The Access Ranking indicates how much access to mental health care exists within a state. The access measures include access to insurance, access to treatment, quality and cost of insurance, access to special education, and workforce availability. A high Access Ranking (1-13) indicates that a state provides relatively more access to insurance and mental health treatment.
The 9 measures that make up the Access Ranking include:
- Adults with AMI who Did Not Receive Treatment
- Adults with AMI Reporting Unmet Need
- Adults with AMI who are Uninsured
- Adults with Cognitive Disability who Could Not See a Doctor Due to Costs
- Youth with MDE who Did Not Receive Mental Health Services
- Youth with Severe MDE who Received Some Consistent Treatment
- Children with Private Insurance that Did Not Cover Mental or Emotional Problems
- Students Identified with Emotional Disturbance for an Individualized Education Program
- Mental Health Workforce Availability
Rank Sort descending | State |
---|---|
01 | Vermont |
02 | Massachusetts |
03 | Maine |
04 | District of Columbia |
05 | Delaware |
06 | Minnesota |
07 | Wisconsin |
08 | Rhode Island |
09 | Ohio |
10 | New Hampshire |
11 | Maryland |
12 | Pennsylvania |
13 | Connecticut |
14 | Hawaii |
15 | Iowa |
16 | Washington |
17 | Michigan |
18 | Kentucky |
19 | Montana |
20 | New York |
21 | Oregon |
22 | South Dakota |
23 | New Jersey |
24 | North Dakota |
25 | New Mexico |
26 | Indiana |
27 | Louisiana |
28 | Illinois |
29 | Nebraska |
30 | West Virginia |
31 | Colorado |
32 | Utah |
33 | Oklahoma |
34 | California |
35 | Idaho |
36 | Kansas |
37 | Alaska |
38 | Wyoming |
39 | Virginia |
40 | Arizona |
41 | Missouri |
42 | Arkansas |
43 | Tennessee |
44 | North Carolina |
45 | South Carolina |
46 | Nevada |
47 | Alabama |
48 | Florida |
49 | Mississippi |
50 | Texas |
51 | Georgia |
10.8% (over 5.1 million) of adults with a mental illness remain uninsured.
The rankings for this indicator used data from the 2017-2018 NSDUH. In December 2017, Congress passed the Tax Cuts and Jobs Act, which eliminated the individual mandate penalty from the ACA.
There was a 0.5% increase from last year's dataset, the first time this indicator has increased since the passage of the ACA.
The increase in this indicator is consistent with data from the U.S. Census Bureau, which found that in 2018, the rate of uninsured Americans rose for the first time since the ACA took effect.
Only twenty states saw a reduction in Adults with AMI who are uninsured in this year's dataset. The largest reductions were seen in Louisiana (5.0%), South Dakota (3.3%), Kentucky (2.4%) and Kansas (2.2%). The largest increases were seen in Iowa (5.1%), Mississippi (3.9%), Arkansas (3.7%) and Missouri (3.2%).
The state prevalence of uninsured adults with mental illness ranges from 2.5% in the District of Columbia to 23.0% in Wyoming.
