Medicaid is the single largest payer for mental health services in the United States, serving as the critical conduit for access to behavioral health care among vulnerable populations. An estimated 58.7 million U.S. adults—nearly one in four—live with a mental illness. Among Medicaid enrollees, the prevalence is even higher: 34.6% experienced some form of mental illness in 2023, compared to 23.9% of those with private insurance.
Mental illness rates have climbed steadily across the nation. In 2015, 17.9% of adults reported a mental illness; by 2023, that figure had risen to 22.8%. Young adults aged 18 to 25 have been disproportionately affected, with rates rising from 21.7% in 2015 to 36.2% in 2022, before dipping slightly to 33.8% in 2023. Income level significantly impacts mental health outcomes. In 2023, 19.4% of adults living below the federal poverty line reported regularly feeling worried, nervous, or anxious, compared to 15.8% of those with incomes between 100% and 199% of the poverty line, and 10.7% of those at or above 200% of the poverty line.
A Behavioral Health Performance Index developed by Addiction-Rep ranks state Medicaid programs across four categories: initiation and engagement, evidence-based medication use, care continuity and follow-up, and patient experience. Top-performing states—including New Hampshire (first), Massachusetts (second), and Vermont (third)—scored above 73. These states in the Northeast and Appalachia excelled at treatment initiation, follow-up care, and evidence-based medication use.
Nevada ranked near the bottom with a Behavioral Health Performance Index score of 32.43. The state scored 50.00 for initiation and engagement, 20.73 for evidence-based medication use, 41.13 for care continuity and follow-up, and just 17.87 for patient experience. Large, populous states including California, Texas, Illinois, Georgia, Arkansas, and Oklahoma all appeared in the bottom 10 rankings. California demonstrated strength in evidence-based medications and follow-up care but struggled with treatment initiation and patient experience.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://jrreport.wordandbrown.com/2025/05/15/nevada-medicaid-program-ranks-5th-worst-for-mental-health-services/