Key findings:

  • An estimated 9.2 million people have lost employer-provided health insurance from over 20 million unemployment claims as of April 16th.
  • People losing employer-provided health insurance could decline by up to 35 million, including both workers and family members.
  • 88% of workers reported experiencing moderate to extreme stress over the past 4 to 6 weeks of the COVID-19 pandemic.
  • States with a high rate of access to mental healthcare saw a decrease in depression rates from 2014 to 2018.
  • Access to mental healthcare through insurance is an already significant barrier for people with depression and mental illness could worsen.

Depression is one of the most common mental illnesses in America, with over 17 million U.S. adults suffering from it. As it is one of the most common mental illnesses, there are many risk factors that affect Americans: Many are predisposed to depression through genetics, while some can be affected by things like stress, poor diet and substance abuse. For people to manage depression, access to mental health care is essential for those suffering from it.

Lack of access to mental health care is a serious issue for many with depression. Over 24 million adults with a mental illness did not receive any mental health treatment — nine million adults with a mental illness reported having tried and not been able to receive treatment. Another five million people with mental illness are living uninsured.

With lack of treatment for people already dealing with mental illness and depression, the heightened levels of anxiety from the COVID-19 pandemic have created a greater need for treatment. According to Dr. Dani Fallin, chair of the department of mental health at Johns Hopkins, “The wave of anxiety from the pandemic, plus the additional consequences of social isolation, can be a difficult combination.”

The need for mental health care treatment has been met by advances in telehealth. Companies like Ginger provide a technological platform for patients to connect with therapists on demand. A recent survey by Ginger indicates nearly 88% of workers reported experiencing moderate to extreme stress over the past four to six weeks during the COVID-19 outbreak. The elevated stress of Americans during shelter-in-place orders has to be met with online therapy. Kaiser Permanente announced that over 90% of mental health visits are now happening virtually.

Many with mental health care needs are lucky to have their treatment available online during the shelter-in-place orders. However, what can’t be overlooked during the COVID-19 pandemic are the millions of people losing their jobs and insurance with it. With over 20 million unemployment claims across the country, the Economic Policy Institute estimates 9.2 million of those workers likely lost employer-provided health insurance. Along with employer health insurance, those 9.2 million people are also losing access to mental health care coverage during a critical time where people need it the most. Those uninsured figures could increase to 12 to 35 million people, including family members, over the coming months.

The chain reaction from the millions of people filing for unemployment are the millions who will seek to enroll in Medicaid as a result. Health Management Associates estimates Medicaid enrollment could increase from 71 million to 82 to 94 million. The increase in Medicaid enrollment is the likely route for many as COBRA and ACA insurance plans will likely become too costly for those filing for unemployment. In many states, job loss will qualify most people for Medicaid; however, those unemployed seeking health insurance in the 14 non-expansion Medicaid states — which account for over one-third of all jobs in the country — could face hurdles. Given the requirements, many recently unemployed may not qualify for Medicaid in non-expansion states, which could push the number of uninsured Americans to over 40 million.

The troubling outlook here is that people who have lost their insurance to unemployment and live in non-expansion states could struggle to even qualify for Medicaid, leaving people who need mental health care during this critical time of heightened anxiety without coverage to receive treatment. What’s more is that nine of the top 10 worst states for mental health care access are also non-expansion states. Texas, Georgia, Mississippi and South Carolina are non-expansion states that top the country in lack of access to mental health care. The troubling outlook could leave millions of people jobless and uninsured without the support of mental health care during arguably one of the greatest times of need for mental health care.

To get rankings, we analyzed Centers for Disease Control and Prevention (CDC) data on depression rates in each state over a five-year period from 2014 to 2018. Our final rankings are an average rate over the same five-year period. States with the highest rates of depression are ranked 1st to 50th (lowest rate of depression). Also included with each state’s depression rates is the percentage of change in depression rates from 2014 to 2018. The percentage change is intended to show which states have seen an increase or decrease in depression rates. Access rankings from Mental Health America rank states from 1 to 50, with 1 being the state with the best access to mental health care and 50 being that with the worst access to mental health care.

Rank State Depression Rate % Change in Depression Rate Access Rank
1 Oregon 25.20% 9.17% 23
2 West Virginia 24.62% 12.71% 28
3 Maine 23.52% -3.80% 5
4 Arkansas 23.2% 4.65% 34
5 Kentucky 22.84% 0.42% 30
6 Oklahoma 22.70% 6.88% 38
7 Alabama 22.64% 12.68% 45
8 Vermont 22.64% -2.75% 1
9 Tennessee 22.36% 17.76% 41
10 Washington 22.22% 9.26% 24
11 Utah 21.98% 17.39% 37
12 Missouri 21.96% 2.30% 25
13 Michigan 21.74% 13.17% 14
14 Rhode Island 21.62% 0.97% 3
15 New Hampshire 21.54% -1.43% 9
16 Louisiana 20.76% 24.06% 40
17 Montana 20.58% 7.35% 27
18 Ohio 20.10% -4.31% 10
19 South Carolina 20.06% 0.00% 46
20 Indiana 20.06% -4.83% 21
21 Mississippi 19.86% 9.05% 47
22 Pennsylvania 19.62% 9.64% 12
23 New Mexico 19.60% -18.48% 20
24 Massachusetts 19.56% -16.59% 2
25 Kansas 19.24% 11.29% 42
26 North Carolina 19.16% 4.21% 43
27 Idaho 19.14% 0.00% 31
28 Wyoming 18.92% -5.79% 44
29 Minnesota 18.18% -3.30% 7
30 North Dakota 18.14% 13.29% 17
31 Nebraska 17.96% -2.26% 33
32 Wisconsin 17.92% 15.29% 6
33 Delaware 17.90% -7.65% 13
34 Iowa 17.88% -12.30% 4
35 Arizona 17.88% -10.70% 35
36 Colorado 17.58% -7.65% 16
37 Georgia 17.32% -6.56% 49
38 Connecticut 16.98% -15.30% 8
39 Virginia 16.92% -4.60% 36
40 Alaska 16.90% 29.49% 22
41 Illinois 16.80% 5.99% 19
42 South Dakota 16.42% -1.81% 29
43 Nevada 16.14% 0.64% 48
44 Maryland 16.12% -3.14% 11
45 Florida 15.92% -3.70% 39
46 Texas 15.28% 13.01% 50
47 New York 14.88% -5.03% 15
48 California 14.48% 15.79% 26
49 New Jersey 12.98% -11.94% 32
50 Hawaii 11.76% 17.76% 18

Methodology

QuoteWizard analyzed Center for Disease Control (CDC) data to find the prevalence of depression in each state. We analyzed depression rates in each state over a period from 2014 to 2018 to find a five-year average in each state. Rankings 1 to 50 are based on the five-year average of depression rates. Prevalence of depression rates in each state are determined by people who have indicated a diagnosis of a form of depression. Also included is the percentage change in depression rates from 2014 to 2018 to show to increase and decrease of depression rates in each state. Access to mental healthcare rankings provided by Mental Health America to show direct correlation of how access to mental healthcare impacts the increase or decrease of depression rates.