Rank Sort descending | State | Percentage | Number |
---|---|---|---|
01 | District of Columbia | 2.5 | 3000 |
02 | Vermont | 3.9 | 4000 |
03 | Massachusetts | 4.2 | 51000 |
04 | Connecticut | 4.6 | 25000 |
05 | Kentucky | 4.8 | 37000 |
06 | New York | 5.1 | 139000 |
07 | Rhode Island | 5.8 | 11000 |
08 | Pennsylvania | 6 | 108000 |
09 | Michigan | 6.4 | 93000 |
10 | New Mexico | 6.4 | 19000 |
11 | Hawaii | 6.4 | 12000 |
12 | Delaware | 6.8 | 10000 |
13 | Maryland | 7 | 55000 |
14 | Ohio | 7.1 | 138000 |
15 | Minnesota | 7.3 | 58000 |
16 | Wisconsin | 7.4 | 62000 |
17 | New Hampshire | 7.5 | 17000 |
18 | California | 7.8 | 434000 |
19 | South Dakota | 8.2 | 9000 |
20 | West Virginia | 8.3 | 31000 |
21 | Iowa | 8.4 | 39000 |
22 | New Jersey | 8.8 | 94000 |
23 | North Dakota | 8.8 | 9000 |
24 | Illinois | 8.9 | 151000 |
25 | Colorado | 9 | 84000 |
26 | Oregon | 9 | 67000 |
27 | Arizona | 9.6 | 97000 |
28 | Louisiana | 9.7 | 72000 |
29 | Nebraska | 10.3 | 25000 |
30 | Montana | 10.3 | 17000 |
31 | Nevada | 10.5 | 51000 |
32 | Washington | 10.6 | 140000 |
33 | Arkansas | 10.9 | 51000 |
34 | Indiana | 11.4 | 134000 |
35 | Alaska | 11.6 | 12000 |
36 | Utah | 11.7 | 67000 |
37 | Kansas | 12.4 | 52000 |
38 | South Carolina | 12.5 | 85000 |
39 | Maine | 12.7 | 29000 |
40 | Virginia | 13.5 | 147000 |
41 | Idaho | 13.7 | 46000 |
42 | North Carolina | 13.8 | 204000 |
43 | Oklahoma | 15.9 | 92000 |
44 | Missouri | 16.2 | 169000 |
45 | Florida | 17.4 | 503000 |
46 | Georgia | 18.5 | 255000 |
47 | Alabama | 18.8 | 154000 |
48 | Tennessee | 19 | 171000 |
49 | Texas | 20.1 | 664000 |
50 | Mississippi | 22.2 | 95000 |
51 | Wyoming | 23 | 21000 |
52 | National | 10.8 | 511,400 |
Rank Sort descending | State | Percentage | Number |
---|---|---|---|
01 | Vermont | 42.8 | 45000 |
02 | Arkansas | 47.5 | 221000 |
03 | Rhode Island | 49 | 89000 |
04 | Wisconsin | 49.2 | 412000 |
05 | Massachusetts | 49.5 | 597000 |
06 | Delaware | 49.7 | 75000 |
07 | Iowa | 49.8 | 231000 |
08 | Maine | 49.9 | 114000 |
09 | Ohio | 50.7 | 978000 |
10 | Kentucky | 50.9 | 392000 |
11 | Colorado | 50.9 | 475000 |
12 | Kansas | 51.1 | 213000 |
13 | Utah | 51.2 | 294000 |
14 | South Carolina | 51.4 | 349000 |
15 | Tennessee | 51.7 | 463000 |
16 | New Hampshire | 51.9 | 116000 |
17 | West Virginia | 52.2 | 193000 |
18 | District of Columbia | 52.2 | 68000 |
19 | Minnesota | 52.6 | 416000 |
20 | Arizona | 52.7 | 535000 |
21 | Pennsylvania | 53 | 953000 |
22 | Nebraska | 53 | 128000 |
23 | Washington | 53.5 | 704000 |
24 | Idaho | 53.5 | 177000 |
25 | Michigan | 53.8 | 779000 |
26 | Connecticut | 53.9 | 287000 |
27 | Montana | 54.2 | 89000 |
28 | Virginia | 54.5 | 589000 |
29 | North Dakota | 54.5 | 56000 |
30 | South Dakota | 54.8 | 57000 |
31 | Missouri | 55.3 | 576000 |
32 | Illinois | 55.8 | 946000 |
33 | Indiana | 55.9 | 653000 |
34 | North Carolina | 56.5 | 833000 |
35 | New Mexico | 56.6 | 167000 |
36 | Alabama | 56.7 | 463000 |
37 | Mississippi | 57.7 | 247000 |
38 | Oklahoma | 58.9 | 340000 |
39 | Maryland | 59.1 | 459000 |
40 | Oregon | 59.3 | 442000 |
41 | Texas | 59.6 | 1960000 |
42 | New Jersey | 60 | 644000 |
43 | New York | 60.3 | 1655000 |
44 | Nevada | 60.3 | 282000 |
45 | Louisiana | 62 | 459000 |
46 | Florida | 63 | 1816000 |
47 | Wyoming | 64.8 | 60000 |
48 | Georgia | 64.9 | 888000 |
49 | California | 65 | 3620000 |
50 | Alaska | 65.5 | 70000 |
51 | Hawaii | 65.8 | 124000 |
52 | National | 57 | 267,970 |
Almost a quarter (23.6%) of all adults with a mental illness reported that they were not able to receive the treatment they needed. This number has not declined since 2011.
