A new nationwide analysis has revealed which U.S. states have the highest rates of major depressive episodes among adolescents — and the findings highlight how unevenly youth mental health challenges are spread across the country. While the national average sits at 118.3 cases per 1,000 adolescents, several states far exceed that number, indicating an urgent need for expanded support, early intervention, and accessible resources for young people.
The study, conducted by Simmrin Law Group using federal data from KFF's Mental Health dataset (2021–2023), examined how many adolescents aged 10–19 reported experiencing a major depressive episode in each state and calculated the rates per 1,000 teens.
Nevada Has the Highest Rate of Teen Depression in the U.S.
Nevada ranked number one with 144.0 cases per 1,000 adolescents, placing it more than 21% above the national average.
The state recorded an average of 57,000 adolescents experiencing a major depressive episode each year from 2021 to 2023.
Although the number dipped slightly between 2022 and 2023, the overall rate remains the highest in the country. Nevada has long struggled with mental health access and provider shortages, and experts say limited availability of care may be contributing to consistently elevated numbers.
Oregon and Arizona Follow Closely Behind
In second place, Oregon reported 139.0 cases per 1,000 adolescents, while Arizona followed in third with 136.1 cases per 1,000.
Both states saw tens of thousands of teens affected annually, with Oregon averaging 71,000 affected adolescents and Arizona averaging 130,000 during the three-year period.
These states have also reported rising levels of sadness, anxiety, and stress among teens in recent youth surveys — trends that align with national increases documented by the CDC.
Maryland and Colorado Round Out the Top Five
The fourth- and fifth-highest prevalence rates were seen in:
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Maryland: 134.3 per 1,000 adolescents
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Colorado: 134.2 per 1,000 adolescents
Each of these states sits more than 13% above the national average, suggesting a combination of social, environmental, and access-related factors may be shaping mental health outcomes for young people.
Other States With Elevated Teen Depression Rates
The top 10 highest-risk states also include:
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New Mexico — 133.1 per 1,000
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Washington — 132.8 per 1,000
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Minnesota — 130.3 per 1,000
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New Hampshire — 127.9 per 1,000
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Idaho — 127.6 per 1,000
Although these states vary widely in population, culture, and geography, experts say several shared influences may be contributing: digital stress, academic pressure, economic instability, and limited access to youth-specific mental health services.
What Experts Say These Numbers Really Mean
A spokesperson for Simmrin Law Group explained that the findings underscore how urgently adolescents need accessible support:
“Adolescent depression is a serious and often under-recognized public health issue. These disparities suggest that healthcare access, socioeconomic conditions, and community support all play critical roles in shaping mental health outcomes.”
The spokesperson added that state and local strategies — not just national ones — will be key in closing the gap.
A Look at the States With the Lowest Rates
At the other end of the spectrum, Hawaii reported the lowest adolescent depression rate at 98.8 cases per 1,000 adolescents.
Researchers say cultural protective factors, strong community ties, and high engagement with outdoor activities may help explain why Hawaii consistently ranks lower in youth depression metrics.
How Families and Communities Can Support Teens
While the data highlights where support is most urgently needed, mental health experts stress that there are meaningful steps families, schools, and communities can take right now:
Encourage early conversations: Normalizing discussions about emotional wellbeing helps teens feel more comfortable seeking support later.
Promote daily routines: Regular sleep patterns, physical activity, and outdoor time can help stabilize mood and reduce symptoms.
Strengthen social connection: In-person friendships and supportive adults play a major role in protecting mental health.
Watch for early warning signs: Behavioral changes, withdrawal, mood swings, declining school performance, or persistent sadness should be taken seriously.
Seek help early: School counselors, mental health hotlines, youth support services, and teletherapy offer accessible pathways to professional support.
Why This Data Matters
Major depressive episodes in adolescence can shape long-term health, academic performance, relationships, and overall well-being. Identifying which states carry the highest risk helps policymakers allocate resources more effectively — but it also empowers families and communities to act early.
The study draws from publicly available KFF Mental Health data covering the years 2021–2023.
