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Frequent Mental Distress in United States
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United States
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Explore national- and state-level data for hundreds of health, environmental and socioeconomic measures, including background information about each measure. Use features on this page to find measures; view subpopulations, trends and rankings; and download and share content.

United States Value:

15.6 %

Percentage of adults who reported their mental health was not good 14 or more days in the past 30 days

Value and rank based on data from 2024

Frequent Mental Distress in depth:

Additional Measures:

Frequent Mental Distress - Age 65+
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Frequent Mental Distress - Women
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Appears In:

Annual Report
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Frequent Mental Distress by State: Not Served

Percentage of adults who have not served in the U.S. armed forces who reported their mental health was not good 14 or more days in the past 30 days

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Frequent Mental Distress in

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Frequent Mental Distress Trends in
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State Data
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Data from U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2024

12.4% - 14.0%

14.1% - 15.2%

15.3% - 15.9%

16.0% - 17.3%

17.4% - 20.1%

No Data

• Data Unavailable
Top StatesRankValue
Hawaii
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112.4 %
Illinois
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North Dakota
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213.0 %
Massachusetts
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413.2 %
New Jersey
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513.3 %
South Dakota
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613.5 %
Bottom StatesRankValue
Oklahoma
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4518.6 %
Oregon
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4619.4 %
West Virginia
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4719.8 %
Louisiana
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4819.9 %
Arkansas
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4920.1 %

Frequent Mental Distress: Not Served

Hawaii
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112.4 %
Illinois
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213.0 %
North Dakota
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213.0 %
Massachusetts
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413.2 %
New Jersey
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513.3 %
South Dakota
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613.5 %
Mississippi
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713.6 %
Nebraska
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713.6 %
Connecticut
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914.0 %
Maryland
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1014.2 %
New York
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1014.2 %
Minnesota
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1214.3 %
Arizona
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1314.4 %
North Carolina
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1414.5 %
Rhode Island
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1514.6 %
California
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1614.8 %
Iowa
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1714.9 %
New Hampshire
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1815.0 %
Colorado
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1915.2 %
Idaho
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2015.3 %
South Carolina
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2015.3 %
Texas
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2215.4 %
Utah
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2215.4 %
Vermont
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2415.6 %
Wyoming
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2515.7 %
Florida
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2615.8 %
Kansas
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2615.8 %
Alaska
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2815.9 %
Virginia
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2815.9 %
Georgia
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3016.2 %
Pennsylvania
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3116.5 %
Washington
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3216.6 %
Maine
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3316.7 %
Montana
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3316.7 %
Delaware
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3516.8 %
Indiana
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3617.1 %
Michigan
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3617.1 %
Ohio
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3617.1 %
Wisconsin
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3917.3 %
Missouri
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4017.5 %
New Mexico
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4117.8 %
Alabama
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4217.9 %
Nevada
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4217.9 %
Kentucky
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4418.5 %
Oklahoma
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4518.6 %
Oregon
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4619.4 %
West Virginia
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4719.8 %
Louisiana
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4819.9 %
Arkansas
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4920.1 %
United States
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•15.5 %
District of Columbia
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•13.4 %
Tennessee
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[3]
••
• Data Unavailable
[3] Data is missing in the source files
Source:
  • U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2024

Frequent Mental Distress Trends by Veteran Status

Percentage of adults who reported their mental health was not good 14 or more days in the past 30 days

About Frequent Mental Distress

US Value: 15.6 %

Top State(s): Hawaii, North Dakota: 12.6 %

Bottom State(s): Arkansas: 19.9 %

Definition: Percentage of adults who reported their mental health was not good 14 or more days in the past 30 days

Data Source and Years(s): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2024

Suggested Citation: America's Health Rankings analysis of U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2026.

A healthy mental state is key to overall health and well-being and is influenced by individual, community, family and societal factors. Frequent mental distress, defined by 14 or more days of poor mental health a month, aims to capture the population experiencing persistent and likely severe mental health issues. There is a strong link between the 14-day period and clinically diagnosed mental disorders, such as depression and anxiety.

Mental health problems among young adults are associated with a higher prevalence of risky health behaviors, including smoking, alcohol use, unhealthy diet and lack of physical activity. These health behaviors increase the likelihood of developing chronic diseases like diabetes, cancer and cardiovascular disease. Chronic stressors such as housing insecurity, food insecurity and insufficient sleep are also related to frequent mental distress. In severe cases, poor mental health can lead to suicide, one of the leading causes of death in the United States. 

A recent study found that the estimated cost attributed to mental health in the U.S. is $282 billion annually. 

According to America’s Health Rankings data, the prevalence of frequent mental distress is higher among:

  • Women compared with men.
  • Adults ages 18-44 compared with older adults.
  • Multiracial, American Indian/Alaska Native and Hawaiian/Pacific Islander adults compared with Asian adults.
  • Adults with less than a high school education compared with college graduates.
  • Adults with an annual household income of $25,000 or less, who have a prevalence nearly three times higher than adults with an annual income of $150,000 or more.
  • Adults who have difficulty with cognition, who have a prevalence five times higher than adults without a disability.
  • Lesbian, gay, bisexual and queer (LGBQ+) adults compared with straight adults.

Additionally, a study investigating avoidance of care due to cost found that the prevalence of frequent mental distress was higher among adults without health insurance, adults who are unemployed or unable to work, and adults who are divorced, widowed or separated.

