Mental Distress Among Seniors Surging

An increasing number of America’s seniors are struggling with mental health issues. According to the Centers for Disease Control and Prevention, nearly 10% of older adults experience mental distress regularly, an increase of 24% from 7.4% in 2015 (CDC). Compared to all other age groups, seniors aged 65+ experienced the sharpest rise in mental health diagnoses between 2019 and 2023 (FAIR Health analysis).

The data suggests the pandemic and its fallout have taken a heavy toll on older adults. Seniors were particularly vulnerable during COVID-19, as heightened health risks, coupled with social distancing measures, likely fostered social isolation and contributed to a rise in anxiety, grief, and depression.

Unfortunately for many seniors, mental health concerns have not subsided in 2024. Mental well-being, encompassing emotional, psychological, and social aspects, holds particular significance for older adults due to its substantial impact on physical health. 

Several key factors shape the mental health of older adults, including social support, loneliness, and isolation. These factors can be exacerbated by common stressors seniors often face, such as declining health, rising costs (including inflation and assisted living expenses), and staffing shortages in senior care.

While seniors experience different challenges as they age, where they live and how much they interact with friends and family can have a big impact. Compared with older adults who live alone, those living in multigenerational households are 23% less likely to experience frequent mental distress, according to a 2023 study. Meanwhile, researchers recently found that seniors who maintain an active and regular social life reap the benefits in terms of their emotional well-being. 

That may be because older adults who live alone are at higher risk of social isolation, which is tied to a slew of other health problems, including a 50% higher risk of dementia. In fact, social isolation is comparable with high blood pressure, smoking or obesity when it comes to risk factors for premature death, according to the National Academies of Sciences, Engineering, and Medicine.

Despite proven benefits of social interaction and the well-documented risks of isolation, Census Bureau data reveals that only 63.7% of older adults report receiving regular social and emotional support. Notably, older women are more likely to report feelings of loneliness compared to men. These findings emphasize the critical need to prioritize mental health in older adults and ensure they have access to the social support systems they need.

To identify the best and worst states for seniors’ mental health, Seniorly measured the most recent federal data across all 50 states and Washington, D.C. We analyzed five metrics from the Census Bureau and the Centers for Disease Control and Prevention, tracking social and emotional support, mentally unhealthy days, depression, living alone, and the availability of mental health specialists relative to the older population.

Key Findings:

• Utah is the No. 1 Best State: 71.2% of older adults say they get enough social and emotional support, one of the highest rates in the U.S., and they’re unlikely to live alone (30.6%). The rest of the top five – Hawaii, Minnesota, South Dakota and Alaska – have their own strengths and weaknesses, but generally boast few mentally unhealthy days per month and lower depression rates than the rest of the country.
• Louisiana is the Worst State: Older adults have an average of 3.9 mentally unhealthy days per month in Louisiana, the highest rate in the U.S. The rest of the bottom-ranked states are geographically concentrated – Tennessee, Alabama, West Virginia and Oklahoma – and tend to have fewer mental health specialists available and higher depression rates among seniors.
• Importance of Social Ties: States that score well for seniors’ social and emotional support tend to rank highly overall, with five of the overall top 10 states landing among the best for this metric (Minnesota, South Dakota, Colorado and Iowa and Utah). The share of seniors who said they get enough social and emotional support varies across the states, with a high of 74.3% in Maine and a low of 52.2% in Washington, D.C.
• 9 of 10 Best States in West and Midwest, 8 of 10 Worst in South: Nine of the 10 best states are in the West (5) and Midwest (4) with Delaware the only other region represented in the top 10.  Seven of the 10 worst states are in the South.

Top and Bottom States

Utah is the top state for seniors’ mental health, driven by its high level of social and emotional support reported among older adults (71.2%), low ratio of older adults to mental health specialists (19 to 1), and the fact that just 30.6% of older householders live alone. Interestingly, Utah lands in the middle of the pack when it comes to the share of seniors who have ever been told they have depression (16.5%), and their average number of mentally unhealthy days per month (2.9).

Rounding out the top five are Hawaii, Minnesota, South Dakota and Alaska. These states tend to have lower rates of lifetime depression (9.9% in No. 2 Hawaii, for example) and a better ratio of older adults to mental health specialists (22 to 1 in No. 5 Alaska). In No. 4 South Dakota, 71.5% of older adults say they always or usually get emotional and social support, and in No. 3 Minnesota, seniors have an average of just 2.2 mentally unhealthy days per month.
 

On the other end of the spectrum, Louisiana ranks as the worst state for seniors' mental health, ranking among the bottom 10 states across five key metrics. Residents experience an average of 3.9 mentally unhealthy days monthly, the highest in the nation. Additionally, 20.9% of seniors have received a depression diagnosis, second only to Tennessee.

The worst states for older adults’ mental health also include Tennessee, Alabama, West Virginia and Oklahoma. These four states have high rates of depression and mentally unhealthy days among seniors. In West Virginia (No. 48), for example, older adults spend an average of 3.5 days per month in a mentally unhealthy place, compared with the U.S. median of 2.9 days. In Alabama (No. 49), there are 59 older adults per mental health specialist, while in Oklahoma (No. 47), 59.9% of seniors say they get social and emotional support, some of the worst rates in the U.S. for those metrics.

