These are the 10 worst U.S. states to live in for your mental health, according to a new study

Overall well-being is influenced by your financial standing, relationships, work, sense of purpose, and safety, but where you live and your community’s health care system also play a vital role. In an analysis published last month, Universal Drugstore, an online pharmacy, ranked the best and worst states to live in for mental health after evaluating various data points, including the prevalence of mental illness and the cost of care.

Montana came in number one as the best place to live for mental health, scoring 8.06 out of 10. The state had the lowest number by population of “mentally unhealthy adults” who cannot afford care, and residents took the second-fewest mental health sick days in 2022.

By contrast, Nevada is ranked the worst state for mental health, with a score of 2.06 out of 10. The Silver State placed in the top five for several measurements including the highest number of mental health sick days taken and the most youth reporting depressive episodes. Nevada also has one of the lowest ratios of psychologists to residents across the nation.

Breaking the data down further, South Dakota, ranked fourth as the best state for mental health, had the fewest reported mental health sick days (three), while West Virginia and Louisiana, ranked 34 and 44, reported the most (six). Adults in New Jersey, ranked 16th, have the lowest rates of mental illness diagnoses (16%), while adults residing in Utah, ranked 25th, have the highest rates of mental illness (27%). Oregon, in 50th place, ranked as the second-worst state for mental health with a score of 2.89 out of 10, tied with New Mexico, ranked 42nd, for the nation’s highest percentage of youth experiencing depressive episodes (19%); the lowest is in Washington, D.C. (11%). D.C., ranked 13th, which is also home to the highest proportion of psychologists compared to Alabama, Maine, Georgia, and Louisiana.

Researchers used data from the U.S. Bureau of Labor Statistics, the Kaiser Family Foundation, Mental Health America, the U.S. Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration to compile the ranking. They compared each state’s ratio of psychologists to residents, the average number of mental health sick days taken, the prevalence of mental illness for adults and youth, the number of beds available in mental health facilities, and the cost of prescription drugs.