North Dakota Mental Health Statistics

Mental health conditions affect a significant portion of North Dakota's population, mirroring national trends but with unique local challenges. Approximately 20.1% of adults in the state meet the criteria for any mental illness (AMI) within a 12-month period^[2]. This data provides a broad overview of the mental health landscape, indicating that one in five adults faces a diagnosable condition annually. Understanding these top-line numbers is crucial for policymakers, healthcare providers, and communities to grasp the scale of need and allocate resources effectively.

Substance Use Disorder (SUD) is a significant public health concern in North Dakota, often co-occurring with other mental health conditions. The overall 12-month prevalence of SUD among adults is approximately 7.8%^[3]. This issue is particularly pronounced among young adults aged 18-25, where the prevalence rate is higher at 9.2%^[8]. The opioid crisis has also left its mark, with an Opioid Use Disorder (OUD) prevalence of 2.3% among adults^[3].

Access to mental healthcare is one of the most pressing issues in North Dakota. The state is designated as a Mental Health Professional Shortage Area (HPSA) with a score of 18, indicating a severe lack of providers^[10]. This shortage is especially acute in the state's vast rural regions, where nearly 80% of the population resides and 60% of the state's 75 HPSAs are located^[11]. These workforce gaps create significant barriers, leading to long wait times and forcing many residents to travel long distances for care.

Navigating the treatment landscape in North Dakota can be difficult. Beyond provider shortages, insurance-related barriers are common. In 2023, coverage denial rates for mental health services were 15.2%, more than triple the rate for medical services (4.5%)^[3]. Despite these challenges, the state has made strides in leveraging technology and crisis response systems. Telehealth utilization for mental health reached an estimated 70% in 2025, bridging some of the geographic gaps in care^[3]. Additionally, the implementation of the 988 crisis hotline and expansion of mobile crisis teams are improving immediate access to support.

Mental health does not affect all North Dakotans equally. Stark disparities exist across racial, ethnic, gender, and geographic lines. These differences are often rooted in systemic inequities, historical trauma, and social determinants of health. For example, Native American populations in the state face a disproportionately high burden of mental health conditions and suicide, coupled with lower rates of treatment access^[3]. Examining these disparities is essential for developing culturally competent and equitable healthcare solutions.

Certain populations in North Dakota face unique mental health challenges. The state's 48,000 veterans experience higher-than-average rates of PTSD and depression^[15]. College students also report high levels of anxiety and depression, which can negatively impact their academic performance^[3]. Additionally, older adults grapple with issues like loneliness, depression, and a critical shortage of specialized geriatric care providers.

Eating disorders represent a serious and growing concern in North Dakota. Binge eating disorder (BED) is the most common, affecting an estimated 3.5% of adults^[18]. Other conditions like anorexia nervosa and bulimia nervosa also affect residents, particularly young women. The state has seen a troubling rise in hospitalizations related to these conditions, underscoring the need for more specialized treatment options.

The economic impact of mental illness on North Dakota is profound, affecting everything from healthcare budgets to workforce productivity. The total economic burden is estimated at $3.2 billion for the 2020-2025 period^[5]. This figure includes direct costs like treatment and indirect costs such as lost wages and productivity, which alone account for an estimated $450 million annually^[19]. While the state has increased its mental health budget, spending per capita still lags behind the national average.

In recent years, North Dakota's legislature has taken steps to address the state's mental health crisis. Key legislation includes the '988 Crisis Hotline Implementation Act' in 2021, which allocated $5 million to establish the necessary infrastructure^[20]. In 2025, the 'Telehealth Parity Law Amendment' was enacted to broaden the scope of telehealth services to include counseling and follow-up care, further improving access for rural residents^[13]. These policy changes reflect a growing recognition of the importance of mental healthcare and a commitment to improving the system.