Report Finds Large Variations in Access to Care, Prevalence of Mental Illness in US

doc with chartA new report from the mental health advocacy organization Mental Health America has found that several states in the Northeast lead the country in access to mental health care and boast the lowest rates of mental illness for both adults and children.

A number of Southern and Southwestern states rank among the lowest in access to mental health care and highest in incidence of mental illness.

The report, “Parity or Disparity: The State of Mental Health in America 2015” is the group’s first large-scale report on mental health status in the US, and was created as a starting point for measuring response to, and success of, the Affordable Care Act in terms of people with mental illness.

Each US state and the District of Columbia was ranked on 15 measures related to mental health, including overall rates of mental illness, suicidality, and substance abuse; and access/utilization of insurance and mental health treatment.

The states with the highest level of access to care and the lowest prevalence of mental illness (called the “overall” ranking in the report) include:

  1. Massachusetts
  2. Vermont
  3. Maine
  4. North Dakota
  5. Delaware

Coming in last in the “overall” ranking was Arizona, which was found to have the highest incidence of mental illness and lowest access to care. The bottom five states include:

  1. Arizona
  2. Mississippi
  3. Nevada
  4. Washington
  5. Louisiana

Data used in the analysis were gathered from a number of national surveys, including SAMHSA’s National Survey of Drug Use and Health (NSDUH) and the National Survey of Children’s Health (NSCH).

MHA’s initial goal in gathering the data was to see if and how the ACA would affect access to mental health care. Long-term, they hope to use that information to determine if getting insurance will actually lead to  increased utilization of mental health services and ultimately better outcomes.

The report’s authors point out that there are many unmet mental health needs in every state in the US, including those that rank high in certain measures. “A higher ranking does not necessarily indicate that a state is ‘doing well’ in an objective sense,” the report states. “Rather a high ranking only means that the particular state is doing better on that measure than those states that rank lower.”

 Vermont Ranks #1 for Youth

The numbers changed a bit when data were analyzed only for factors related to youth. Vermont is the highest ranked state for access to care and lowest rates of mental illness for youth. It is closely followed by North Dakota, Wisconsin, Iowa, and Maine.

The measures analyzed for children in each state included:

  • Dependence or abuse of drugs or alcohol
  • Emotional behavioral developmental issues in children with both adequate and inadequate medical insurance
  • Students with severe emotional problems, according to IEPs
  • At least one major depressive episode
  • Children who needed, but did not get, mental health services

 Large Variation in Rates of Mental Illness, Substance Abuse across States

Four US states make the grade by being in the top 25% for all three groupings: adults, children, and the combined “overall” ranking. They include Massachusetts, Maine, North Dakota, and Minnesota. Five states are in the bottom quarter for all three rankings: Oklahoma, New Mexico, Washington, Mississippi, and Arizona.

Many of the data from the report showed large variations between states. This led the writers to highlight the need for more research in nearly all areas.

For example, data showed that nine out of 10 states with the lowest rates of dependence/abuse of drugs and alcohol are located in the South. In fact, the District of Columbia has more than twice the percentage of residents (13.8%) reportedly dependent on alcohol or drugs than Alabama (6.6%). The South had the lowest reported rates of suicidal thoughts, as well.

The full report, “Parity or Disparity: The State of Mental Health in America 2015,” can be read here.

Image courtesy of pakorn at

Report Finds Large Variations in Access to Care, Prevalence of Mental Illness in US

Amy Harding

Amy Harding is an editor at Psych Central Pro. She has worked as a writer and editor in the healthcare field for more than 10 years, in roles as diverse as writing marketing copy for a large hospital system to serving as executive editor at a psychiatry CME publisher. Her career has focused primarily on creating accessible, timely, and reader-friendly professional education for those in the mental and behavioral health fields. You can reach her at [email protected]


APA Reference
Harding, A. (2014). Report Finds Large Variations in Access to Care, Prevalence of Mental Illness in US. Psych Central. Retrieved on September 18, 2020, from


Scientifically Reviewed
Last updated: 19 Dec 2014
Last reviewed: By John M. Grohol, Psy.D. on 19 Dec 2014
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