Health Insurance
2024 Children's Mental Health Report
Mental health treatment is critical for many Americans. It’s particularly important for children, as early intervention and care can help shape how they approach challenges into adulthood.
According to the latest ValuePenguin study, 15.9% of American households with children have a kid who needs mental health treatment. Of this group, only 13.5% don’t receive the necessary care.
In addition to reviewing our findings, learn how you can utilize your health insurance to access mental health care for your child.
On this page
- Key findings
- Percentage of households with children needing treatment falls
- Where kids most need mental health treatment (and receive it)
- Families face difficulties receiving treatment
- Louisiana sees biggest drop in kids needing mental health care
- Treatment accessibility increases most in Alaska
- Accessing children’s mental health care: Top expert tips
- Methodology
Key findings
- 15.9% of households with children have a kid who needs mental health treatment. This marks a decrease from 18.6% in June 2023. Among the children who required treatment, only 13.5% didn’t receive it in June 2024, an improvement from 16.4% a year earlier.
- New Hampshire households with children have the highest rate of kids who need mental health treatment. 31.9% report that at least one child needs it. Vermont and Oregon follow at 29.7% and 24.6%, respectively. The rates are lowest in Louisiana (9.2%), Hawaii (10.5%) and California (11.0%).
- In Hawaii and West Virginia, 96.9% of households with children in need of mental health treatment receive the necessary support, including counseling or medication. Meanwhile, just 72.6% of Louisiana households with children in need of mental health treatment receive this support. Nevada and Idaho have the next lowest rates, at 77.8% and 78.1%, respectively.
- When seeking treatment for their child, 38.1% of households needing care find it easy to access. South Dakota (72.1%), Hawaii (66.1%) and Montana (61.5%) households are the most likely to say treatment is easy to access. Conversely, access to care is most challenging in Rhode Island, where only 21.3% find it easy to get treatment. It’s followed by Idaho (22.7%) and Washington and Massachusetts (tied at 23.4%).
- Louisiana had the biggest decrease in the percentage of households with children needing mental health treatment, dropping 61.7% between June 2023 and June 2024. That’s followed by Maryland (44.0%) and Rhode Island (37.2%). On the other hand, the percentage of households with children needing mental health treatment jumped 57.1% in New Hampshire — the only state with an increase of over 50.0%. Hawaii (40.0%) ranked second, and Vermont (20.7%) was a distant third.
- The percentage of households with children who needed and then received mental health treatment increased in 36 states in the same period. Alaska (39.8%), Kentucky (32.5%) and Oklahoma (28.8%) saw the most significant improvements in mental health treatment accessibility for children. Meanwhile, Louisiana saw the biggest decrease, with the percentage of households with children needing and receiving mental health care dropping 17.7% in the same period. That’s followed by New York (10.7%) and Arizona (9.9%).
Percentage of households with children needing treatment falls
American households are ensuring their children are properly treated. As of June 2024, 15.9% of American households with children have a kid who needs mental health treatment, and just 13.5% of this group don’t receive it. That’s an improvement from June 2023, when 18.6% of households with children had a kid needing mental health treatment and 16.4% didn’t receive it.
According to ValuePenguin health insurance expert Divya Sangameshwar, the decrease in those needing mental health treatment is to be expected.
"The COVID-19 pandemic caused an unprecedented disruption to children's daily lives due to school closures, online learning, strict social distancing measures, limited access to outdoor activities and many other restrictions," she says. "As children are more vulnerable to stress than adults, there was growing concern about the debilitating consequences of COVID-19 for children's mental health. A decline in the number of children needing mental health care is good news, and a sign we’re finally seeing the end of the COVID-19 pandemic’s impact on our children’s mental health."
By race, 19.0% of white households with children have a kid in need of mental health treatment. That compares with 12.7% of Hispanic households, 12.6% of Black households and 7.7% of Asian households.
As for receiving the needed mental health treatment, 90.5% of white households report help for the child, versus 75.8% of Black households.
% of households with children where at least 1 kid needs mental health treatment — and whether they receive it (by race)
Race | % of households with children where at least 1 kid needs mental health treatment | % of households where kid who needs mental health treatment receives it |
|---|---|---|
| Hispanic or Latino | 12.7% | 80.3% |
| White | 19.0% | 90.5% |
| Black | 12.6% | 75.8% |
| Asian | 7.7% | 81.0% |
| 2 or more races | 17.1% | 85.3% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
Where kids most need mental health treatment (and receive it)
By state, New Hampshire households with children have the highest rate of kids who need mental health treatment. Here, just over 3 in 10 (31.9%) households with children have at least one kid needing treatment.
