The Worst States For Mental Health Care, 2024 – Forbes Advisor

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Millions of people in the U.S.—one in five American adults—experience a mental health condition each year.

Despite an obvious need for mental health care, a majority of Americans (76%) are dissatisfied with the state of mental health treatment in the U.S.

More than half of adults with a mental illness (54.7%) do not receive any treatment—over 28 million people—and more than one in four (28.2%) do not receive adequate treatment, according to Mental Health America.

In some states, getting access to mental health care can be more difficult due to high costs, too few treatment centers, and a lack of health insurance coverage.

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

Key Takeaways

For the second year in a row, Texas tops the list of worst states for mental health care, while Vermont ranks as the best state for mental health care.
Six of the top 10 worst states for mental health care are located in the South, including Texas, Georgia, Alabama, Florida, Mississippi and South Carolina.
Five of the top 10 best states for mental health care are in the Northeast, including Vermont, Connecticut, Rhode Island, Pennsylvania and Massachusetts.
In Georgia, residents experiencing mental illness are the most likely in the nation to skip a doctor’s appointment because of the expense (34.4%).

The Top 10 Worst States For Mental Health Care

1. Texas

Texas’ score: 100 out of 100

Texas tops our list as the worst state for mental health care for the second time in two years. The state has a large population of uninsured adults with mental illness and has significant barriers to mental health resources.

The Lone Star State has the second highest percentage of adults with a mental illness who are uninsured (21.4%).
Texas also has the second highest percentage of youth with depression who do not receive mental health services (74.9%).
According to our study, Texas has the second highest percentage of youth with private health insurance that does not include coverage for mental or emotional problems (19.4%).
Roughly one-third of adults in Texas (31.5%) who have a mental health disorder are not able to see a doctor due to cost—the third highest percentage in the nation.
The state of Texas also has the third fewest mental health treatment centers, with 8.4 per 10,000 businesses.
More than half of adults with mental illness in Texas (62.3%) do not receive any treatment at all—the fifth highest percentage in the country.

2. Georgia

Georgia’s score: 91.76 out of 100

Georgia has a high percentage of adults with mental illnesses that can’t access care due to cost and a lack of insurance coverage.

Georgia has the highest percentage of adults who are struggling with mental health and could not see a doctor due to cost (34.4%).
The state also has the fourth fewest mental health treatment centers with 10.05 per 10,000 businesses.
We also found that Georgia has the fifth highest percentage of adults with a mental illness who are uninsured (17.4%).
The state has the seventh highest percentage of youth with depression who do not receive mental health services (66.6%).
Georgia has the eighth highest percentage of youth with private health insurance that does not cover mental or emotional problems (13.2%).
The Peach State also has the ninth highest percentage of adults with a mental illness who do not receive any treatment (57.8%).

3. Alabama

Alabama’s score: 87.6 out of 100

More than half of individuals with mental illness in Alabama don’t receive the health care they need due to cost.

Alabama has the third highest percentage of adults with a mental illness who are uninsured (17.9%).
The state also has the fourth highest percentage of adults (62.4%) with a mental illness who do not receive any treatment.
Alabama has the fifth highest percentage of adults with a mental illness who do not receive adequate treatment (35.4%).
Alabama stands out with the sixth highest percentage of youth with private health insurance that does not cover mental or emotional problems (13.8%).
The state has the eighth fewest mental health treatment centers with 12.46 per 10,000 businesses.
Alabama also has the eighth highest percentage of adults who have a mental health disorder but could not see a doctor due to cost (28.7%).

4. Florida

Florida’s score: 83 out of 100

Individuals with mental illness in Florida lack access to mental health care due to high costs and a shortage of mental health treatment centers.

Florida has the fourth highest percentage of adults who have a mental health disorder and could not see a doctor due to cost (30.1%).
The Sunshine State stands out as having the seventh fewest mental health treatment centers with 11.88 per 10,000 businesses.
The state also has the seventh highest percentage of adults with a mental illness who do not receive any treatment (58.4%).
Florida has the 12th highest percentage of adults with a mental illness who are uninsured (13.6%).
The state ranks 12th highest for the percentage of youth with private health insurance that does not cover mental or emotional problems (11.4%).

5. Mississippi

Mississippi’s score: 63.62 out of 100

Mississippi has a high percentage of youth with health insurance that doesn’t cover mental health treatment, and has the second-lowest number of mental health treatment centers in the country.

