Where It Is Hardest to Find a Therapist: Federal Shortage Data, State by State
If you have tried to find a therapist and kept hitting full caseloads and waitlists, the federal government has a way of measuring part of that problem. It is called a mental health Health Professional Shortage Area (HPSA), or shortage area for short.
The Health Resources and Services Administration (HRSA), part of the U.S. Department of Health and Human Services, designates these areas when there are too few mental health providers for the people who live there. As of September 30, 2026, HRSA counted 7,127 mental health shortage designations covering about 154.6 million people. Across all of them, HRSA estimates that 26.2% of the need for providers is being met, and that 7,796 more practitioners would be needed to remove every designation.1
Below is every state plus the District of Columbia, a closer look at eight states, and what you can do if you live in one of these areas.
What the numbers measure, and what they do not
Before the table, a few plain notes so the numbers are read fairly.
A shortage area is about providers per person. An area, a group of people (for example, low income residents of a county), or a facility (such as a community health center, a rural health clinic, a tribal clinic or a prison) can be designated when the ratio of people to mental health providers passes a federal threshold.1
Most designations count psychiatrists only. HRSA says that while the rules allow designations based on all core mental health providers, most mental health designations are currently based on the ratio of people to psychiatrists. Those designations do not count psychologists, clinical social workers, psychiatric nurse specialists or marriage and family therapists in the area.1 So these numbers say more about access to psychiatrists than about access to every kind of therapist. They are still the main federal measure of where mental health providers are scarce.
Percent of need met is the number of providers available divided by the number needed to bring the area under the shortage threshold. Lower means a bigger gap. It covers geographic areas, population groups, prisons and state mental hospitals, but not health centers and clinics that are designated automatically by law.1
People in shortage areas is HRSA's count of the population covered by the designations. It is not the same as a share of the state's residents, and it should not be read that way.
Two survey measures come from the National Survey on Drug Use and Health (NSDUH), run by the Substance Abuse and Mental Health Services Administration (SAMHSA). They estimate the share of adults with any mental illness in 2023 to 2024,2 and the share of adults who received any mental health treatment in 2024, including counseling, medication or telehealth.3 These are model based estimates with margins of error, so small differences between states may not be real differences. The two measures cover different groups and different years, so one should not be subtracted from the other.
None of these numbers show why a state has a shortage. They show where the gaps are.
Every state
| District of Columbia | 0.0% | 126,214 | 8 | 10 | 29.0% | 34.2% |
|---|---|---|---|---|---|---|
| West Virginia | 5.7% | 810,123 | 94 | 124 | 28.1% | 24.6% |
| Delaware | 6.6% | 537,966 | 61 | 16 | 22.1% | 23.3% |
| Maine | 11.4% | 470,030 | 21 | 82 | 26.7% | 27.3% |
| North Carolina | 11.8% | 4,104,845 | 253 | 224 | 21.4% | 23.1% |
| New York | 14.4% | 4,047,428 | 256 | 213 | 21.9% | 21.8% |
| Tennessee | 14.9% | 2,999,680 | 220 | 98 | 27.0% | 25.6% |
| Arizona | 15.7% | 4,088,063 | 224 | 282 | 24.6% | 20.9% |
| Connecticut | 17.2% | 1,932,543 | 126 | 55 | 23.7% | 22.8% |
| Virginia | 18.0% | 2,253,193 | 150 | 133 | 23.1% | 23.0% |
| South Dakota | 18.7% | 657,991 | 36 | 65 | 21.8% | 28.1% |
| Kentucky | 19.7% | 2,778,040 | 151 | 228 | 25.3% | 25.7% |
| Maryland | 19.8% | 2,882,446 | 150 | 69 | 22.7% | 22.5% |
| Kansas | 19.9% | 1,196,031 | 52 | 118 | 23.7% | 24.0% |
| Iowa | 20.1% | 1,899,150 | 82 | 174 | 25.0% | 29.0% |
| Idaho | 20.1% | 1,282,788 | 56 | 65 | 24.5% | 25.0% |
| Illinois | 21.0% | 8,646,794 | 395 | 245 | 22.2% | 21.5% |
