Measures › Health status › Frequent Mental Distress
Health status · BRFSS 2023
Frequent mental distress among adults
US estimate 15.6% (95% interval 15.3–15.8), age-adjusted 16.3% (16.0–16.6). Published in the 2022, 2023, 2024, 2025 releases.
- Population: All Adults
- Prevalence (crude and age-adjusted) Time Period of Case Past 30 days Definition
Frequent mental distress among adults: CDC's PLACES 2025 release estimates 15.6% nationally (95% confidence interval 15.3–15.8%), or 16.3% age-adjusted, from 2023 BRFSS responses.
Across the 2,956 counties with a 2025 estimate, the median county is 17.2% and the middle half of counties fall between 15.8% and 18.4%; the full range runs from 11.5% to 25.7%. Population-weighted state figures computed by this site (no interval) range from 14.1% (Nebraska) to 21.1% (West Virginia).
CDC advises that areas may be compared on individual measures but that the estimates should not be used to rank overall health; the county lists below are ordered by point estimate and every row carries its 95% confidence interval.
CDC's definition
A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults aged ≥ 18 years who report that their mental health (including stress, depression, and problems with emotions) was not good for 14 or more days during the past 30 days. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation.
CDC's notes: Although this measure is based on self-assessment, the number of days has been demonstrated to have good reliability, validity, and responsiveness.
Quoted from CDC's PLACES measure definitions (cdc.gov/places/measure-definitions). BRFSS is the Behavioral Risk Factor Surveillance System, the telephone survey the model is trained on.
National distribution across counties
Crude county point estimates in the 2025 release, 24 equal bins. Deciles: 10th 14.4%, 25th 15.8%, median 17.2%, 75th 18.4%, 90th 19.6%. Counties without a 2025 estimate (Kentucky, Pennsylvania and the states without the social-needs module) are excluded here.
By state
Crude prevalence is the estimated share of all adults. Age-adjusted prevalence is standardised to the 2000 US standard population so that areas with different age structures can be compared. CDC: "Age-adjusted estimates are only available at the county and place-level."
| State | State figure, crude (site aggregate) | Lowest county | Highest county | Counties |
|---|---|---|---|---|
| West Virginia | 21.1% | 18.6% | 24.1% | 55 |
| Louisiana | 19.3% | 16.9% | 23.2% | 64 |
| Tennessee | 19.3% | 15.1% | 23.4% | 95 |
| Arkansas | 18.5% | 16.5% | 21.0% | 75 |
| Nevada | 18.4% | 14.5% | 19.7% | 17 |
| Oklahoma | 18.0% | 14.4% | 21.2% | 77 |
| Maine | 17.7% | 15.3% | 19.7% | 16 |
| Indiana | 17.6% | 13.7% | 20.2% | 92 |
| Michigan | 17.6% | 13.4% | 21.7% | 83 |
| Missouri | 17.5% | 15.1% | 20.5% | 115 |
| Ohio | 17.5% | 13.5% | 21.5% | 88 |
| Oregon | 17.5% | 15.6% | 19.3% | 36 |
| Kentucky (2024 release) | 17.4% | 13.8% | 22.0% | 120* |
| Mississippi | 17.3% | 14.6% | 20.3% | 82 |
| Utah | 17.3% | 13.6% | 20.5% | 29 |
| Alabama | 17.2% | 14.6% | 20.1% | 67 |
| Montana | 17.2% | 14.8% | 23.2% | 56 |
| Georgia | 16.9% | 13.2% | 20.8% | 159 |
| Texas | 16.9% | 12.8% | 20.3% | 253 |
| Rhode Island | 16.7% | 13.9% | 17.9% | 5 |
