- Oct 6, 2025
The State of Mental Health in America 2025: Key Insights for Clinicians and Therapists
By Rebecca Stone, LMHC-QS of Stone Counseling & Consulting Services, LLC
As mental health professionals, we often live in the micro — focusing on individual clients, caseloads, and clinical systems. Reports such as The State of Mental Health in America 2025 from Mental Health America (MHA) help remind us of the broader epidemiological, policy, and systemic trends that undergird individual care.
Below is a summary of the key findings from the 2025 report, reflections on what they mean for practice, and possible action steps.
Overview: Goals, Methods, and Context
The 2025 report uses the most recent publicly available data to produce state‐level comparisons and national trends. The data primarily covers years 2022 through 2024.
The report ranks all 50 states plus the District of Columbia across 17 measures covering prevalence of mental illness, substance use, suicidal ideation, access to care, insurance coverage, and provider availability.
The purpose is to provide a snapshot that can guide policy, program planning, evaluation, and advocacy.
The 2025 edition also includes a “Youth Spotlight” supplement, produced in collaboration with the MHA Young Leaders Council, offering strategies for translating data into youth‑oriented advocacy and action.
Key Findings: Trends, Improvements, and Persistent Gaps
1. Prevalence Among Adults: Unchanged but Concerns Remain High
While the plateau in adult reported data might seem superficially “less bad,” the data is still worthy of focus, and the small fluctuations in the recent years’ data should not reduce urgency in addressing this.
In 2024, 23.4%, or approximately 60 million, adults experienced any mental illness (AMI) in the past year.
Serious thoughts of suicide were reported by 5.5% of adults, which is over 14 million people.
Substance use disorders continue to affect a sizeable number of adults at 17.7% or over 46 million adults.
2. Youth Mental Health: Signs of Slight Improvement, but Still Troubling
While the report highlights a modest improvement in youth mental health, youth mental health remains an important area of focus to address.
The proportion of youth ages 12–17 experiencing a major depressive episode (MDE) reduced from 18.10% in 2023 to 15.40% in 2024.
11.30% of youth, or approximately 2.8 million, experienced an MDE with severe impairment (i.e., substantial impact on functioning at school, work, or home).
Similarly, serious thoughts of suicide reported among youth ages 12-17 reduced from 12.30% in 2023 to 10.10% in 2024.
Frequent thoughts of suicide were reported by nearly 3 million youth ages 12-17.
3. Access to Care and Insurance Gaps
Access to mental health care remains a significant barrier to those who need it. Insurance premiums can make access difficult for many. Additionally, low reimbursement rates can lead some mental health providers to remain out-of-network, leading individuals to experience difficulty accessing affordable care.
While the mental health care workforce has grown, the demand is still overwhelming to providers. Approximately 122 million people in the U.S. live in a mental health workforce shortage area. On average in the U.S. in 2024, the ratio of mental health providers to individuals is 1:320.
For adults:
One in four (25%) of adults with AMI reported they had a need for mental health care which was unmet.
Approximately 9.2% of adults with AMI were uninsured in 2022–2023, which is over 5 million people.
Approximately 77% of adults with substance use disorder did not receive treatment.
For youth:
Adolescents aged 12-17, 28.6%, or over 7 million youth, did not have a preventative health care visit in the last year where they could be screened for mental health conditions.
In 2024, just under half (48%) of schools reported they could effectively provide mental health services to students in need, and this represents a 10% decrease from the 2021-2022 school year. Alternatively, this means that approximately 52% of schools have students with mental health needs who are not able to access adequate support. A lack of staffing (55%) and funding (54%) were reported by over half of schools.
Geographic, regional, and demographic disparities continue to present barriers to care. States in the South and ones with greater rural populations tend to show greater gaps in access, higher uninsured rates, and higher unmet need.
4. State Rankings: Winners, Laggards, and Patterns
The report presents state-level rankings across various data points in an effort to identify areas of need and focus, rather than to shame. For instance, New York, Hawaii, and New Jersey rank highest nationally across the 17 measures. Alabama, Arizona, and Nevada, however, scored at the bottom end with lower access to care and a higher prevalence of mental health concerns. Of note, Nevada and Arizona scored he lowest in last year’s report as well.
Detailed rankings are available in the full report.
Implications for Mental Health Professionals
Reading the report through a clinical or systems lens suggests several reflections and possible action paths:
A. Elevate Prevention and Early Intervention
The large numbers of people with mental health problems who remain untreated — especially youth — underscore the importance of upstream approaches:
Integrate screening into routine primary care and school-based settings.
