Mental Health Shortage Rankings by State
States ranked by mental health HPSA designations. These areas lack sufficient psychiatrists, psychologists, and licensed clinical social workers.
| # | State | Mental Health HPSAs |
|---|---|---|
| 1 | California | 518 |
| 2 | Alaska | 329 |
| 3 | Texas | 328 |
| 4 | Missouri | 253 |
| 5 | Michigan | 248 |
| 6 | Kentucky | 208 |
| 7 | North Carolina | 208 |
| 8 | Arizona | 203 |
| 9 | Washington | 202 |
| 10 | Florida | 198 |
| 11 | New York | 198 |
| 12 | Illinois | 180 |
| 13 | Louisiana | 169 |
| 14 | Iowa | 159 |
| 15 | Wisconsin | 156 |
| 16 | Minnesota | 136 |
| 17 | Ohio | 131 |
| 18 | Oregon | 127 |
| 19 | Oklahoma | 125 |
| 20 | Pennsylvania | 124 |
| 21 | Virginia | 123 |
| 22 | West Virginia | 119 |
| 23 | Kansas | 109 |
| 24 | Montana | 98 |
| 25 | Indiana | 96 |
| 26 | New Mexico | 92 |
| 27 | Nebraska | 91 |
| 28 | Arkansas | 90 |
| 29 | Mississippi | 84 |
| 30 | Tennessee | 83 |
| 31 | Georgia | 79 |
| 32 | Colorado | 79 |
| 33 | South Carolina | 76 |
| 34 | Puerto Rico | 74 |
| 35 | North Dakota | 67 |
| 36 | Idaho | 65 |
| 37 | South Dakota | 63 |
| 38 | Utah | 61 |
| 39 | Maine | 57 |
| 40 | Alabama | 56 |
| 41 | Massachusetts | 51 |
| 42 | Nevada | 45 |
| 43 | New Jersey | 43 |
| 44 | Connecticut | 40 |
| 45 | Hawaii | 32 |
| 46 | Maryland | 29 |
| 47 | Wyoming | 26 |
| 48 | New Hampshire | 20 |
| 49 | Rhode Island | 14 |
| 50 | Vermont | 12 |
| 51 | Delaware | 10 |
| 52 | District of Columbia | 10 |
| 53 | Virgin Islands | 5 |
| 54 | Guam | 4 |
| 55 | American Samoa | 2 |
| 56 | Northern Mariana Islands | 2 |
What the HRSA Mental Health Data Shows
The HRSA Data Warehouse currently lists 6,207 mental health Health Professional Shortage Area designations across the 56 states and territories ranked above. The three states with the heaviest mental health shortage load are California (518 HPSAs), Alaska (329 HPSAs), and Texas (328 HPSAs). The top five states alone account for roughly 27.0% of all mental health HPSA designations nationally, reflecting how unevenly mental health provider capacity is distributed across the country.
States ranked by mental health HPSA designations. These areas lack sufficient psychiatrists, psychologists, and licensed clinical social workers. HRSA designates an area as a mental health HPSA when the population-to-provider ratio crosses a category-specific threshold — 30,000:1 for core mental-health providers (20,000:1 in high-needs areas) — and when barriers like travel time, poverty, or limited nearby providers prevent residents from realistically using the providers they do have. Designations are scored on a 0–25 scale that weights the provider ratio, poverty rate, and travel distance, with scores of 17 and above considered high-priority areas eligible for National Health Service Corps placement and enhanced federal reimbursement. The median state in this ranking reports 84 mental health HPSAs.
The practical meaning of these numbers is that millions of residents in the top-ranked states live in geographies where the nearest mental health provider is either operating above HRSA's supply threshold or too distant to reach on a routine visit. HRSA designations drive eligibility for more than thirty federal programs — NHSC loan repayment up to $50,000, Community Health Center grants, Medicare bonus payments, and J-1 visa waivers for international medical graduates who commit to serving in HPSAs — so the states appearing at the top of this ranking typically also attract a disproportionate share of federal workforce spending. HRSA refreshes designations on a quarterly cycle, and the 56-state ranking here reflects the most recent release in the portal's data refresh. These figures describe the structural supply of mental health providers only, not clinical quality or individual appointment availability, and are not medical advice — residents seeking care should contact a provider directly or consult their insurance network.
About Mental Health Shortages
What is a mental health shortage area?
A mental health HPSA is designated when the population-to-core-mental-health-provider ratio exceeds 30,000:1 (or 20,000:1 with high needs). Core mental health providers include psychiatrists, clinical psychologists, and licensed clinical social workers.
How severe is the US mental health provider shortage?
The US mental health provider shortage is one of the most severe in healthcare. Over half of US counties lack a single psychiatrist. HRSA estimates the nation needs tens of thousands of additional mental health providers to meet current demand.
Are rural areas disproportionately affected by mental health shortages?
Yes. Rural areas face disproportionately high rates of mental health HPSAs. Factors include lower provider pay in rural markets, lack of specialist infrastructure, stigma, and limited telehealth adoption in some communities.
What types of mental health providers count toward HPSA designation?
Core mental health providers include psychiatrists, clinical psychologists, clinical social workers, psychiatric nurse specialists, and marriage and family therapists. The provider-to-population ratio threshold for mental health HPSAs is 30,000:1 (or 20,000:1 in areas with high needs such as high substance abuse or poverty rates).
How does telehealth impact mental health shortage areas?
Telehealth has expanded access to mental health services in some shortage areas, but adoption varies significantly. Rural communities with limited broadband access, older populations less comfortable with technology, and patients requiring in-person psychiatric care still face substantial barriers. HRSA does not currently factor telehealth availability into HPSA designation scoring.
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Read our methodology — how this data is sourced, computed, and verified.