| North Carolina | 16.5% | 13.8% | 20.1% | 100 |
| California | 16.4% | 13.1% | 20.0% | 58 |
| Iowa | 16.4% | 14.1% | 17.5% | 99 |
| Pennsylvania (2024 release) | 16.4% | 13.3% | 19.3% | 67* |
| South Carolina | 16.4% | 13.1% | 20.2% | 46 |
| Washington | 16.4% | 13.0% | 20.9% | 39 |
| Idaho | 16.2% | 13.1% | 22.7% | 44 |
| Massachusetts | 16.2% | 13.8% | 18.9% | 14 |
| Alaska | 16.1% | 13.0% | 24.5% | 30 |
| New Mexico | 16.1% | 12.1% | 23.3% | 33 |
| Colorado | 16.0% | 12.5% | 18.3% | 64 |
| Kansas | 16.0% | 13.2% | 19.6% | 105 |
| Virginia | 15.9% | 12.2% | 23.4% | 133 |
| Vermont | 15.9% | 14.8% | 17.1% | 14 |
| Connecticut | 15.8% | 13.9% | 17.2% | 9 |
| Florida | 15.8% | 11.5% | 19.8% | 67 |
| Wyoming | 15.8% | 12.7% | 17.1% | 23 |
| Illinois | 15.6% | 13.4% | 18.9% | 102 |
| Wisconsin | 15.5% | 12.9% | 19.3% | 72 |
| Arizona | 15.4% | 13.8% | 21.2% | 15 |
| Delaware | 15.4% | 13.8% | 17.7% | 3 |
| New Hampshire | 15.3% | 13.8% | 17.5% | 10 |
| South Dakota | 15.3% | 12.4% | 25.7% | 66 |
| Minnesota | 15.1% | 13.2% | 19.8% | 87 |
| Maryland | 15.0% | 12.0% | 18.9% | 24 |
| New York | 15.0% | 13.2% | 18.2% | 62 |
| New Jersey | 14.7% | 12.6% | 17.7% | 21 |
| Hawaii | 14.5% | 13.6% | 15.6% | 5 |
| North Dakota | 14.2% | 11.9% | 22.2% | 53 |
| District of Columbia | 14.1% | 14.1% | 14.1% | 1 |
| Nebraska | 14.1% | 11.8% | 17.7% | 93 |
| State | State figure, age-adjusted (site aggregate) | Counties |
|---|---|---|
| West Virginia | 22.9% | 55 |
| Louisiana | 20.2% | 64 |
| Tennessee | 20.2% | 95 |
| Maine | 19.6% | 16 |
| Arkansas | 19.5% | 75 |
| Nevada | 19.2% | 17 |
| Michigan | 18.7% | 83 |
| Ohio | 18.6% | 88 |
| Oklahoma | 18.6% | 77 |
| Oregon | 18.6% | 36 |
| Missouri | 18.5% | 115 |
| Montana | 18.5% | 56 |
| Indiana | 18.4% | 92 |
| Kentucky (2024 release) | 18.3% | 120* |
| Alabama | 18.2% | 67 |
| Mississippi | 18.2% | 82 |
| Pennsylvania (2024 release) | 17.5% | 67* |
| Rhode Island | 17.5% | 5 |
| South Carolina | 17.5% | 46 |
| Georgia | 17.4% | 159 |
| Florida | 17.3% | 67 |
| Iowa | 17.3% | 99 |
| North Carolina | 17.3% | 100 |
| Vermont | 17.3% | 14 |
| New Mexico | 17.1% | 33 |
| Texas | 17.1% | 253 |
| Massachusetts | 17.0% | 14 |
| Utah | 17.0% | 29 |
| Washington | 17.0% | 39 |
| California | 16.9% | 58 |
| Delaware | 16.8% | 3 |
| Idaho | 16.8% | 44 |
| Wyoming | 16.8% | 23 |
| Connecticut | 16.7% | 9 |
| Virginia | 16.7% | 133 |
| Kansas | 16.6% | 105 |
| New Hampshire | 16.6% | 10 |
| Wisconsin | 16.5% | 72 |
| Colorado | 16.4% | 64 |
| Alaska | 16.3% | 30 |
| Illinois | 16.3% | 102 |
| Arizona | 16.2% | 15 |
| South Dakota | 16.2% | 66 |
| Hawaii | 15.9% | 5 |
| Minnesota | 15.9% | 87 |
| New York | 15.9% | 62 |
| Maryland | 15.7% | 24 |
| New Jersey | 15.6% | 21 |
| Nebraska | 14.8% | 93 |
| North Dakota | 14.7% | 53 |
| District of Columbia | 13.7% | 1 |
State figures are population-weighted county estimates computed by this site (PLACES publishes no state row) and carry no interval; they are listed by point estimate, which is not a ranking of states' health. Lowest and highest county columns are crude point estimates. * This measure was not published for the state in the 2025 release; its figure, county count and county range come from the release in brackets, the most recent that has them.