Individuals seeking treatment but still not receiving needed services face the same barriers that contribute to the number of individuals not receiving treatment:
- No insurance or limited coverage of services.
- Shortfall in psychiatrists, and an overall undersized mental health workforce.
- Lack of available treatment types (inpatient treatment, individual therapy, intensive community services).
- Disconnect between primary care systems and behavioral health systems.
- Insufficient finances to cover costs ñ including copays, uncovered treatment types, or when providers do not take insurance.
The state prevalence of adults with AMI reporting unmet treatment needs ranges from 12% in Hawaii to 31.6% in Kansas.
Rank Sort descending | State | Percentage | Number |
---|---|---|---|
01 | Hawaii | 12 | 23000 |
02 | Alabama | 18.7 | 153000 |
03 | Texas | 19.9 | 655000 |
04 | Wyoming | 19.9 | 18000 |
05 | Minnesota | 20.7 | 163000 |
06 | New Mexico | 20.8 | 61000 |
07 | Tennessee | 20.9 | 188000 |
08 | Louisiana | 21 | 155000 |
09 | New York | 21.4 | 585000 |
10 | Massachusetts | 21.6 | 263000 |
11 | Florida | 21.9 | 633000 |
12 | Ohio | 22.1 | 427000 |
13 | Idaho | 22.1 | 73000 |
14 | Vermont | 22.5 | 24000 |
15 | California | 22.8 | 1272000 |
16 | Illinois | 22.9 | 388000 |
17 | West Virginia | 22.9 | 84000 |
18 | Delaware | 23 | 35000 |
19 | Georgia | 23.1 | 317000 |
20 | North Dakota | 23.3 | 24000 |
21 | Oklahoma | 23.5 | 136000 |
22 | Washington | 23.7 | 310000 |
23 | Mississippi | 23.8 | 102000 |
24 | Indiana | 23.9 | 281000 |
25 | Michigan | 24.4 | 353000 |
26 | New Jersey | 24.4 | 262000 |
27 | Alaska | 24.4 | 26000 |
28 | Kentucky | 24.5 | 189000 |
29 | Montana | 24.6 | 41000 |
30 | Maine | 24.8 | 57000 |
31 | New Hampshire | 24.8 | 55000 |
32 | Wisconsin | 24.9 | 209000 |
33 | Maryland | 25.2 | 196000 |
34 | Connecticut | 25.4 | 135000 |
35 | Iowa | 25.5 | 117000 |
36 | Arizona | 25.8 | 259000 |
37 | Arkansas | 26 | 122000 |
38 | Missouri | 26.1 | 272000 |
39 | Nevada | 26.1 | 122000 |
40 | Nebraska | 26.2 | 63000 |
41 | South Dakota | 26.4 | 28000 |
42 | North Carolina | 26.5 | 391000 |
43 | South Carolina | 26.6 | 181000 |
44 | Pennsylvania | 26.8 | 480000 |
45 | Rhode Island | 27.9 | 50000 |
46 | Colorado | 28.2 | 263000 |
47 | Virginia | 28.6 | 309000 |
48 | District of Columbia | 29.4 | 38000 |
49 | Utah | 30.1 | 172000 |
50 | Oregon | 30.2 | 225000 |
51 | Kansas | 31.6 | 132000 |
52 | National | 23.6 | 111,190 |
28.69% of adults with a cognitive disability were not able to see a doctor due to costs.