Best and Worst States by Metric

Mental health

The number of mentally unhealthy days that people face per month is considered an indicator of daily emotional stress, and is tied to day-to-day functioning. South Dakota is the best for this metric, with seniors experiencing just 1.8 mentally unhealthy days per month, on average, while Louisiana is the worst with 3.9 days.

Social support

Emotional and social support is key for older adults’ overall health as they age, with research showing that those with support are less likely to be depressed or report chronic pain. However, many seniors don’t get these needs met, especially those living at home. Maine is the best for this metric, with 74.3% of older adults getting social and emotional support, while Washington, D.C. is the worst, with a level of 52.2%.

Depression

While depression is less common in older adults than their younger peers, it is associated with higher risk of health issues, suicide and cognitive functioning. Nebraska is the best for this metric, with 9.8% of older adults saying they’ve ever been told they are depressed, while Tennessee is the worst, with 22.4% saying the same.

Specialist availability

According to SAMHSA, under 40% of older adults with mental health or substance use problems get treatment. A dearth of supportive specialists in an area can exacerbate these challenges. Washington, D.C. is the best for this metric, with just 15 older adults per mental health specialist, while South Carolina is the worst, with 61 seniors per specialist in the state.

Living alone

Seniors who live alone are at higher risk of depression, research shows, and may be more socially isolated. Social isolation is tied to an approximately 50% higher risk of dementia and other serious health issues, according to the CDC. Utah is the best for this metric, with 30.6% of older householders living alone, while Washington, D.C.  is the worst, with 56.8% living alone.

5 Mental Health Tips for Seniors

As we age, prioritizing mental well-being becomes just as important as physical health. Here are some key strategies to keep your mind sharp, stay connected, and combat feelings of isolation:

Cultivate Strong Social Connections: Humans are social creatures, and social interaction is essential for mental well-being. Reach out to friends and family regularly, whether it's through phone calls, video chats, or in-person visits. Consider joining social groups for seniors, participating in community events, or volunteering for a cause you care about. Social activities not only provide companionship but also offer a sense of purpose and belonging.

Move Your Body, Boost Your Mood: Physical activity is a powerful tool for managing stress, improving sleep, and boosting cognitive function. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. Activities like walking, swimming, yoga, or dancing are all excellent options. Consider joining a fitness class specifically designed for seniors, or find a workout buddy to stay motivated.

Engage Your Mind, Sharpen Your Focus: Keeping your mind active is crucial for maintaining cognitive health and overall well-being. Learn a new skill, like painting or playing an instrument. Take a class on a topic that interests you, or challenge yourself with brain teasers and puzzles. Read books, articles, or listen to educational podcasts. Engaging your mind in new ways helps create new neural connections and can improve memory and focus.

Embrace Relaxation Techniques: Stress can take a toll on both physical and mental health. Regularly practicing relaxation techniques can help manage stress, improve mood, and encourage better sleep. Consider incorporating mindfulness meditation, deep breathing exercises, or progressive muscle relaxation into your daily routine. There are many guided meditations and relaxation apps available to help you get started.

Seek Professional Support When Needed: There's no shame in seeking professional help for mental health concerns. A therapist can provide a safe and supportive space to discuss challenges, develop coping mechanisms, and improve emotional well-being. Don't hesitate to reach out to a geriatric psychiatrist or therapist specializing in working with older adults.

Remember, taking care of your mental health is an ongoing process. By incorporating these tips into your daily routine, you can promote positive mental well-being and enjoy a happier, healthier life as you age.

Conclusion

Our report sheds light on the stark differences in seniors’ mental health across the U.S., making clear that while no state is perfect, factors like availability of specialists, social support and health outcomes go hand in hand. Understanding these differences at the state level can help providers and community organizations develop solutions that ensure America’s seniors have the support they need to thrive mentally and emotionally as they age – no matter where they live.

Methodology

We used the most recent data for five metrics to determine which states are best and worst for older adults’ mental health. We used a Z-score distribution to scale each metric relative to the mean across all 50 states and Washington, D.C., and capped outliers at +/-2. We multiplied Z-scores by -1 when a higher score was a negative sign, such as mentally unhealthy days, depression rate, living alone, and older adults per mental health specialist. A state’s overall ranking was calculated using its average Z-score across the five metrics. Here’s a closer look at the data we used:

• Mental health: Average number of mentally unhealthy days per month (including stress, depression or problems with emotions) among adults 65+, 2022 (CDC)
• Social support: Share of adults 60+ who report always or usually getting emotional and social support, March 2024 (Census Bureau)
• Depression: Share of adults 65+ who have ever been told they have depression, 2022 (CDC)
• Specialist availability: Number of adults 65+ per mental health specialist (including psychiatrists, psychologists, counselors, therapists, social workers, community health workers, technicians and aides), May 2023 employment and 2022 population (Census Bureau)
• Living alone: Share of householders 60+ living alone, 2022 (Census Bureau)