Highest county estimates
| County | Crude | 95% interval |
|---|---|---|
| Oglala Lakota County, SD | 25.7% | 22.8–28.8 |
| Todd County, SD | 24.8% | 21.7–28.0 |
| Kusilvak Census Area, AK | 24.5% | 21.7–27.8 |
| Mingo County, WV | 24.1% | 21.4–27.1 |
| McDowell County, WV | 23.8% | 21.1–26.6 |
| Lake County, TN | 23.4% | 20.7–26.3 |
| Radford city, VA | 23.4% | 19.8–26.9 |
| McKinley County, NM | 23.3% | 20.4–26.2 |
| East Carroll Parish, LA | 23.2% | 20.4–26.1 |
| Glacier County, MT | 23.2% | 20.3–25.9 |
| Hancock County, TN | 23.2% | 20.6–26.1 |
| Buffalo County, SD | 23.1% | 20.1–26.0 |
| Scott County, TN | 23.1% | 20.3–26.0 |
| Logan County, WV | 23.1% | 20.2–26.0 |
| Madison County, ID | 22.7% | 18.1–26.3 |
| Barbour County, WV | 22.6% | 19.9–25.4 |
| Madison Parish, LA | 22.5% | 19.9–25.2 |
| Roosevelt County, MT | 22.5% | 20.0–25.5 |
| Lincoln County, WV | 22.5% | 20.1–25.4 |
| Wyoming County, WV | 22.4% | 19.5–25.4 |
| County | Age-adj. | 95% interval |
|---|---|---|
| Mingo County, WV | 26.6% | 23.6–29.9 |
| McDowell County, WV | 26.0% | 23.0–29.1 |
| Hancock County, TN | 25.7% | 22.8–28.9 |
| Calhoun County, WV | 25.7% | 22.3–28.8 |
| Logan County, WV | 25.4% | 22.4–28.6 |
| Clay County, WV | 25.0% | 22.0–28.2 |
| Webster County, WV | 25.0% | 21.9–28.2 |
| Wyoming County, WV | 25.0% | 21.7–28.3 |
| Lincoln County, WV | 24.9% | 22.2–28.0 |
| Braxton County, WV | 24.8% | 21.9–27.9 |
| Summers County, WV | 24.8% | 21.7–28.0 |
| Roane County, WV | 24.7% | 21.4–27.9 |
| Oglala Lakota County, SD | 24.5% | 21.7–27.4 |
| Scott County, TN | 24.4% | 21.5–27.5 |
| Barbour County, WV | 24.4% | 21.4–27.5 |
| Fayette County, WV | 24.3% | 21.0–27.5 |
| Raleigh County, WV | 24.3% | 21.4–27.4 |
| Ritchie County, WV | 24.3% | 21.2–27.5 |
| Boone County, WV | 24.1% | 21.1–27.3 |
| Wayne County, WV | 24.1% | 21.1–27.2 |
Lowest county estimates
| County | Crude | 95% interval |
|---|---|---|
| Sumter County, FL | 11.5% | 9.8–13.3 |
| Wheeler County, NE | 11.8% | 10.2–13.7 |
| Griggs County, ND | 11.9% | 10.2–13.7 |
| Montgomery County, MD | 12.0% | 10.6–13.3 |
| Los Alamos County, NM | 12.1% | 10.3–14.1 |
| Fairfax County, VA | 12.2% | 10.7–13.9 |
| Loup County, NE | 12.2% | 10.5–13.9 |
| Sheridan County, ND | 12.2% | 10.6–14.0 |
| Banner County, NE | 12.3% | 10.5–14.2 |
| Nelson County, ND | 12.3% | 10.6–14.2 |
| Falls Church city, VA | 12.4% | 10.7–14.2 |
| Custer County, SD | 12.4% | 10.6–14.4 |
| Logan County, NE | 12.4% | 10.7–14.3 |
| Slope County, ND | 12.4% | 10.6–14.3 |
| Cavalier County, ND | 12.4% | 10.8–14.0 |
| Howard County, MD | 12.4% | 10.8–14.0 |
| Garfield County, NE | 12.5% | 10.7–14.4 |
| Hinsdale County, CO | 12.5% | 10.7–14.5 |
| Campbell County, SD | 12.6% | 10.8–14.5 |
| Mora County, NM | 12.6% | 10.7–14.6 |
| County | Age-adj. | 95% interval |
|---|---|---|
| Fairfax County, VA | 12.7% | 11.2–14.5 |
| Montgomery County, MD | 12.8% | 11.4–14.3 |
| Falls Church city, VA | 13.0% | 11.2–14.9 |
| Arlington County, VA | 13.0% | 11.3–14.8 |
| Los Alamos County, NM | 13.0% | 11.0–15.1 |
| Howard County, MD | 13.0% | 11.4–14.8 |
| Aleutians West Census Area, AK | 13.0% | 11.3–14.7 |
| Aleutians East Borough, AK | 13.0% | 11.2–14.8 |
| Teton County, WY | 13.3% | 11.3–15.5 |