Promote universal prevention programs (e.g., social-emotional learning, resilience curricula).
Advocate for policies that reduce stigma and promote help-seeking.
B. Focus on Equity, Access, and Telehealth/Hybrid Innovations
The gaps in rural, Southern, and underserved states demand creative service models (telehealth, mobile clinics, community mental health programs, partnerships with community organizations).
Disparities by race, ethnicity, socioeconomic status, and region – not just aggregated averages – should be of specific focus.
Advocacy for access to affordable insurance, as well as sustainable insurance reimbursement rates for providers, can help reduce access barriers.
Clinicians and agencies can collaborate on sliding‐scale models, pro bono services, or other reduced rate or consultation networks to reach underinsured populations.
Mental health educator programs can examine program access to improve growth and diversity in the workforce.
C. Youth-Centered Engagement and Youth Voice
The Youth Spotlight report is a reminder that youth themselves offer valuable insights into access barriers, stigma, and intervention preferences that can be of focus.
Incorporating youth advisory councils, peer support models, and youth-driven collaborative program design can enhance relevance and interest.
D. Use Data for Local Advocacy and Program Planning
Many states and local jurisdictions can evaluate their own data on the 17 measures to examine strengths and areas for improvement.
Clinicians, agencies, and associations can benchmark performance, articulate gaps, and push for funding or legislative changes.
In grant proposals, quoting national and state-level trends from MHA can strengthen arguments for resource allocation.
E. Support Workforce Expansion and Burnout Mitigation
The provider availability metric (i.e. number of mental health providers per population) continues to be a concern in many areas and may, not only effect access to care, but also provider burnout.
Mental health professionals and organizations can advocate for funding, incentives, and training pipelines (e.g. loan forgiveness, tele‑supervision).
Within agencies, implement clinician wellness supports and manageable caseload strategies in recognition of workforce strain.
Limitations & Cautions
While the report is helpful to get an overview of the state of mental health in the U.S., please be sure to interpret the report wisely. A few important things to consider include:
Data lag and snapshots: Because much of the data comes from 2022–2023, it may not reflect more recent shifts (e.g. effects of policy changes, funding initiatives).
State comparisons mask within-state variation: Even a “high ranking” state may have underserved subregions or demographic groups which may have important factors that are masked by larger, well-served subregions or demographic groups.
Unmeasured dimensions: The report relies on available federal metrics — quality of care, patient satisfaction, functional outcomes, and social determinants often lie outside the metrics.
Causality not implied: The report is descriptive rather than explanatory; it cannot tell us exactly why a state fares better or worse, but it gives pointers for further inquiry.
Final Thoughts & Call to Action
The State of Mental Health in America 2025 is simultaneously hopeful and concerning. On the one hand, its finding of a slight uptick in youth mental health suggests that policy efforts, awareness, and innovations may be starting to move the needle. On the other, the vast numbers of adults and youth with unmet needs and the overwhelm on the workforce remind us how far we must go.
For mental health professionals, the report is not just a passive read — it is a catalyst:
Use it to inform program design and strategic priorities.
Partner with policymakers, schools, public health agencies, and community organizations.
Advocate locally using state‐level data as leverage, and encourage a deeper-dive into more micro-level data of mental health within the state.
Amplify underserved populations and youth voices.
Continue to experiment with new care models (e.g. telehealth, peer support, group therapy, collaborative care) especially in under-resourced settings.
Advocate for healthcare and insurance reform, including affordable access and higher reimbursement rates for mental health care providers, to improve sustainable access to care.
Wanting to Create Your Own Practice?
Learn how to plan, launch, and maintain your own solo mental health practice (including how to credential with insurance and improve access to care) in our self-paced e-course, How to Start a Solo Private Practice.
Wanting to learn more? Looking for something specific?
About Rebecca Stone, LMHC-QS
Rebecca Stone, LMHC-QS, is a Licensed Mental Health Counselor, Qualified Supervisor, and owner of Stone Counseling & Consulting Services, LLC, a private practice based in Florida. With over a decade of experience in clinical therapy and a strong background in business and office management, Rebecca blends compassionate care with operational expertise. She is passionate about supporting individuals on their mental health journey—and empowering fellow professionals through supervision, consultation, training and education, and practical tools to grow thriving practices.