According to the Centers for Disease Control (CDC), 11.5% of people in the U.S. had a cognitive disability in 2018, even when adjusted for age. The percentage of people with cognitive disability ranged from 7.9% in some states to 17.9%.
A 2017 study found that compared to working-age adults without disabilities, those with disabilities are more likely to live below the federal poverty level and to use public insurance. Their average health costs were also 3-7 times higher than those without disabilities.
The prevalence of adults with cognitive disability who couldn't see a MD due to cost ranges from 17.10% in the District of Columbia to 41.92% in Georgia.
Rank Sort descending | State | Percentage | Number |
---|---|---|---|
01 | District of Columbia | 17.10 | 8373 |
02 | Iowa | 17.54 | 37774 |
03 | Hawaii | 17.63 | 16639 |
04 | Massachusetts | 18.56 | 109857 |
05 | Vermont | 19.02 | 9542 |
06 | New York | 20.97 | 314383 |
07 | Delaware | 20.98 | 18284 |
08 | Ohio | 21.02 | 236528 |
09 | Connecticut | 21.61 | 53913 |
10 | Pennsylvania | 22.48 | 277857 |
11 | Montana | 22.85 | 20088 |
12 | North Dakota | 23.74 | 12428 |
13 | Minnesota | 24.20 | 91135 |
14 | Maine | 24.37 | 33492 |
15 | Washington | 24.84 | 141746 |
16 | Michigan | 25.18 | 252279 |
17 | New Jersey | 25.19 | 177138 |
18 | Nevada | 25.27 | 76372 |
19 | Rhode Island | 25.71 | 26383 |
20 | Kentucky | 25.85 | 137755 |
21 | West Virginia | 25.99 | 65433 |
22 | Oregon | 26.03 | 108294 |
23 | New Hampshire | 26.91 | 28858 |
24 | California | 27.05 | 796447 |
25 | Indiana | 27.10 | 157334 |
26 | Arizona | 27.17 | 153262 |
27 | Wyoming | 27.44 | 12362 |
28 | Colorado | 27.45 | 88135 |
29 | Maryland | 27.45 | 111740 |
30 | Louisiana | 28.08 | 160506 |
31 | Oklahoma | 28.18 | 115914 |
32 | Wisconsin | 28.20 | 119187 |
33 | New Mexico | 28.23 | 54533 |
34 | South Dakota | 28.36 | 17869 |
35 | Illinois | 29.66 | 249140 |
36 | Kansas | 30.27 | 70938 |
37 | Alaska | 30.90 | 17348 |
38 | Idaho | 31.04 | 43794 |
39 | Nebraska | 31.66 | 39724 |
40 | Tennessee | 31.86 | 245411 |
41 | Utah | 31.92 | 75977 |
42 | Missouri | 32.87 | 190827 |
43 | South Carolina | 33.75 | 179775 |
44 | Arkansas | 34.16 | 111986 |
45 | Virginia | 34.24 | 223528 |
46 | Texas | 34.57 | 690102 |
47 | Mississippi | 35.20 | 130909 |
48 | North Carolina | 35.23 | 343530 |
49 | Florida | 35.36 | 754413 |
50 | Alabama | 36.70 | 212868 |
51 | Georgia | 41.92 | 410646 |
52 | National | 28.69 | 815,377 |
59.6% of youth with major depression do not receive any mental health treatment.
Youth experiencing MDE continue to go untreated. Even among the states with greatest access for youth, over 1 in 3 youth are still not receiving the mental health services they need.
The state prevalence of untreated youth with depression ranges from 38.6% in Maine to 71.0% in Nevada.