| Loudoun County, VA | 13.3% | 11.7–15.2 |
| Somerset County, NJ | 13.5% | 12.0–15.1 |
| Cass County, ND | 13.5% | 11.7–15.6 |
| Sarpy County, NE | 13.6% | 11.8–15.4 |
| Johnson County, KS | 13.7% | 11.9–15.7 |
| Kalawao County, HI | 13.7% | 11.5–15.9 |
| Forsyth County, GA | 13.7% | 11.7–15.8 |
| District of Columbia, DC | 13.7% | 11.8–15.6 |
| Burleigh County, ND | 13.8% | 12.0–15.9 |
| San Mateo County, CA | 13.9% | 12.2–15.8 |
| Lincoln County, SD | 14.0% | 12.0–16.1 |
Twenty counties at each end by point estimate. Small counties have wide intervals; many of these intervals overlap one another, so the order within each list is not a meaningful ranking. CDC: "the data should not be used for ranking the overall health of any county, place, census tract, or ZCTA."
National estimate by release
| Release | Crude | Age-adjusted | BRFSS year |
|---|---|---|---|
| 2022 release | 13.5% 13.3–13.8 | 13.9% | 2020 |
| 2023 release | 14.7% 14.5–14.9 | 15.2% | 2021 |
| 2024 release | 15.8% 15.5–16.0 | 16.4% | 2022 |
| 2025 release | 15.6% 15.3–15.8 | 16.3% | 2023 |
CDC's US row from each release's county file, for reference. Survey questions and modelling details change between releases; see the release pages.
Questions and answers
How does PLACES define "frequent mental distress among adults"?
A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults aged ≥ 18 years who report that their mental health (including stress, depression, and problems with emotions) was not good for 14 or more days during the past 30 days. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Population: All Adults.
What is the national estimate for frequent Mental Distress?
15.6% (95% confidence interval 15.3–15.8%) crude and 16.3% age-adjusted in the 2025 release.
Which counties have the highest and lowest estimates?
The highest county point estimate is 25.7% (Oglala Lakota County, SD) and the lowest 11.5% (Sumter County, FL). Because the intervals for neighbouring positions usually overlap, the lists are a reference for point estimates, not a ranking.
Is a higher figure better or worse?
This site does not grade measures. CDC groups them as health outcomes, prevention, health risk behaviors, disability, health status and health-related social needs; for prevention measures such as checkups and screening a higher share reports the service, for the others a higher share reports the condition or circumstance.
Where does this data come from?
CDC PLACES: Local Data for Better Health, 2025 release (data updated 4 Dec 2025); the definition text is CDC's own from its measure definitions pages.
Provenance
Source: Centers for Disease Control and Prevention, PLACES: Local Data for Better Health, 2025 release (data updated 4 Dec 2025), with the 2022, 2023, 2024 releases for reference; US government work, public domain. Dataset on data.cdc.gov. Boundaries and ZIP-to-county relationships: US Census Bureau. Percentages are shown to one decimal as CDC publishes them; state figures are population-weighted means computed by this site. Definition text is CDC's own, from the PLACES measure definitions pages (public domain), with its burden narrative and references omitted. Processing errors are corrected at the next daily build; see corrections. Generated 30 Sep 2026.