Mapping Mental Health Across US States: the Role of Economic and Social Support Policies

Mental health (e.g., anxiety, depression) continues to be a major public health concern in the United States that impacts millions of individuals, their families, and communities. Approximately 21% of adults 18 years and older, or 55 million adults, reported symptoms of recent depression in 2022, demonstrating the wide reach of mental health challenges.¹ Moreover, rates of depression and anxiety spiked at the onset of the COVID-19 pandemic and have not fully recovered to prepandemic levels, indicating that mental health will continue to be a major concern for population health.^1-3 In addition to the impacts on individuals and their families, mental health challenges have vast economic and social costs. For instance, estimates suggest that depression accounted for $83 billion in costs in 2000,⁴ and suicide and nonfatal self-harm injuries, which are linked to mental health, cost the United States over $500 billion annually from 2015 to 2020.⁵

However, significant variation in mental health exists across states, pointing to states as an important contextual environment to consider. In this perspective, we propose a theoretical perspective that examines how state-level variation in mental health is shaped by clusters of state policies, especially economic and social support policies. To this end, we first describe patterns of population mental health at the national and state level. We then argue that differences in state policy contexts contribute to different rates of mental health outcomes (e.g., depression, anxiety) across states. We conclude by recommending key areas for future research on state policy contexts and mental health that can yield greater insight into potential policy solutions to improve mental health.

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