In the Granite State, an inability to treat those with mental health conditions may play a role. Children’s mental health centers face long wait lists and staffing issues, preventing many from accessing critical early intervention.
Vermont (29.7%) and Oregon (24.6%) follow. In Vermont, this reflects a trend. According to the State of Vermont’s Children report in 2023, the rate of children ages 3 to 8 diagnosed with behavioral conditions like ADHD, anxiety and depression rose from 8.8% in 2016-17 to 16.1% in 2020-21. During this time, overall U.S. rates remained fairly stable, from 9.9% to 10.5%.
States with highest % of households with children where at least 1 kid needs mental health treatment
Rank | State | % of households with children where at least 1 kid needs mental health treatment |
|---|---|---|
| 1 | New Hampshire | 31.9% |
| 2 | Vermont | 29.7% |
| 3 | Oregon | 24.6% |
| 4 | Utah | 23.2% |
| 5 | Kansas | 22.9% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
On the other hand, rates are lowest in Louisiana (9.2%), Hawaii (10.5%) and California (11.0%).
Where are kids who need care most likely to receive it? Despite having the second-lowest rate of children needing mental health treatment, Hawaii ties here with West Virginia. In these two states, 96.9% of households with children in need of mental health treatment receive support such as counseling or medication. Montana (96.8%) rounds out the top three.
States with highest % of households where kid who needs mental health treatment receives it
Rank | State | % of households where kid who needs mental health treatment receives it |
|---|---|---|
| 1 | Hawaii | 96.9% |
| 1 | West Virginia | 96.9% |
| 3 | Montana | 96.8% |
| 4 | Kansas | 96.7% |
| 5 | Kentucky | 95.7% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
Several nationwide changes have been implemented to make accessing children’s mental health care easier.
In late 2021, the Health Resources and Services Administration’s Bright Futures Program updated its guidelines to include universal suicide risk screenings for people ages 12 to 21 and introduced new guidance for behavioral, social and emotional screenings. The next year, the U.S. Preventive Services Task Force (a group of volunteer health professionals) recommended anxiety screenings for youths ages 8 to 18.
"Due to these recommendations, more doctors and health care practitioners have started including mental health screenings as part of their annual screenings for children, catching issues early and providing them the care they need," she says. "The good news is the Affordable Care Act (ACA) requires most health insurance plans to cover mental health services as essential health benefits. And the Mental Health Parity and Addiction Equity Act of 2008 prevents health insurers from imposing less favorable benefits or limitations on policyholders for mental health when compared to physical health coverage."
On the other hand, just 72.6% of Louisiana households with children needing mental health treatment receive care. Nevada (77.8%) and Idaho (78.1%) follow.
Full rankings
% of households with children where at least 1 kid needs mental health treatment (by state)
Rank | State | % of households with children where at least 1 kid needs mental health treatment |
|---|---|---|
| 1 | New Hampshire | 31.9% |
| 2 | Vermont | 29.7% |
| 3 | Oregon | 24.6% |
| 4 | Utah | 23.2% |
| 5 | Kansas | 22.9% |
| 5 | New York | 22.9% |
| 7 | Minnesota | 22.0% |
| 8 | West Virginia | 21.1% |
| 9 | Montana | 20.8% |
| 10 | Tennessee | 20.3% |
| 11 | New Mexico | 20.1% |
| 12 | Massachusetts | 19.9% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
% of households where kid who needs mental health treatment receives it (by state)
Rank | State | % of households where kid who needs mental health treatment receives it |
|---|---|---|
| 1 | Hawaii | 96.9% |
| 1 | West Virginia | 96.9% |
| 3 | Montana | 96.8% |
| 4 | Kansas | 96.7% |
| 5 | Kentucky | 95.7% |
| 6 | Ohio | 94.8% |
| 7 | Iowa | 93.8% |
| 8 | Wisconsin | 93.7% |
| 9 | Rhode Island | 93.5% |
| 10 | North Dakota | 93.3% |
| 10 | Arkansas | 93.3% |
| 12 | Virginia | 93.2% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
Families face difficulties receiving treatment
Even with the best intentions, it can be hard to find treatment options. In fact, just 38.1% of households with children with a kid who needs mental health treatment found it easy to get it, versus 53.1% who found it somewhat or very difficult and 5.9% who weren’t able to access treatment altogether.
Sangameshwar attributes this difficulty to two factors: access and affordability.
