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Youth Ranking 2022



 

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States with rankings 1-13 have lower prevalence of mental illness and higher rates of access to care for youth. States with rankings 39-51 indicate that youth have higher prevalence of mental illness and lower rates of access to care.

The 7 measures that make up the Youth Ranking include:

  1. Youth with At Least One Major Depressive Episode (MDE) in the Past Year
  2. Youth with Substance Use Disorder in the Past Year
  3. Youth with Severe MDE
  4. Youth with MDE who Did Not Receive Mental Health Services
  5. Youth with Severe MDE who Received Some Consistent Treatment
  6. Children with Private Insurance that Did Not Cover Mental or Emotional Problems
  7. Students Identified with Emotional Disturbance for an Individualized Education Program.
Rank Sort ascending State
01 Pennsylvania
02 Maine
03 District of Columbia
04 Vermont
05 Massachusetts
06 New Hampshire
07 New Jersey
08 Connecticut
09 New York
10 Maryland
11 Wisconsin
12 Illinois
13 Colorado
14 Minnesota
15 Rhode Island
16 Mississippi
17 Georgia
18 Delaware
19 Ohio
20 Alabama
21 Virginia
22 Missouri
23 South Dakota
24 Kentucky
25 Louisiana
26 Indiana
27 Michigan
28 Oklahoma
29 Hawaii
30 Florida
31 Iowa
32 Utah
33 Kansas
34 North Dakota
35 South Carolina
36 California
37 Nebraska
38 Montana
39 Washington
40 Tennessee
41 Texas
42 North Carolina
43 Wyoming
44 West Virginia
45 Oregon
46 Alaska
47 New Mexico
48 Arkansas
49 Arizona
50 Idaho
51 Nevada

Youth with At Least One Major Depressive Episode (MDE) 2022



 

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15.08% of youth (age 12-17) report suffering from at least one major depressive episode (MDE) in the past year.

Childhood depression is more likely to persist into adulthood if gone untreated.

The number of youth experiencing MDE increased by 306,000 (1.24%) from last year's dataset.

The state prevalence of youth with MDE ranges from 11.36% in the District of Columbia to 18.62% in Oregon.

Rank Sort ascending State Percentage Number
01 District of Columbia 11.36 4,000
02 Mississippi 12.64 31,000
03 New Jersey 12.71 86,000
04 Pennsylvania 12.88 117,000
05 Florida 13.25 191,000
06 New York 13.29 179,000
07 Tennessee 13.72 70,000
08 Georgia 13.75 119,000
09 South Carolina 13.82 52,000
10 Louisiana 14.14 51,000
11 Hawaii 14.16 13,000
12 Connecticut 14.41 39,000
13 Alabama 14.51 54,000
14 Texas 14.60 363,000
15 Rhode Island 14.64 11,000
16 Ohio 14.73 131,000
17 Maryland 14.93 67,000
18 Colorado 15.02 65,000
19 North Dakota 15.07 8,000
20 Montana 15.11 12,000
21 Kentucky 15.15 51,000
22 Illinois 15.15 149,000
23 California 15.22 459,000
24 South Dakota 15.41 11,000
25 Delaware 15.48 11,000
26 Nebraska 15.50 24,000
27 Missouri 15.54 72,000
28 Virginia 15.57 98,000
29 Maine 15.60 14,000
30 Massachusetts 15.61 75,000
31 New Hampshire 15.85 15,000
32 Minnesota 15.94 70,000
33 Wisconsin 15.99 71,000
34 Arkansas 16.27 39,000
35 Vermont 16.36 7,000
36 Kansas 16.53 39,000
37 Michigan 16.55 125,000
38 Indiana 16.61 89,000
39 West Virginia 16.62 21,000
40 North Carolina 16.68 132,000
41 Iowa 16.69 41,000
42 Oklahoma 17.01 54,000
43 Arizona 17.41 98,000
44 Idaho 17.44 27,000
45 Wyoming 17.59 8,000
46 Utah 17.77 56,000
47 Nevada 17.93 42,000
48 Alaska 17.93 10,000
49 Washington 18.22 99,000
50 New Mexico 18.60 31,000
51 Oregon 18.62 55,000
52 National 15.08 3,755,000

Youth with Severe Major Depressive Episode 2022



 

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10.6% of youth (or over 2.5 million youth) cope with severe major depression.

The number of youths experiencing Severe MDE increased by 197,000 from last year's dataset.

The state prevalence of youth with Severe MDE ranges from 7.3% in the District of Columbia to 14.8% in Wyoming.