Rank Sort descending | State | Percentage | Number |
---|---|---|---|
01 | Maine | 38.6 | 6000 |
02 | District of Columbia | 38.8 | 1000 |
03 | Vermont | 40.7 | 2000 |
04 | Maryland | 41.3 | 23000 |
05 | Utah | 45.2 | 22000 |
06 | Washington | 47 | 38000 |
07 | Wisconsin | 47.2 | 33000 |
08 | Delaware | 47.9 | 4000 |
09 | Kentucky | 49.3 | 19000 |
10 | South Dakota | 49.7 | 3000 |
11 | Ohio | 52.2 | 59000 |
12 | Virginia | 53 | 51000 |
13 | Indiana | 53 | 48000 |
14 | Iowa | 53 | 20000 |
15 | North Dakota | 53.4 | 3000 |
16 | Rhode Island | 53.4 | 5000 |
17 | Oregon | 53.9 | 30000 |
18 | Kansas | 54.7 | 19000 |
19 | Louisiana | 54.9 | 24000 |
20 | Minnesota | 55.4 | 32000 |
21 | Nebraska | 55.4 | 12000 |
22 | Montana | 55.6 | 5000 |
23 | Michigan | 55.7 | 66000 |
24 | New Jersey | 55.7 | 40000 |
25 | Hawaii | 56.2 | 5000 |
26 | Wyoming | 56.6 | 4000 |
27 | New Hampshire | 56.9 | 9000 |
28 | Pennsylvania | 57.5 | 56000 |
29 | Alaska | 57.8 | 5000 |
30 | Missouri | 58.8 | 40000 |
31 | New York | 59.1 | 85000 |
32 | Connecticut | 59.1 | 24000 |
33 | West Virginia | 59.3 | 11000 |
34 | Arizona | 59.6 | 52000 |
35 | North Carolina | 60.2 | 77000 |
36 | Colorado | 60.9 | 29000 |
37 | Oklahoma | 61.1 | 35000 |
38 | Idaho | 61.2 | 15000 |
39 | Massachusetts | 61.2 | 41000 |
40 | Tennessee | 61.5 | 35000 |
41 | Illinois | 62.1 | 90000 |
42 | New Mexico | 62.9 | 20000 |
43 | Arkansas | 63.9 | 23000 |
44 | Florida | 64.7 | 116000 |
45 | California | 66 | 259000 |
46 | Mississippi | 66.3 | 18000 |
47 | Texas | 67.1 | 209000 |
48 | South Carolina | 68 | 36000 |
49 | Alabama | 69.7 | 31000 |
50 | Georgia | 70.4 | 73000 |
51 | Nevada | 71 | 23000 |
52 | National | 59.60% | 1988000 |
High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes.
Nationally, only 27.3% of youth with severe depression receive some consistent treatment (7-25+ visits in a year).
Late recognition in primary care settings and limited coverage of mental health services often prevent youth from receiving timely and effective treatment.
The state prevalence of youth with severe depression who received some outpatient treatment ranges from 50.0% in Maine to 11.2% in Nevada.
Rank Sort descending | State | Percentage | Number |
---|---|---|---|
01 | Maine | 50 | 5000 |
02 | Maryland | 49.2 | 21000 |
03 | Vermont | 45.4 | 2000 |
04 | Delaware | 41.5 | 2000 |
05 | Rhode Island | 41.2 | 3000 |
06 | Wisconsin | 40.4 | 23000 |
07 | Oregon | 37.9 | 14000 |
08 | Massachusetts | 37.7 | 15000 |
09 | District of Columbia | 37.3 | 1000 |
10 | Pennsylvania | 37.1 | 23000 |
11 | Wyoming | 36.3 | 2000 |
12 | Ohio | 36 | 28000 |
13 | Nebraska | 35.9 | 5000 |
14 | Idaho | 35.8 | 6000 |
15 | New Hampshire | 34.9 | 3000 |
16 | Kentucky | 34.2 | 10000 |
17 | Minnesota | 33.7 | 13000 |
18 | North Dakota | 33 | 1000 |
19 | New Jersey | 32.5 | 16000 |
20 | Louisiana | 32 | 9000 |
21 | Kansas | 31.1 | 7000 |
22 | Arkansas | 30 | 7000 |
23 | Alaska | 29.9 | 2000 |
24 | Michigan | 29.8 | 24000 |
25 | Montana | 29.3 | 2000 |
26 | South Dakota | 29.2 | 1000 |
27 | Iowa | 28.8 | 7000 |
28 | South Carolina | 28.3 | 9000 |
29 | Hawaii | 28.3 | 2000 |
30 | West Virginia | 27.8 | 4000 |
31 | Tennessee | 27.3 | 12000 |
32 | Washington | 26.7 | 13000 |
33 | Indiana | 26.1 | 16000 |
34 | Virginia | 26.1 | 16000 |
35 | Alabama | 25.9 | 6000 |
36 | Texas | 25 | 54000 |
37 | Illinois | 25 | 26000 |
38 | Arizona | 24.7 | 15000 |
39 | California | 24.6 | 59000 |
40 | Utah | 24.5 | 8000 |
