The State of Mental Health in 2024

Annual Report on Mental Health in America

Mental Health America – National has released their 2024 State of Mental Health in America report. It ranks all 50 states and the District of Columbia according to 15 mental health access and prevalence measures.

Why Is This Important?

We believe that gathering and providing up-to-date data and information about disparities faced by individuals with mental health problems is a tool for change.

Where South Carolina Ranks

Adult Mental Health: 25th

For adult mental health, South Carolina ranks 25 out of the 50 states + DC.

The seven measures that make up the Adult Ranking include:

1.  Adults with Any Mental Illness (AMI)
2.  Adults with Substance Use Disorder in the Past Year
3.  Adults with Serious Thoughts of Suicide
4.  Adults with SUD Who Needed But Did Not Receive Treatment
5.  Adults with AMI Who are Uninsured
6.  Adults Reporting 14+ Mentally Unhealthy Days a Month Who Could Not See a Doctor Due to Costs
7.  Adults with AMI with Private Insurance That Did Not Cover Mental or Emotional Problems

States that are ranked 1-13 have a lower prevalence of mental illness and higher rates of access to care for adults. States that are ranked 39-51 indicate that adults have a higher prevalence of mental illness and lower rates of access to care.

Youth Mental Health: 35th

The seven 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 Serious Thoughts of Suicide
4.  Youth (Ages 6-17) Flourishing
5.  Youth with MDE Who Did Not Receive Mental Health Services
6.  Youth with Private Insurance That Did Not Cover Mental or Emotional Problems
7.  Students (K+) Identified with Emotional Disturbance for an Individualized Education Program.

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

Prevalence of Mental Illness: 4th

South Carolina ranks 4 out of the 50 states + DC.

A ranking 1-13 for Prevalence indicates a lower prevalence of mental health and substance use issues compared to states that ranked 39-51.

The seven measures that make up the Prevalence Ranking include:

1. Adults with Any Mental Illness (AMI)
2. Adults with Substance Use Disorder in the Past Year
3. Adults with Serious Thoughts of Suicide
4. Youth with at Least One Major Depressive Episode (MDE) in the Past Year
5. Youth with Substance Use Disorder in the Past Year
6. Youth with Serious Thoughts of Suicide
7. Youth (Ages 6-17) Flourishing

Key Findings

Access to Care: 49th

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 mental health workforce availability. A high Access Ranking (1-13) indicates that a state provides relatively more access to insurance and mental health treatment than those ranked 39-51.

The eight measures that make up the Access Ranking include:  

1. Adults with SUD Who Needed But Did Not Receive Treatment
2. Adults with AMI who are Uninsured
3. Adults Reporting 14+ Mentally Unhealthy Days a Month Who Could Not See a Doctor Due to Costs
4. Adults with AMI with Private Insurance that Did Not Cover Mental or Emotional Problems
5. Youth with MDE Who Did Not Receive Mental Health Services
6. Youth with Private Insurance that Did Not Cover Mental or Emotional Problems
7. Students (K+) Identified with Emotional Disturbance for an Individualized Education Program
8. Mental Health Workforce Availability

Overall: 30th

An overall ranking of 1-13 indicates lower prevalence of mental illness and higher rates of access to care. An overall ranking of 39-51 indicates higher prevalence of mental illness and lower rates of access to care. The combined scores of all 15 measures make up the overall ranking.  The overall ranking includes both adult and youth measures, as well as prevalence and access to care measures. 