Mississippi has the second fewest mental health treatment centers with 7.52 per 10,000 businesses.
The state has the ninth highest percentage of adults who have a mental illness and could not see a doctor due to cost (28.2%).
The Magnolia State ranks the ninth highest for the percentage of youth with private health insurance that does not cover mental or emotional problems (12.1%).
Mississippi has the 11th highest percentage of adults with a mental illness who do not receive any treatment (56.1%).

6. Arizona

Arizona’s score: 63.58 out of 100

Arizona is one of two western states that rank among the top 10 worst states for mental health care. A high number of individuals in the state with a mental illness don’t receive any treatment.

Arizona has the second highest percentage of adults with a mental illness who do not receive any treatment (63.5%).
The state also has the third highest percentage of adults with a mental illness who do not receive adequate treatment (36%).
The Grand Canyon State has the ninth highest percentage of adults with a mental illness who are uninsured (14.9%).

7. Indiana

Indiana’s score: 62.94 out of 100

Indiana is one of two midwest states that rank among the top 10 worst states for mental health care in our study. It has the highest percentage of adults with a mental illness who do not receive adequate treatment (38.8%).

The Hoosier State also has the ninth highest percentage of youth with private health insurance that does not cover mental or emotional problems (12.1%).
The state has the 13th highest percentage of adults with a mental illness who are uninsured (13.5%).

8. South Carolina

South Carolina’s score: 62.76 out of 100

South Carolina is the sixth and final Southern state to rank among the top 10 worst states for mental health care. It has the fewest mental health treatment centers nationwide (6.84 per 10,000 businesses).

The Palmetto State also has the highest percentage of youth with depression in the country who do not receive mental health services (77.1%).
The state has the seventh highest percentage of adults who are struggling with mental health and could not see a doctor due to cost (29.1%).

9. Kansas

Kansas’ score: 54.74 out of 100

Kansas is the second Midwest state to rank among the worst for mental health care.

Kansas ranks fourth highest for the percentage of adults with a mental illness who are uninsured (17.5%).
The Sunflower State has the fourth highest percentage of adults with a mental illness who do not receive adequate treatment (35.8%).

10. Colorado

Colorado’s score: 54.38 out of 100

Coming in at the bottom of our list of worst states for mental health care is Colorado. A large number of youth in this state don’t have health insurance that covers mental health care.

Colorado has the third highest percentage of youth with private health insurance that does not cover mental or emotional problems (17.2%).
The Centennial State also has the sixth highest percentage of adults with a mental illness who do not receive adequate treatment (34.2%).

Tips For Choosing The Best Mental Health Insurance Plan

While it may be more difficult in some states than others to access quality mental health care, it’s possible to get the medical care you deserve and need.

Thanks to the Affordable Care Act (ACA) and Mental Health Parity and Addiction Equity Act, it’s easier now to find affordable health insurance that will cover mental health care. Mental health is one of 10 critical health benefits that ACA marketplace plans must cover.

The mental health parity law also requires that health insurance plans cover mental health care at the same level as other types of care.

When looking for health insurance coverage, it’s important to consider the following:

Confirm the health plan covers local mental health providers: If you have a provider in mind, it’s always best to confirm it’s in-network with the plan you’re considering. In-network vs. out-of-network providers will make a difference on how much you pay for care.
Consider all the associated costs of the plan: Don’t forget your health insurance costs include both your monthly premium and all of your out-of-pocket costs. So when comparing health insurance quotes, review all costs like copays, deductibles, coinsurance and out-of-pocket maximums.
Review the plan’s prescription drug coverage: Many health insurance companies include prescription drug coverage, but covered medications and your copay can vary by plan. If you’re already taking medication, confirm its coverage with the potential plan.
Consider virtual health care coverage: Since the pandemic, telehealth visits have grown and are preferred by many as being more convenient. Especially for mental health care, telehealth can remove the barriers to finding care. Confirm that the plan you’re considering will cover online counseling services.
Will you need a referral for mental health care? Some health insurance plans require a referral from a primary care provider for mental health services. For example, an HMO usually requires referrals for most types of specialized coverage, while a PPO and EPO do not.
Consider free services available to you: Many workplaces offer free mental health services for employees. And some health insurance companies also provide free access to apps and free services.

The bottom line is there is help available for mental health care. With a little research, you can find affordable health insurance, and affordable mental health care.