"Despite there being entrenched protections for mental health coverage, many Americans still struggle to find care for themselves and their children," she says. "Access is a huge issue, with 36.4% of the country living in mental health shortage areas. Shortages also lead to long wait times for care, which can be an issue if a child is suffering and needs help urgently."
Additionally, while most insurance plans offer coverage for mental health services, more than 1 in 2 American private-sector employees are enrolled in high-deductible health plans (HDHPs), which means they’ll need to pay thousands of dollars out of pocket before their insurance coverage kicks in. This may deter them from seeking mental health treatment for their kids.
Where is treatment easiest to get? Among households with a kid needing care, 72.1% in South Dakota say treatment is easy to access, followed by Hawaii (66.1%) and Montana (61.5%).
States with highest % of households with children where kid receives easy access to mental health treatment
Rank | State | % of households with children where access is easy |
|---|---|---|
| 1 | South Dakota | 72.1% |
| 2 | Hawaii | 66.1% |
| 3 | Montana | 61.5% |
| 4 | Arkansas | 58.6% |
| 5 | Kentucky | 58.0% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
On the other hand, Rhode Island households share this sentiment the least, with just about 1 in 5 households (21.3%) finding it easy to get treatment for their kids. Idaho follows at 22.7%, with Washington and Massachusetts tying for third at 23.4%.
Full rankings
% of households with children where kid receives easy access to mental health treatment (by state)
Rank | State | % of households with children where access is easy | % of households with children where access is somewhat or very difficult |
|---|---|---|---|
| 1 | South Dakota | 72.1% | 18.6% |
| 2 | Hawaii | 66.1% | 30.8% |
| 3 | Montana | 61.5% | 38.5% |
| 4 | Arkansas | 58.6% | 40.7% |
| 5 | Kentucky | 58.0% | 41.3% |
| 6 | Wyoming | 56.9% | 43.1% |
| 7 | New York | 53.8% | 40.3% |
| 8 | South Carolina | 49.2% | 48.6% |
| 9 | Alaska | 48.9% | 40.8% |
| 10 | Ohio | 48.7% | 47.4% |
| 11 | Alabama | 48.4% | 51.6% |
| 12 | North Dakota | 45.3% | 54.7% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data. Note: The rankings are based on easy access.
Louisiana sees biggest drop in kids needing mental health care
Louisiana had the biggest drop in the percentage of households with children where at least one kid needed mental health care, falling 61.7% between June 2023 and June 2024.
That isn’t necessarily positive. This may mean that families might not have the resources to have their children diagnosed. In fact, 66.5% of Louisiana residents live in mental health shortage areas, and a significant chunk of workers in the state (50.4%) are enrolled in HDHPs.
Maryland (44.0%) and Rhode Island (37.2%) saw the next biggest decreases in children needing mental health care.
States with biggest decreases in % of households with children where at least 1 kid needs mental health treatment
Rank | State | % of households with children where at least 1 kid needs mental health treatment, June 2023 | % of households with children where at least 1 kid needs mental health treatment, June 2024 | % change |
|---|---|---|---|---|
| 1 | Louisiana | 24.0% | 9.2% | -61.7% |
| 2 | Maryland | 25.9% | 14.5% | -44.0% |
| 3 | Rhode Island | 24.2% | 15.2% | -37.2% |
| 4 | Delaware | 25.5% | 16.7% | -34.5% |
| 5 | California | 16.6% | 11.0% | -33.7% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
Meanwhile, there’s a significant disparity between the three states at the bottom. New Hampshire saw the percentage of households with children where at least one kid needed mental health treatment jump 57.1%, while Hawaii and Vermont followed at 40.0% and 20.7%, respectively.
Full rankings
Biggest decreases/increases in % of households with children where at least 1 kid needs mental health treatment (by state)
Rank | State | % of households with children where at least 1 kid needs mental health treatment, June 2023 | % of households with children where at least 1 kid needs mental health treatment, June 2024 | % change |
|---|---|---|---|---|
| 1 | Louisiana | 24.0% | 9.2% | -61.7% |
| 2 | Maryland | 25.9% | 14.5% | -44.0% |
| 3 | Rhode Island | 24.2% | 15.2% | -37.2% |
| 4 | Delaware | 25.5% | 16.7% | -34.5% |
| 5 | California | 16.6% | 11.0% | -33.7% |
| 6 | North Carolina | 19.6% | 13.2% | -32.7% |
| 7 | Florida | 20.0% | 14.0% | -30.0% |
| 8 | Nevada | 16.5% | 11.7% | -29.1% |
| 9 | Oklahoma | 22.3% | 16.1% | -27.8% |
| 9 | Connecticut | 22.7% | 16.4% | -27.8% |
| 11 | Virginia | 21.3% | 15.7% | -26.3% |
| 12 | South Dakota | 18.4% | 13.7% | -25.5% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
Treatment accessibility increases most in Alaska
Overall, 36 states had an increase in the percentage of households where a child who needed mental health treatment received it. Alaska leads here, with a 39.8% increase, followed by Kentucky (32.5%) and Oklahoma (28.8%).