The 15 measures that make up the overall ranking include:

1. Adults with Any Mental Illness (AMI)
2. Adults with Substance Use Disorder in the Past Year
3. Adults with Serious Thoughts of Suicide
4. Youth with at Least One Major Depressive Episode (MDE) in the Past Year
5. Youth with Substance Use Disorder in the Past Year
6. Youth with Serious Thoughts of Suicide
7. Youth (Ages 6-17) Flourishing
8. Adults with SUD Who Needed But Did Not Receive Treatment
9. Adults with AMI Who Are Uninsured
10. Adults Reporting 14+ Mentally Unhealthy Days a Month Who Could Not See a Doctor Due to Costs
11. Adults with AMI with Private Insurance That Did Not Cover Mental or Emotional Problems
12. Youth with MDE Who Did Not Receive Mental Health Services
13. Youth with Private Insurance That Did Not Cover Mental or Emotional Problems
14. Students (Grades K+) Identified with Emotional Disturbance for an Individualized Education Program
15. Mental Health Workforce Availability

National Key Findings

• In 2021-2022, 23% of adults experienced a mental illness in the past year, equivalent to nearly 60 million Americans.
• More than 5% of the U.S. adult population (12.8 million people) reported experiencing serious thoughts of suicide. After slight decreases in suicide deaths in 2019 and 2020, the number of individuals who died by suicide in 2022 was the highest number ever recorded in the U.S.
• 13% of youth ages 12-17 reported experiencing serious thoughts of suicide. The percentage of youth reporting suicidal ideation was highest among youth who identified as Native Hawaiian or Other Pacific Islander (25%) and more than one race (20%).
• 1 in 5 youth had at least one major depressive episode (MDE) in the past year. Over half of them – nearly 3 million youth – did not receive treatment. Of those who did receive treatment, only 65% said it helped them.
• The vast majority of individuals with a substance use disorder in the U.S. are not receiving treatment. 18% of adults in the U.S. had a substance use disorder in the past year. Of them, 77% did not receive treatment.
• 9% of youth in the U.S. had a substance use disorder in the past year. Youth were more likely to struggle with drugs than alcohol – 3% had an alcohol use disorder in the past year, while 7% had a drug use disorder.

• 60.5% of youth in the U.S. are flourishing, which is associated with school engagement and other positive outcomes for youth. The percentage of youth who were flourishing was highest in Georgia, Illinois, and Hawaii.
• Cost is still a significant barrier to accessing mental health care. 1 in 4 adults with frequent mental distress could not see a doctor due to cost, a 2% increase over the last report.
• 10% of adults with a mental illness are uninsured. In 2022, 64% of adults who were uninsured said that they did not have health insurance because they could not afford it.
• Millions of adults and youth in the U.S. still lack parity in insurance coverage of mental health and substance use services. 10% of adults and 8.5% of youth still have private insurance that does not cover mental health.
• Only 0.67% of students are identified as having an emotional disturbance (ED) for an Individualized Education Program (IEP). While there was an increase in mental distress among students from 2019-2021, the percentage of students identified with emotional disturbance for an IEP decreased in all states except for Wyoming, Texas, and South Dakota.
• There are 340 people for every 1 mental health provider in the U.S. However, these figures may be an overestimate of active mental health professionals, as it may include providers who are no longer practicing or accepting new patients.

Methods for Rankings

MHA used data that was: publicly available and as current as possible to provide up-to-date results; available for all 50 states and the District of Columbia; available for both adults and youth; and able to capture information regardless of varying utilization of the private and public mental health system.

The rankings are based on the percentages, or rates, for each state collected from the most recently available data, mostly up through 2022 (see below for more specifics on time period). States with positive outcomes are ranked higher (closer to one) than states with poorer outcomes (closer to 51). The overall, adult, youth, prevalence, and access rankings were analyzed by calculating a standardized score (Z score) for each measure and ranking the sum of the standardized scores. For most measures, lower percentages equated to more positive outcomes (e.g., lower rates of substance use or those who are uninsured).

There are three measures where high percentages equate to better outcomes. These include “Youth Flourishing,” “Students Identified with Emotional Disturbance for an Individualized Education Program,” and “Youth with MDE Who Reported Treatment or Counseling Helped Them.” Here, the calculated standardized score was multiplied by -1 to obtain a reverse Z score that was used in the sum. All measures were considered equally important, and no weights were given to any measure in the rankings.