Rank Sort ascending State Percentage Number
01 District of Columbia 7.30% 2,000
02 Alabama 7.50% 27,000
03 Connecticut 7.80% 20,000
04 Mississippi 8.00% 19,000
05 Pennsylvania 8.20% 73,000
06 New York 8.30% 109,000
07 Rhode Island 8.30% 6,000
08 Hawaii 8.40% 8,000
09 New Jersey 8.40% 55,000
10 Colorado 9.00% 38,000
11 Florida 9.00% 124,000
12 Ohio 9.00% 78,000
13 Georgia 9.10% 76,000
14 South Carolina 9.10% 33,000
15 Texas 9.70% 234,000
16 California 9.80% 284,000
17 Kentucky 9.90% 32,000
18 Louisiana 10.20% 36,000
19 New Hampshire 10.20% 9,000
20 North Dakota 10.30% 5,000
21 Tennessee 10.30% 51,000
22 Missouri 10.40% 47,000
23 Massachusetts 10.50% 48,000
24 Illinois 11.00% 104,000
25 Kansas 11.20% 26,000
26 Montana 11.40% 8,000
27 Minnesota 11.60% 49,000
28 Arizona 11.90% 64,000
29 Michigan 11.90% 87,000
30 South Dakota 12.00% 8,000
31 Alaska 12.10% 7,000
32 Maryland 12.30% 54,000
33 Nebraska 12.40% 19,000
34 Wisconsin 12.70% 55,000
35 Delaware 12.80% 9,000
36 Oklahoma 12.80% 39,000
37 Virginia 13.00% 79,000
38 Nevada 13.20% 29,000
39 West Virginia 13.30% 16,000
40 Iowa 13.50% 32,000
41 Washington 13.50% 69,000
42 Maine 13.60% 12,000
43 Vermont 13.70% 5,000
44 New Mexico 13.80% 22,000
45 Oregon 14.10% 40,000
46 North Carolina 14.20% 110,000
47 Arkansas 14.30% 33,000
48 Indiana 14.50% 76,000
49 Utah 14.50% 45,000
50 Idaho 14.70% 22,000
51 Wyoming 14.80% 6,000
52 National 10.60% 2,540,000

Youth with Substance Use Disorder 2022



 

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4.08% of youth in the U.S. reported having a substance use disorder in the past year.  

1.64% had an alcohol use disorder in the past year, while 3.16% had an illicit drug use disorder.

The state prevalence of youth with substance use disorder ranges from 3.19% in Alabama to 5.77% in Oregon.

Rank Sort ascending State Percentage Number
01 Alabama 3.19 12,000
02 Louisiana 3.29 12,000
03 Mississippi 3.32 8,000
04 New Jersey 3.33 22,000
05 Georgia 3.45 30,000
06 Texas 3.49 87,000
07 Pennsylvania 3.52 32,000
08 Arkansas 3.63 9,000
09 Maryland 3.70 17,000
10 Virginia 3.71 23,000
11 Connecticut 3.74 10,000
12 Hawaii 3.75 4,000
13 Utah 3.77 12,000
14 Florida 3.86 56,000
15 New York 3.87 52,000
16 North Carolina 3.91 31,000
17 Nebraska 3.94 6,000
18 South Carolina 3.95 15,000
19 Michigan 3.98 30,000
20 Tennessee 4.00 21,000
21 Kansas 4.02 10,000
22 Missouri 4.04 19,000
23 Kentucky 4.10 14,000
24 Massachusetts 4.10 20,000
25 Indiana 4.20 23,000
26 Ohio 4.23 38,000
27 Illinois 4.25 42,000
28 Delaware 4.31 3,000
29 Wisconsin 4.34 19,000
30 Oklahoma 4.36 14,000
31 West Virginia 4.44 6,000
32 Idaho 4.47 7,000
33 California 4.55 137,000
34 New Hampshire 4.57 4,000
35 Rhode Island 4.58 3,000
36 South Dakota 4.60 3,000
37 Minnesota 4.62 20,000
38 Alaska 4.63 3,000
39 Maine 4.67 4,000
40 Arizona 4.83 27,000
41 Washington 4.84 26,000
42 Iowa 5.07 12,000
43 North Dakota 5.08 3,000
44 Wyoming 5.22 2,000
45 New Mexico 5.43 9,000
46 Colorado 5.44 24,000
47 Vermont 5.50 2,000
48 District of Columbia 5.57 2,000
49 Nevada 5.59 13,000
50 Montana 5.68 4,000
51 Oregon 5.77 17,000
52 National 4.08 1,017,000

Youth with MDE Who Did Not Receive Mental Health Services 2022



 

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60.3% 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, 1 in 3 youth are still not receiving the mental health services they need.

The state prevalence of untreated youth with depression ranges from 30.0% in Maine to 73.1% in Texas.