41 | Oklahoma | 23.5 | 8000 |
42 | New Mexico | 22.6 | 5000 |
43 | New York | 21.9 | 22000 |
44 | North Carolina | 21.9 | 21000 |
45 | Connecticut | 21.6 | 5000 |
46 | Colorado | 21.5 | 8000 |
47 | Florida | 19.7 | 24000 |
48 | Georgia | 19.2 | 15000 |
49 | Missouri | 19 | 9000 |
50 | Mississippi | 14.9 | 2000 |
51 | Nevada | 11.2 | 3000 |
52 | National | 27.3 | 614000 |
The Mental Health Parity and Addiction Equity law (MHPAE) was enacted in 2008, and promised the equal coverage of mental health and substance use services. The rate of children with private insurance that does not cover mental or emotional problems decreased 0.3% from last year's dataset. However, there are still 901,000 youth without coverage for their behavioral health.
In 2019, a Milliman research report found large disparities between behavioral health and medical/surgical services, including that patients saw out-of-network behavioral health providers at much higher rates than physical health providers. It also found that these disparities were worse for children. In 2017, a behavioral health visit for a child was over 10 times more likely to be out-of-network than a primary care office visit. This was over two times the disparity shown for adults.
To improve the worsening mental health of children and adolescents in the U.S., insurance companies must not only achieve parity in coverage of services, but also in network adequacy, so people are able to access those services when they need them.
The state prevalence of children lacking mental health coverage ranges from 0.6% in Vermont to 14.8% in South Carolina.
Rank Sort descending | State | Percentage | Number |
---|---|---|---|
01 | Vermont | 0.6 | 0 |
02 | Massachusetts | 1.2 | 4000 |
03 | New Hampshire | 2.5 | 1000 |
04 | Connecticut | 3.3 | 5000 |
05 | Maine | 3.4 | 2000 |
06 | New Jersey | 4 | 14000 |
07 | District of Columbia | 4.6 | 1000 |
08 | Washington | 5.2 | 16000 |
09 | Rhode Island | 5.3 | 2000 |
10 | Montana | 5.4 | 2000 |
11 | South Dakota | 5.4 | 2000 |
12 | Michigan | 5.5 | 23000 |
13 | Wisconsin | 5.5 | 16000 |
14 | Ohio | 5.9 | 26000 |
15 | Missouri | 5.9 | 14000 |
16 | Alabama | 5.9 | 7000 |
17 | Pennsylvania | 6.1 | 29000 |
18 | Georgia | 6.5 | 23000 |
19 | Virginia | 6.6 | 21000 |
20 | Oregon | 6.7 | 10000 |
21 | Delaware | 6.9 | 3000 |
22 | Indiana | 7.1 | 22000 |
23 | Illinois | 7.2 | 34000 |
24 | Maryland | 7.2 | 18000 |
25 | West Virginia | 7.2 | 4000 |
26 | California | 7.5 | 100000 |
27 | Minnesota | 7.5 | 20000 |
28 | Mississippi | 7.5 | 6000 |
29 | Iowa | 7.5 | 10000 |
30 | Louisiana | 7.6 | 10000 |
31 | New Mexico | 7.8 | 4000 |
32 | Utah | 7.8 | 16000 |
33 | Oklahoma | 7.9 | 11000 |
34 | Kansas | 7.9 | 9000 |
35 | New York | 8.3 | 49000 |
36 | Colorado | 8.3 | 17000 |
37 | Hawaii | 9.2 | 3000 |
38 | Florida | 9.4 | 52000 |
39 | North Carolina | 10 | 33000 |
40 | Alaska | 10.3 | 2000 |
41 | Kentucky | 11 | 17000 |
42 | Texas | 11.5 | 108000 |
43 | Wyoming | 12 | 3000 |
44 | Arizona | 12.1 | 32000 |
45 | Nevada | 12.6 | 13000 |
46 | Nebraska | 12.6 | 10000 |
47 | Idaho | 12.7 | 10000 |
48 | North Dakota | 13.5 | 5000 |
49 | Tennessee | 13.5 | 27000 |
50 | Arkansas | 14.4 | 13000 |
51 | South Carolina | 14.8 | 23000 |
52 | National | 7.8 | 901000 |
High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes
Only .757% of students are identified as having an Emotional Disturbance (ED) for an Individualized Education Program (IEP).