| Washington | 21.1% | 5,635,742 | 249 | 244 | 27.9% | 28.0% |
| Missouri | 21.4% | 2,713,118 | 140 | 265 | 25.7% | 29.3% |
| Nevada | 21.7% | 2,715,680 | 185 | 66 | 24.6% | 21.8% |
| Florida | 21.8% | 12,331,976 | 710 | 241 | 20.8% | 17.6% |
| California | 21.9% | 12,270,229 | 673 | 643 | 21.6% | 21.9% |
| Alabama | 23.2% | 3,491,919 | 227 | 72 | 23.0% | 23.3% |
| Oklahoma | 24.0% | 2,604,390 | 148 | 139 | 22.6% | 20.1% |
| Minnesota | 24.3% | 2,709,724 | 123 | 150 | 22.6% | 24.9% |
| Oregon | 25.4% | 1,703,364 | 90 | 135 | 31.6% | 28.6% |
| New Mexico | 25.7% | 1,617,847 | 83 | 100 | 23.9% | 20.8% |
| Arkansas | 26.3% | 1,176,745 | 73 | 94 | 26.6% | 24.1% |
| Massachusetts | 26.5% | 553,097 | 30 | 56 | 24.9% | 26.1% |
| Louisiana | 27.7% | 2,893,539 | 139 | 179 | 24.1% | 23.7% |
| Alaska | 27.8% | 627,057 | 29 | 343 | 24.0% | 22.2% |
| Wyoming | 30.6% | 567,575 | 23 | 26 | 24.7% | 26.3% |
| Texas | 31.9% | 14,065,653 | 631 | 414 | 20.7% | 19.6% |
| Hawaii | 32.2% | 504,844 | 23 | 33 | 19.8% | 15.3% |
| South Carolina | 32.7% | 5,371,248 | 233 | 101 | 19.8% | 22.5% |
| Mississippi | 33.3% | 2,312,386 | 107 | 87 | 20.4% | 18.9% |
| Pennsylvania | 34.3% | 1,012,322 | 67 | 130 | 23.9% | 25.5% |
| Ohio | 34.3% | 5,432,847 | 240 | 138 | 23.9% | 25.7% |
| Wisconsin | 35.9% | 1,753,519 | 85 | 170 | 24.6% | 24.9% |
| Michigan | 37.3% | 4,663,345 | 195 | 276 | 23.6% | 24.4% |
| North Dakota | 37.4% | 464,452 | 16 | 69 | 23.0% | 26.5% |
| Indiana | 37.9% | 6,500,041 | 251 | 117 | 25.3% | 26.1% |
| Colorado | 40.4% | 4,054,296 | 137 | 85 | 26.4% | 29.1% |
| Montana | 40.9% | 1,318,372 | 55 | 115 | 25.6% | 28.4% |
| Nebraska | 44.8% | 1,069,236 | 30 | 91 | 24.1% | 24.3% |
| Rhode Island | 45.4% | 411,900 | 15 | 14 | 25.8% | 30.4% |
| Georgia | 46.1% | 5,680,979 | 194 | 93 | 25.2% | 21.8% |
| Utah | 48.0% | 2,986,377 | 97 | 63 | 26.7% | 25.0% |
| New Hampshire | 48.1% | 153,649 | 4 | 22 | 27.7% | 26.6% |
| New Jersey | 50.5% | 776,426 | 37 | 43 | 18.1% | 18.1% |
| Vermont | Not reported | Not reported | Not reported | 12 | 29.1% | 29.1% |
Vermont: HRSA lists 12 mental health shortage designations, all of them facilities, and publishes no population or need figures for them. The District of Columbia is included with the states.
A few things stand out in the full table.
Lowest percent of need met: the District of Columbia (0.0%, across 10 designations), West Virginia (5.7%), Delaware (6.6%), Maine (11.5%) and North Carolina (11.8%).1
Most people in shortage areas: Texas (about 14.1 million), Florida (about 12.3 million), California (about 12.3 million), Illinois (about 8.6 million) and Indiana (about 6.5 million).1
Most practitioners needed: Florida (710), California (673), Texas (631), Illinois (395) and New York (256).1
Michigan
Michigan has 276 mental health shortage designations, more than any state except California, Texas, Alaska and Arizona. They cover about 4.7 million people. HRSA estimates 37.3% of the need is met there, better than the national figure of 26.2%, and that 195 more practitioners would be needed to remove the designations. Most of Michigan's designations, 206 of them, are facilities such as health centers and rural clinics.1 An estimated 23.6% of Michigan adults had any mental illness in 2023 to 2024,2 and 24.4% received mental health treatment in 2024.3
Illinois
Illinois has 245 designations covering about 8.6 million people, the fourth largest count in the country. HRSA estimates 21.0% of the need is met, below the national figure, and that 395 more practitioners are needed, also the fourth most of any state.1 An estimated 22.2% of Illinois adults had any mental illness in 2023 to 2024,2 and 21.5% received mental health treatment in 2024.3
Colorado
Colorado has 85 designations covering about 4.1 million people. HRSA estimates 40.4% of the need is met, one of the higher figures in the country, with 137 more practitioners needed.1 Colorado also has one of the higher survey estimates for treatment: 29.1% of adults received mental health treatment in 2024.3 An estimated 26.4% of adults had any mental illness in 2023 to 2024.2 A higher share met does not mean it is easy to find care there. It means the gap is smaller than in many other states.