States with biggest increases in % of households where child who needs mental health treatment receives it
Rank | State | % of households where kid who needs mental health treatment receives it, June 2023 | % of households where kid who needs mental health treatment receives it, June 2024 | % change |
|---|---|---|---|---|
| 1 | Alaska | 64.0% | 89.5% | 39.8% |
| 2 | Kentucky | 72.2% | 95.7% | 32.5% |
| 3 | Oklahoma | 72.1% | 92.9% | 28.8% |
| 4 | Alabama | 73.5% | 93.0% | 26.5% |
| 5 | Iowa | 76.1% | 93.8% | 23.3% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
On the other hand, access to care dropped the most in Louisiana, falling 17.7% in the same period. That’s followed by New York and Arizona, at 10.7% and 9.9%, respectively.
Full rankings
% of households where child who needs mental health treatment receives it (by state)
Rank | State | % of households where kid who needs mental health treatment receives it, June 2023 | % of households where kid who needs mental health treatment receives it, June 2024 | % change |
|---|---|---|---|---|
| 1 | Alaska | 64.0% | 89.5% | 39.8% |
| 2 | Kentucky | 72.2% | 95.7% | 32.5% |
| 3 | Oklahoma | 72.1% | 92.9% | 28.8% |
| 4 | Alabama | 73.5% | 93.0% | 26.5% |
| 5 | Iowa | 76.1% | 93.8% | 23.3% |
| 6 | Georgia | 69.5% | 82.7% | 19.0% |
| 7 | Hawaii | 82.5% | 96.9% | 17.5% |
| 8 | South Carolina | 79.6% | 92.9% | 16.7% |
| 9 | Virginia | 80.1% | 93.2% | 16.4% |
| 10 | Wisconsin | 80.8% | 93.7% | 16.0% |
| 11 | Minnesota | 74.8% | 86.4% | 15.5% |
| 12 | Maine | 80.5% | 91.9% | 14.2% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
Accessing children’s mental health care: Top expert tips
If you’re a parent of a struggling child, it’s important to know that a lot of insurers provide coverage for mental health services. However, it may not be something families have explored in depth.
Sangameshwar says a good first step would be to call your insurer to ask about how mental health coverage works for your plan. Particularly, she recommends the following questions:
- Do I need a referral from my child’s pediatrician, a primary care doctor or my company’s employee assistance program to receive mental health services? "If you need a referral and go see a mental health practitioner without one, your claim may be denied, leaving you with a huge bill to pay out of pocket," she says.
- What are the in-network doctors and providers in my area? "Staying in your network will allow you to keep the cost of care affordable," Sangameshwar says. "Don’t forget to ask about telehealth options, too."
- What will my out-of-pocket costs be? "This will be helpful to compare provider costs for the budget-conscious or those with high-deductible health plans," she says. "You can also ask for the cost with and without insurance, as some providers charge lower fees for patients without insurance."
- Are there any limits to how many visits my child is allowed each year? "In some states, Medicaid only covers 20 to 30 visits to a mental health provider per year," Sangameshwar says. "Knowing this number is important for children who need more intensive treatment and therapy and helps you negotiate a lower rate with your health care provider."
- What mental health care hospitals and facilities can be used under the plan? "For children in need of residential or hospital care for their mental health, it’ll be important to know the in-network facilities near you and the amount of coverage your insurer provides," she says. "You can use that information to purchase supplemental insurance to cover nonmedical costs associated with your child’s hospital stay."
Methodology
ValuePenguin researchers analyzed U.S. Census Bureau Household Pulse Survey data from Phase 4.1, Cycle 6 of the survey, conducted from May 26 to June 24, 2024.
The analysis excluded those who didn’t respond to the relevant questions. Analysts also compared the results to numbers or rates reported roughly one year earlier in the Week 58 survey, conducted between June 7 and 19, 2023.
Specifically, researchers estimated:
- The percentage of households with children in which any children needed mental health treatment during the last four weeks, including services like counseling or medication.
- Percentage of households where the children who needed mental health treatment received it.
- The difficulty of receiving mental health treatment for households with children who need it.