Health Status

Frequent Mental Distress by County — US Rankings

CDC PLACES 2023 · Age-adjusted prevalence · All 3,144 US counties

Frequent mental distress is the share of adults who report their mental health was "not good" on 14 or more days in the past 30 days. It is a symptom-anchored measure — distinct from the diagnosis-anchored DEPRESSION ranking, which only counts adults who have been formally told they have a depressive disorder. The two rankings can diverge sharply in the same county, and that gap is itself informative: high frequent mental distress combined with low diagnosed depression typically signals under-served populations rather than absence of need.

How this ranking is built

Source: CDC PLACES 2023 release. Methodology: BRFSS survey responses pooled across years, fitted with a small-area statistical model, age-adjusted to the 2000 US standard population. Confidence intervals (95%) are shown for each county — wider intervals indicate more uncertainty in the modeled estimate, typically driven by smaller populations.

Lowest Frequent Mental Distress Rates — Top 100 Counties

Counties with the lowest reported frequent mental distress prevalence — these counties show the most favorable position on this measure.

#CountyRate
1Fairfax County12.7%
2Montgomery County12.8%
3Aleutians East Borough13.0%
4Aleutians West Census Area13.0%
5Howard County13.0%
6Los Alamos County13.0%
7Arlington County13.0%
8Falls Church city13.0%
9Loudoun County13.3%
10Teton County13.3%
11Somerset County13.5%
12Cass County13.5%
13Sarpy County13.6%
14District of Columbia13.7%
15Forsyth County13.7%
16Kalawao County13.7%
17Johnson County13.7%
18Burleigh County13.8%
19San Mateo County13.9%
20Santa Clara County14.0%
21Colfax County14.0%
22Morris County14.0%
23Lincoln County14.0%
24Washington County14.1%
25DuPage County14.2%
26Hamilton County14.2%
27Kearney County14.2%
28Saunders County14.2%
29Washington County14.2%
30Nassau County14.2%
31Delaware County14.2%
32Fairfax city14.2%
33Waukesha County14.2%
34San Francisco County14.3%
35Carver County14.3%
36Westchester County14.3%
37Dawson County14.4%
38Johnson County14.4%
39Platte County14.4%
40Middlesex County14.4%
41Queens County14.4%
42Alexandria city14.4%
43Olmsted County14.5%
44Wheeler County14.5%
45Hudson County14.5%
46Ward County14.5%
47Summit County14.5%
48Denver County14.6%
49Dallas County14.6%
50Cass County14.6%
51Dakota County14.6%
52Hall County14.6%
53Lancaster County14.6%
54Seward County14.6%
55Thomas County14.6%
56Bergen County14.6%
57Billings County14.6%
58Traill County14.6%
59Fort Bend County14.6%
60Kodiak Island Borough14.7%
61Broomfield County14.7%
62Pitkin County14.7%
63Blaine County14.7%
64Teton County14.7%
65Lake County14.7%
66Dodge County14.7%
67Logan County14.7%
68Burke County14.7%
69Griggs County14.7%
70Nelson County14.7%
71Collin County14.7%
72King County14.7%
73Dane County14.7%
74Douglas County14.8%
75Prince George's County14.8%
76Dakota County14.8%
77Scott County14.8%
78Banner County14.8%
79Cedar County14.8%
80Douglas County14.8%
81Hamilton County14.8%
82Madison County14.8%
83Saline County14.8%
84Hunterdon County14.8%
85New York County14.8%
86Cavalier County14.8%
87Grand Forks County14.8%
88Morton County14.8%
89Western Connecticut Planning Region14.9%
90Hennepin County14.9%
91Buffalo County14.9%
92Chase County14.9%
93Garfield County14.9%
94Gosper County14.9%
95Loup County14.9%
96Stanton County14.9%
97Monmouth County14.9%
98Putnam County14.9%
99Wake County14.9%
100Stark County14.9%

Best 100 counties for Frequent Mental Distress.