California
California has 643 mental health shortage designations, the most of any state. They cover about 12.3 million people. HRSA estimates 21.9% of the need is met, and that 673 more practitioners are needed, the second most in the country.1 An estimated 21.6% of California adults had any mental illness in 2023 to 2024,2 and 21.9% received mental health treatment in 2024.3
Florida
Florida has 241 designations covering about 12.3 million people. HRSA estimates 21.8% of the need is met, and that 710 more practitioners are needed, the most of any state.1 Florida also has one of the lowest survey estimates for treatment in the country: 17.6% of adults received mental health treatment in 2024.3 An estimated 20.8% of Florida adults had any mental illness in 2023 to 2024.2
Texas
More people live in Texas mental health shortage areas than in any other state: about 14.1 million, across 414 designations. Texas also has the most geographic designations, 196, meaning whole areas rather than single facilities. HRSA estimates 31.9% of the need is met, with 631 more practitioners needed.1 An estimated 20.7% of Texas adults had any mental illness in 2023 to 2024,2 and 19.6% received mental health treatment in 2024, among the lower estimates in the country.3
Pennsylvania
Pennsylvania has 130 designations covering about 1 million people, a smaller count than most large states. HRSA estimates 34.3% of the need is met, with 67 more practitioners needed. Most of Pennsylvania's designations, 107 of them, are facilities.1 An estimated 23.9% of Pennsylvania adults had any mental illness in 2023 to 2024,2 and 25.5% received mental health treatment in 2024.3 A smaller shortage count statewide does not help much if you live in one of the designated areas.
Washington
Washington has 244 designations covering about 5.6 million people. HRSA estimates 21.1% of the need is met, below the national figure, with 249 more practitioners needed.1 Washington also has one of the higher survey estimates for adults with any mental illness, 27.9% in 2023 to 2024,2 and 28.0% of adults received mental health treatment in 2024.3
If you live in a shortage area
A shortage does not mean there is no help. It means you may need to look wider and keep going after the first few calls. Some things that help:
- Look at telehealth. A therapist generally needs to be licensed in the state where you are, but they do not need to live near you. A video session can connect you with someone across the state.
- Ask your insurance plan for its list, then call more than one office. Directories are often out of date. Ask each office if they are taking new clients and how long the wait is.
- Check community health centers. HRSA funded health centers offer mental health care at many sites and charge on a sliding scale based on income. You can search for one at findahealthcenter.hrsa.gov.
- If you have Medicaid, read how Medicaid covers therapy. If cost is the worry, our therapy cost guide explains what to expect.
- Get on a waitlist and keep looking. Being on a list does not stop you from seeing someone sooner.
Our guide on how to find a therapist walks through the search step by step. If the search itself is what is wearing you down, you are not alone, and this piece on the search that stops people is for you.
If you are in crisis or thinking about suicide, call or text 988, the Suicide and Crisis Lifeline, any time.
StartHere.care is one more free place to look. It is independent, with no fees for clients or therapists, and you can start a search here.
For reporters
Every number above comes from the public files listed below. Each state has its own link (for example, #michigan or #ohio), so you can point readers straight to their state. The raw files and the script that builds the table are kept so the numbers can be checked and refreshed when HRSA publishes its next quarterly summary.
Sources
- Health Resources and Services Administration, Designated Health Professional Shortage Areas Statistics, Designated HPSA Quarterly Summary, Fourth Quarter of Fiscal Year 2026, Table 5 and endnotes, data as of September 30, 2026, report generated November 3, 2026.
- Substance Abuse and Mental Health Services Administration, 2023-2024 National Surveys on Drug Use and Health: Model-Based Estimated Prevalence for States, Table 33, Any Mental Illness in the Past Year among adults 18 or older, published December 17, 2025.
- Same source as note 2, Table 37, Received Mental Health Treatment in the Past Year among adults 18 or older, 2024.