Southern states ranked with the worst access to mental health care, study finds

A recent survey by software provider Calm found that 57% of employees want their companies to help with stress and anxiety.

A new state ranking from Forbes Advisor shows that mental health services are ranked lower in southern states, while the northeast states generally score higher for mental health services.

The report comes at a time when Americans in general are less positive about their mental health. A recent Gallup poll found Americans are ranking their mental health status as the lowest in more than two decades. The poll from December of 2022 found that Americans calling their mental health “good” or “excellent” was at 75% — the lowest rate on record and 10 points lower than the average over the past 20 years. Gallup found that 17% of U.S. adults describe their mental health as “only fair” and 7% as “poor;” those numbers are the highest rate of dissatisfaction with mental health in recent years.

Mental health benefits are increasingly important to both workers and employers — especially as businesses compete for talent. A recent survey by software provider Calm found that 57% of employees want their companies to help with stress and anxiety.

The Forbes ranking looked at a set of metrics measuring health care services available for mental health. Insurance status was considered, as well as access to things like mental health centers and financial barriers to seeing providers.

Southern states scored low

The five worst states for mental health care, according to the Forbes ranking, were Texas, Mississippi, Alabama, Georgia, and Florida.

Texas, with the lowest rating, had the highest percentage of adults with a mental illness who were uninsured. It was also the state with the highest percentage of adults with a cognitive disability who could not see a doctor due to cost (41%), and the highest percentage of youth who had a major depressive episode in the past year and did not receive treatment (73%).

Mississippi was the second worst state in the nation, with poor scores on two of the metrics that Forbes considered: the number of mental health treatment centers (36.33 per 10,000 businesses), and the percentage of youth who had a major depressive episode in the past year and did not receive treatment (71.7%).

The five states with the best ranking for mental health care were Vermont, Massachusetts, Rhode Island, Iowa, and Wisconsin.

States with high rates of mental illness

The report also looked at the states with the highest reported rates of mental illness. Montana ranked first, with 26% of adults reporting any mental illness and 7% reporting a serious mental illness. Other states ranked highly were Oregon, Idaho, North Dakota, and Wyoming.

Forbes found that New Jersey ranked as the state with the lowest rate of mental illness, with 19% of adults reporting having any mental illness and 4% of adults reporting having a serious mental illness.

Advice for mental health insurance coverage

The Forbes analysis made a number of suggestions for choosing a health plan that provides good mental health coverage. It said that consumers should take a close look at costs, including copays and deductibles. Making sure that providers are in-network is also important.

Health plan members should also look closely at what medications are covered by their plan — not only whether certain prescription drugs are covered but what copays might be charged.

Related: 67% of employees want their employer to provide mental health support

An important trend in mental health services since the pandemic is the increase in use of telehealth services. Telehealth coverage policies may be changing among some insurance plans as emergency funding for the COVID pandemic is ending.

Another important point is whether a health plan requires a referral from a primary care provider for mental health treatment. The article noted that preferred provider organization plans (PPOs) and exclusive provider organization plans (EPOs) generally do not require referrals from a primary care provider.