Highest Frequent Mental Distress Rates — Bottom 100 CountiesCounties with the highest reported frequent mental distress prevalence.
#CountyRate
1Mingo County26.6%
2McDowell County26.0%
3Calhoun County25.7%
4Hancock County25.7%
5Logan County25.4%
6Wyoming County25.0%
7Webster County25.0%
8Clay County25.0%
9Lincoln County24.9%
10Summers County24.8%
11Braxton County24.8%
12Roane County24.7%
13Oglala Lakota County24.5%
14Barbour County24.4%
15Scott County24.4%
16Ritchie County24.3%
17Raleigh County24.3%
18Fayette County24.3%
19Wayne County24.1%
20Boone County24.1%
21Pocahontas County24.0%
22Mason County24.0%
23Wirt County23.9%
24Wetzel County23.9%
25Lake County23.8%
26Madison Parish23.8%
27Lewis County23.7%
28Hardy County23.7%
29Todd County23.7%
30McKinley County23.7%
31Glacier County23.7%
32Upshur County23.6%
33Greenbrier County23.6%
34Nicholas County23.5%
35Mercer County23.5%
36Cocke County23.5%
37East Carroll Parish23.5%
38Kusilvak Census Area23.5%
39Tyler County23.4%
40Monroe County23.4%
41Pickett County23.4%
42Grundy County23.4%
43Campbell County23.4%
44Hardin County23.2%
45Fentress County23.2%
46Clay County23.2%
47Tensas Parish23.2%
48Bienville Parish23.2%
49Taylor County23.1%
50Perry County23.1%
51Decatur County23.1%
52Benton County23.1%
53Avoyelles Parish23.1%
54Pendleton County23.0%
55Marshall County23.0%
56Kanawha County23.0%
57Claiborne Parish23.0%
58Wood County22.9%
59Hampshire County22.9%
60Grant County22.9%
61Doddridge County22.9%
62Cabell County22.9%
63Haywood County22.9%
64Bledsoe County22.9%
65Big Horn County22.9%
66Webster Parish22.9%
67Preston County22.8%
68Jackson County22.8%
69Newton County22.8%
70Overton County22.8%
71McNairy County22.8%
72Macon County22.8%
73Red River Parish22.8%
74Franklin Parish22.8%
75Concordia Parish22.8%
76Acadia Parish22.8%
77Randolph County22.7%
78Morgan County22.7%
79Marion County22.7%
80Hancock County22.7%
81San Augustine County22.7%
82Sequatchie County22.7%
83Lauderdale County22.7%
84Johnson County22.7%
85Jackson County22.7%
86Roosevelt County22.7%
87Caldwell Parish22.7%
88Desha County22.7%
89White County22.6%
90Monroe County22.6%
91Meigs County22.6%
92Lawrence County22.6%
93Pike County22.6%
94Sabine Parish22.6%
95Morehouse Parish22.6%
96Lewis County22.5%
97Meigs County22.5%
98St. Landry Parish22.5%
99Pleasants County22.4%
100Berkeley County22.4%

Worst 100 counties for Frequent Mental Distress.

What this ranking suggests

This is one of the most actionable rankings in the dataset for local public-health teams because it is symptom-based, not access-based. A county can show low diagnosed depression and still be in distress; this measure catches that. Compare against the mental-health-provider-ratio data on the county page.

Methodology notes & limitations

Estimates are statistical model outputs, not direct measurements. Small counties have wider confidence intervals; treat narrow rank differences in those rows as within-noise. Counties where the underlying population is too small to support modeling are suppressed entirely (about 1% of US counties). All measures are age-adjusted to the 2000 US standard population. The PLACES dataset uses BRFSS self-reported data — self-report introduces known direction-of-bias in some measures (BMI is under-reported; binge drinking is under-reported), but the bias is roughly uniform across counties so ranking comparability is preserved. See the methodology page for full data-pipeline documentation.

By Logan Johnson, Founder & Data EditorPublished Reviewed by Logan Johnson, Founder & Data Editor

Data source: CDC PLACES 2023 release. Measure ID: MHLTH.

← All rankings