youth Mental Health Trends
While rates of depressive episodes and suicidal thoughts among kids ages 12 to 17 have improved, nearly 3 million youth still reported 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 — a missed opportunity for early 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.
### Regional Disparities in Access
The report also uncovered regional disparities. People in the South or states with larger rural populations still face inadequate access to care.
– Roughly 20% of adults in Tennessee, Mississippi, and Texas were uninsured, compared with just 4% in Vermont and Maryland.
– 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.
MHA collected 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.
### Calls for Policy Action
“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),” said Dr. Marketa M. Wills, CEO and medical director of the American Psychiatric Association, via email.
“Across states, there should not be ‘haves’ and ‘have nots’ in terms of who gets to receive the care they need,” Wills 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, skepticism about the effectiveness of policy changes has been a barrier to improving mental health access, Giliberti said. This report challenges that notion.
For example, in 2018, Maine and Virginia ranked 39th and 40th for adults with any mental illness who were uninsured. After both states expanded Medicaid in 2019, their rankings improved dramatically. In this report, Maine climbed to 10th place, and Virginia moved up to 23rd place.
“This is not a coincidence. It is a success story for mental health policy,” Giliberti explained.
However, this progress comes amidst concerns that President Donald Trump’s “One Big Beautiful Bill Act,” signed into law in July, may cut federal Medicaid spending by roughly $800 billion over 10 years.
### Spotlight on Leading States
Regarding New York topping the list, a spokesperson for Governor Kathy Hochul highlighted the state’s ongoing commitment:
“Since taking office, Governor 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.”
The spokesperson added that the state has taken bold measures, including increasing inpatient capacity, expanding outpatient programs, creating thousands of new units of specialized housing, and improving youth mental health through legislative initiatives targeting social media impacts and smartphone use in K-12 public schools.
Hawaii, the second-highest ranked state, attributes its positive ratings to the community’s collective efforts to expand access to care and support resilience among adults and youth. However, the State of Hawai’i Department of Health acknowledged that youth access to services remains an area needing improvement.
### Challenges for Lower-Ranking States
Nevada’s low ranking stems partly from the highest rates of youth depression and the largest share of youth who did not receive preventive care in the past year — indicating a significant service gap for young people.
The Nevada Health Authority said, “Addressing the state’s mental health crisis remains a top priority for Governor Joe Lombardo and policymakers in Nevada.”
The state is taking a comprehensive approach to improve mental health by:
– Strengthening crisis response systems
– Expanding the behavioral health workforce through loan repayment incentives and telehealth in rural areas
– Reforming forensic mental health systems with new treatment facilities
– Improving access to children’s behavioral health services with expanded community care and higher Medicaid reimbursements
The department added that Nevada invests more than $100 million annually to grow the provider network through expanded Medicaid coverage of services.
Maddy Reinert noted that low-ranking states could also benefit from increased investment in public health services that promote whole-person health and prevention — approaches that can be implemented in primary care, schools, and community settings.
### Responses from Other States
CNN contacted New Jersey’s human services department (the third-highest ranked state) for comment but did not receive a response. The departments for Arizona and Alabama, the second- and third-lowest ranked states, respectively, were unavailable for comment before publication.
### What You Can Do
While the MHA report focuses on policy, individuals can also advocate for better mental health resources.
“Every person has the power to tell public health officials and state legislators what is happening in your state and what changes you want to see,” Reinert encouraged.
For those struggling with mental health issues, Mental Health America offers free mental health screenings on their website, providing access to support and resources.
If you or someone you know needs help with substance use disorders, visit the US Substance Abuse and Mental Health Administration’s treatment locator. To find psychologists near you, use the American Psychological Association’s locator tool.
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Together, raising awareness and advocating for change can help ensure that all Americans receive the mental health care they deserve.
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