Rank Sort ascending State Percentage Number
01 Maine 30.00% 4,000
02 Colorado 39.30% 20,000
03 District of Columbia 41.00% 1,000
04 Vermont 42.60% 3,000
05 Maryland 44.70% 32,000
06 Wyoming 44.90% 4,000
07 Utah 45.40% 25,000
08 New Hampshire 46.60% 7,000
09 Iowa 49.30% 21,000
10 Oregon 49.70% 29,000
11 Washington 49.80% 50,000
12 Indiana 51.50% 50,000
13 North Carolina 51.90% 74,000
14 Delaware 52.30% 6,000
15 Nebraska 52.60% 12,000
16 Montana 53.50% 6,000
17 Kansas 54.50% 21,000
18 North Dakota 54.60% 4,000
19 Wisconsin 55.10% 36,000
20 Illinois 55.20% 77,000
21 Pennsylvania 55.20% 57,000
22 Virginia 55.20% 58,000
23 New Mexico 55.90% 18,000
24 Oklahoma 56.00% 30,000
25 Massachusetts 56.80% 44,000
26 Missouri 57.30% 37,000
27 Minnesota 58.30% 42,000
28 Arkansas 58.90% 23,000
29 New Jersey 58.90% 42,000
30 Kentucky 59.30% 27,000
31 South Dakota 59.60% 6,000
32 Michigan 59.70% 74,000
33 New York 60.90% 103,000
34 Louisiana 62.50% 32,000
35 Ohio 63.30% 76,000
36 Alaska 63.40% 6,000
37 West Virginia 63.90% 13,000
38 California 64.50% 278,000
39 Rhode Island 64.90% 6,000
40 Nevada 65.20% 28,000
41 Connecticut 65.60% 24,000
42 Tennessee 66.50% 40,000
43 Alabama 66.80% 34,000
44 Idaho 67.10% 19,000
45 Florida 67.30% 117,000
46 South Carolina 67.60% 34,000
47 Georgia 67.80% 75,000
48 Arizona 70.10% 67,000
49 Hawaii 71.00% 7,000
50 Mississippi 71.70% 20,000
51 Texas 73.10% 255,000
52 National 60.30% 2,173,000

Youth with Severe MDE Who Received Some Consistent Treatment 2022



 

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Nationally, only 27.2% of youth with severe depression receive some consistent treatment (7-25+ visits in a year). 

Even when simply measuring the number of visits, fewer than 1 in 3 youth with severe depression meet this determination of consistent care.

The state prevalence of youth with severe depression who received some outpatient treatment ranges from 65.6% in Maine to 12.2% in Tennessee.

High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes.

Rank Sort ascending State Percentage Number
01 Maine 65.60% 7,000
02 Vermont 49.70% 3,000
03 New Hampshire 47.60% 4,000
04 Wyoming 45.60% 3,000
05 Colorado 43.10% 16,000
06 Massachusetts 42.20% 19,000
07 Pennsylvania 39.90% 28,000
08 Illinois 38.30% 38,000
09 Oregon 36.60% 14,000
10 Wisconsin 36.40% 19,000
11 Delaware 36.30% 3,000
12 Minnesota 35.90% 17,000
13 District of Columbia 35.80% 1,000
14 Washington 35.70% 24,000
15 Montana 35.50% 3,000
16 Maryland 34.50% 18,000
17 Oklahoma 33.60% 12,000
18 North Dakota 33.00% 2,000
19 Indiana 32.90% 23,000
20 Alabama 31.30% 8,000
21 Michigan 30.40% 26,000
22 Iowa 29.50% 9,000
23 South Dakota 29.30% 2,000
24 Kentucky 28.60% 9,000
25 New Jersey 28.40% 14,000
26 New York 28.30% 29,000
27 Nebraska 27.80% 5,000
28 Idaho 27.70% 6,000
29 Utah 27.30% 11,000
30 California 26.10% 72,000
31 Ohio 25.10% 19,000
32 Virginia 25.00% 19,000
33 North Carolina 24.90% 27,000
34 South Carolina 24.20% 8,000
35 Connecticut 23.60% 5,000
36 Arkansas 22.70% 7,000
37 Kansas 22.70% 6,000
38 New Mexico 22.50% 5,000
39 Louisiana 21.10% 7,000
40 West Virginia 20.90% 3,000
41 Rhode Island 20.40% 1,000
42 Alaska 20.20% 1,000
43 Georgia 20.10% 14,000
44 Texas 19.20% 44,000
45 Nevada 18.70% 5,000
46 Florida 17.00% 20,000
47 Arizona 16.10% 10,000
48 Mississippi 13.50% 2,000
49 Hawaii 13.30% 1,000
50 Missouri 12.60% 5,000
51 Tennessee 12.20% 6,000
52 National 27.20% 661,000

Children with Private Insurance that Did Not Cover Mental or Emotional Problems 2022



 

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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. However, the rate of children with private insurance that does not cover mental or emotional problems increased 0.3 percent from last year's dataset, and there are still 950,000 youth without coverage for their behavioral health.