For purposes of an IEP, the term ìEmotional Disturbanceî is used to define youth with a mental illness that is affecting their ability to succeed in school.
Early identification for IEPs is critical. IEPs provide the services, accommodations and support students with ED need to receive a quality education. Inadequate education leads to poor outcomes such as low academic achievement, social isolation, unemployment, and involvement in the juvenile system. Further, the federal eligibility criteria to identify students as having an emotional disturbance for an IEP have indicated extremely poor reliability among school psychologists,2 and therefore must be revised to adequately identify students in need of more supports.
The rate for this measure is shown as a rate per 1,000 students.
The calculation was made this way for ease of reading.Unfortunately, doing so hides the fact that the percentages are significantly lower. If states were doing a better job of identifying whether youth had emotional difficulties that could be better supported through an IEP ñ the rates would be closer to 8% instead of .8 percent.
The state rate of students identified as having an emotional disturbance for an IEP ranges from 30.41 per 1,000 students in Vermont to 2.09 per 1,000 students in Alabama.
Rank Sort descending | State | Percentage | Number |
---|---|---|---|
01 | Vermont | 30.41 | 2233 |
02 | Minnesota | 20.69 | 16510 |
03 | Massachusetts | 19.51 | 16935 |
04 | Wisconsin | 16.18 | * |
05 | Pennsylvania | 15.76 | 25166 |
06 | Maine | 14.35 | 2328 |
07 | Indiana | 13.41 | 12838 |
08 | Iowa | 13.31 | 5896 |
09 | New Hampshire | 12.77 | 2095 |
10 | Rhode Island | 12.38 | 1615 |
11 | District of Columbia | 12.32 | 827 |
12 | Connecticut | 11.94 | 5691 |
13 | North Dakota | 11.85 | 1183 |
14 | Illinois | 10.19 | 18237 |
15 | Nebraska | 10.06 | 2846 |
16 | Ohio | 9.97 | 15377 |
17 | South Dakota | 9.89 | 1213 |
18 | Oregon | 9.81 | 5286 |
19 | Delaware | 9.25 | 1152 |
20 | New York | 9.15 | 22553 |
21 | Missouri | 8.66 | 7072 |
22 | Michigan | 8.45 | 11458 |
23 | Virginia | 8.38 | 9782 |
24 | Maryland | 7.64 | 6107 |
25 | Mississippi | 7.62 | 3326 |
26 | Arizona | 7.61 | 7742 |
27 | Kentucky | 7.45 | 4524 |
28 | Oklahoma | 6.89 | 4142 |
29 | Colorado | 6.88 | 5596 |
30 | Wyoming | 6.72 | 579 |
31 | Texas | 6.60 | 31519 |
32 | Montana | 6.50 | 881 |
33 | Georgia | 6.45 | 10286 |
34 | Alaska | 6.26 | 745 |
35 | New Mexico | 6.16 | 1853 |
36 | New Jersey | 5.98 | 7485 |
37 | Hawaii | 5.74 | 947 |
38 | Florida | 5.68 | 14604 |
39 | Kansas | 5.53 | 2436 |
40 | Washington | 5.25 | 5324 |
41 | Idaho | 4.95 | 1372 |
42 | West Virginia | 4.80 | 1133 |
43 | Nevada | 4.43 | 1959 |
44 | California | 4.42 | 25118 |
45 | Tennessee | 3.76 | 3381 |
46 | North Carolina | 3.72 | 5275 |
47 | Utah | 3.17 | 1918 |
48 | South Carolina | 3.04 | 2112 |
49 | Louisiana | 2.70 | 1715 |
50 | Arkansas | 2.42 | 1070 |
51 | Alabama | 2.09 | 1406 |
52 | National | 7.57 | 344473 |
The term ìmental health providerî includes psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, and advanced practice nurses specializing in mental health care, but not yet certified peer specialists (because peer specialists are primarily covered only by Medicaid, and qualifications for them vary state by state).