Although occasional short periods of mental distress and a few bad mental health days may be unavoidable, more prolonged and severe episodes are treatable and potentially preventable through early intervention. Mental health parity laws that expanded and protected insurance coverage for mental health care are associated with lower out-of-pocket costs, lower suicide rates and increased use of health care services. Collaborative care models, which connect primary care providers and mental health specialists, are also effective in managing depressive disorders. 

The Community Guide lists several strategies that are effective at improving mental health, including:

  • School-based cognitive behavioral therapy. 
  • Home-based depression care management. 
  • Collaborative care.

The RAND Corporation has recommendations to transform the mental health system centered around three main goals: promoting pathways to care, improving access to care and establishing a continuum of evidence-based care.

Surveillance systems for mental health issues — including frequent mental distress — help prioritize and tailor mental health promotion, mental illness prevention and treatment programs. The Centers for Disease Control and Prevention has a resources page for mental health.

Healthy People 2030 has several objectives related to mental health, including: 

  • Increasing the proportion of primary care visits where adolescents and adults are screened for depression.
  • Increasing the proportion of adults with depression who get treatment.
  • Increasing the proportion of adults with serious mental illness who get treatment.
  • Increasing the proportion of homeless adults with mental health problems who get mental health services.

Abramson, Boaz, Job Boerma, and Aleh Tsyvinski. Macroeconomics of Mental Health. Cambridge, MA: National Bureau of Economic Research, April 2024. https://doi.org/10.3386/w32354.

Arango, Celso, Covadonga M. Díaz-Caneja, Patrick D. McGorry, Judith Rapoport, Iris E. Sommer, Jacob A. Vorstman, David McDaid, et al. “Preventive Strategies for Mental Health.” The Lancet Psychiatry 5, no. 7 (July 2018): 591–604. https://doi.org/10.1016/S2215-0366(18)30057-9.

Bruning, John, Ahmed A. Arif, and James E. Rohrer. “Medical Cost and Frequent Mental Distress Among the Non-Elderly US Adult Population.” Journal of Public Health 36, no. 1 (March 1, 2014): 134–39. https://doi.org/10.1093/pubmed/fdt029.

Caceres, Billy A., Abraham A. Brody, Perry N. Halkitis, Caroline Dorsen, Gary Yu, and Deborah A. Chyun. “Cardiovascular Disease Risk in Sexual Minority Women (18-59 Years Old): Findings from the National Health and Nutrition Examination Survey (2001-2012).” Women’s Health Issues 28, no. 4 (July 1, 2018): 333–41. https://doi.org/10.1016/j.whi.2018.03.004.

Hydes, Theresa J., Robyn Burton, Hazel Inskip, Mark A. Bellis, and Nick Sheron. “A Comparison of Gender-Linked Population Cancer Risks between Alcohol and Tobacco: How Many Cigarettes Are There in a Bottle of Wine?” BMC Public Health 19, no. 316 (March 28, 2019). https://doi.org/10.1186/s12889-019-6576-9.

Liu, Yong, Rashid Njai, and Kurt J. Greenlund. “Relationships Between Housing and Food Insecurity, Frequent Mental Distress, and Insufficient Sleep Among Adults in 12 US States, 2009.” Preventing Chronic Disease 11 (March 13, 2014). https://doi.org/10.5888/pcd11.130334.

Massetti, Greta M., Cheryll C. Thomas, Jessica King, Kathleen Ragan, and Natasha Buchanan Lunsford. “Mental Health Problems and Cancer Risk Factors Among Young Adults.” American Journal of Preventive Medicine 53, no. 3 Suppl 1 (September 1, 2017): S30–39. https://doi.org/10.1016/j.amepre.2017.04.023.

McBain, Ryan K., Nicole K. Eberhart, Joshua Breslau, Lori Frank, M. Audrey Burnam, Vishnupriya Kareddy, and Molly M. Simmons. Transforming Mental Health Care in the United States. RAND Corporation, 2021. https://doi.org/10.7249/RBA889-1.

Rashid, Mamunur, M. Mazharul Islam, Aiping Li, and Naima Shifa. “Frequent Mental Distress among Adults in the United States and Its Association with Socio-Demographic Characteristics, Lifestyle, and Chronic Health Condition.” Journal of Public Health and Development 20, no. 1 (January 30, 2022): 146–62. https://doi.org/10.55131/jphd/2022/200112.

Reeves, William C., Tara W. Strine, Laura A. Pratt, William Thompson, Indu Ahluwalia, Satvinder S. Dhingra, Lela R. McKnight-Eily, et al. “Mental Illness Surveillance Among Adults in the United States.” MMWR Supplements 60 (September 2, 2011). https://www.cdc.gov/mmwr/preview/mmwrhtml/su6003a1.htm.

Slabaugh, S. Lane, Mona Shah, Matthew Zack, Laura Happe, Tristan Cordier, Eric Havens, Evan Davidson, Michael Miao, Todd Prewitt, and Haomiao Jia. “Leveraging Health-Related Quality of Life in Population Health Management: The Case for Healthy Days.” Population Health Management 20, no. 1 (2017): 13–22. https://doi.org/10.1089/pop.2015.0162.

Related Measures

Adverse Childhood Experiences
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Depression
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Drug Deaths
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Excessive Drinking
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Exercise
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Frequent Physical Distress
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Mental Health Providers
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Non-Medical Drug Use - Past Year
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Per Capita Income
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Primary Care Providers
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Suicide
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Teen Suicide
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Unemployment
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Uninsured
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