The state prevalence of children lacking mental health coverage ranges from 1.9% in Massachusetts to 17.7% in Arkansas.

Rank Sort ascending State Percentage Number
01 Massachusetts 1.90% 5,000
02 Vermont 2.10% 0
03 Connecticut 3.50% 5,000
04 Rhode Island 3.80% 1,000
05 Missouri 4.20% 9,000
06 New Hampshire 4.30% 2,000
07 Oklahoma 4.40% 6,000
08 District of Columbia 4.50% 1,000
09 West Virginia 4.50% 2,000
10 Wisconsin 4.50% 12,000
11 South Dakota 4.70% 2,000
12 Utah 4.70% 10,000
13 New Jersey 5.00% 18,000
14 Washington 5.20% 15,000
15 Maine 5.40% 3,000
16 Michigan 6.10% 27,000
17 Virginia 6.40% 22,000
18 Maryland 6.50% 15,000
19 Illinois 6.60% 33,000
20 Oregon 6.60% 10,000
21 Pennsylvania 6.80% 32,000
22 Delaware 7.00% 3,000
23 Georgia 7.00% 25,000
24 Nevada 7.10% 8,000
25 Indiana 7.40% 22,000
26 Iowa 7.40% 10,000
27 Ohio 7.40% 33,000
28 Alaska 7.50% 2,000
29 New York 7.70% 48,000
30 New Mexico 7.80% 5,000
31 Kansas 7.90% 8,000
32 Minnesota 8.00% 20,000
33 California 8.20% 111,000
34 Mississippi 8.20% 6,000
35 Hawaii 8.30% 3,000
36 Tennessee 8.80% 19,000
37 Louisiana 9.00% 11,000
38 Kentucky 9.30% 15,000
39 Montana 9.50% 3,000
40 Colorado 9.60% 22,000
41 North Carolina 10.00% 34,000
42 Arizona 10.20% 27,000
43 Florida 11.70% 65,000
44 Idaho 12.20% 11,000
45 South Carolina 12.40% 19,000
46 Alabama 12.50% 16,000
47 Wyoming 12.70% 3,000
48 Texas 13.80% 135,000
49 Nebraska 15.40% 13,000
50 North Dakota 15.60% 5,000
51 Arkansas 17.70% 17,000
52 National 8.10% 950,000

Students Identified with Emotional Disturbance for An Individualized Education Program 2022



 

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Only .759% of students are identified as having an Emotional Disturbance (ED) for an Individualized Education Program (IEP).

For purposes of an IEP, the term Emotional Disturbance 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.

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 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 32.23 per 1,000 students in Vermont to 2.13 per 1,000 students in Alabama.

 

Rank Sort ascending State Percentage Number
01 Vermont 32.23 2,326
02 Minnesota 21.20 17,016
03 Massachusetts 20.22 17,455
04 Pennsylvania 16.33 26,105
05 Wisconsin 16.18 *
06 Maine 15.32 2,468
07 Indiana 13.36 12,712
08 Iowa 13.31 *
09 New Hampshire 13.24 2,132
10 Connecticut 12.43 5,824
11 Rhode Island 12.34 1,610
12 North Dakota 11.99 1,240
13 District of Columbia 11.54 802
14 Illinois 10.59 18,381
15 Oregon 10.30 5,568
16 South Dakota 10.04 1,251
17 Ohio 10.03 15,281
18 Nebraska 9.98 2,861
19 Delaware 9.47 1,211
20 New York 9.10 22,063
21 Missouri 8.87 7,188
22 Michigan 8.52 11,314
23 Virginia 8.47 9,913
24 Maryland 7.61 6,180
25 Mississippi 7.53 3,193
26 Texas 7.41 35,851
27 Arizona 7.39 7,756
28 Kentucky 7.39 4,501
29 Colorado 6.98 5,687
30 Wyoming 6.80 589
31 Montana 6.68 906
32 Oklahoma 6.66 4,057
33 Alaska 6.48 765
34 Georgia 6.35 10,124
35 New Mexico 6.15 1,830
36 New Jersey 5.84 7,313
37 Hawaii 5.80 959
38 Kansas 5.60 2,459
39 Washington 5.49 5,633
40 Florida 5.43 14,062
41 Idaho 4.95 1,412
42 Nevada 4.64 2,085
43 California 4.51 25,424
44 West Virginia 4.45 1,025
45 Tennessee 3.84 3,470
46 North Carolina 3.65 5,187
47 Utah 3.12 1,933
48 South Carolina 3.05 2,143
49 Louisiana 2.74 1,727
50 Arkansas 2.54 1,123
51 Alabama 2.13 1,420
52 National 7.59 345,160