The rate of mental health providers has improved in nearly every state since last year's report. However, the need for mental health care will greatly outpace these additions to the workforce, especially as rates of depression, anxiety and other mental health concerns increase in response to the coronavirus pandemic and increased awareness of ongoing racial injustice in 2020.
However, the COVID-19 pandemic has also shown that these workforce shortages can be mitigated through different models of care delivery. The Center for Medicare and Medicaid Services (CMS) encouraged states to reduce barriers to tele-mental health under Medicaid, and Medicare allowed audio-only tele-mental health visits during the pandemic. If these changes to care delivery are made permanent and coverage for peer support specialists and other paraprofessionals is expanded, these could help mitigate some of the effects of provider shortages in the future.
The state rate of mental health workforce ranges from 160:1 in Massachusetts to 990:1 in Alabama.
Rank Sort descending | State | Number |
---|---|---|
01 | Massachusetts | 160:1 |
02 | Oregon | 190:1 |
03 | District of Columbia | 210:1 |
04 | Maine | 210:1 |
05 | Vermont | 220:1 |
06 | Alaska | 230:1 |
07 | Rhode Island | 240:1 |
08 | Connecticut | 250:1 |
09 | Oklahoma | 250:1 |
10 | New Mexico | 260:1 |
11 | Washington | 270:1 |
12 | California | 280:1 |
13 | Colorado | 280:1 |
14 | Utah | 300:1 |
15 | Wyoming | 300:1 |
16 | Montana | 330:1 |
17 | New Hampshire | 330:1 |
18 | Louisiana | 340:1 |
19 | New York | 350:1 |
20 | Michigan | 370:1 |
21 | Delaware | 380:1 |
22 | Nebraska | 380:1 |
23 | Maryland | 390:1 |
24 | Hawaii | 400:1 |
25 | Minnesota | 400:1 |
26 | North Carolina | 410:1 |
27 | Ohio | 410:1 |
28 | Arkansas | 440:1 |
29 | Illinois | 440:1 |
30 | Kentucky | 440:1 |
31 | New Jersey | 450:1 |
32 | Nevada | 470:1 |
33 | Idaho | 480:1 |
34 | Pennsylvania | 480:1 |
35 | Wisconsin | 490:1 |
36 | Kansas | 510:1 |
37 | Missouri | 510:1 |
38 | North Dakota | 530:1 |
39 | South Dakota | 550:1 |
40 | South Carolina | 570:1 |
41 | Virginia | 570:1 |
42 | Florida | 620:1 |
43 | Indiana | 620:1 |
44 | Mississippi | 630:1 |
45 | Iowa | 640:1 |
46 | Tennessee | 660:1 |
47 | Georgia | 730:1 |
48 | Arizona | 750:1 |
49 | West Virginia | 770:1 |
50 | Texas | 880:1 |
51 | Alabama | 990:1 |