State-by-state depression resources

Why state resources matter

Crisis lines are national. Almost everything else in mental health care is run state by state. The state mental health authority sets policy and funds the public system. Medicaid is administered by the state, often through regional managed care plans, and that determines which clinicians a low-income resident can see in network. Telepsychiatry licensing is a state-level rule, so a clinician who's licensed in one state generally can't treat patients in another. The university and academic medical center options change depending on where you live, and so do the specialty programs for treatment-resistant depression, perinatal depression, and youth mood disorders. The 51 pages below are the practical first contacts in each state and the District of Columbia.

Each page is built from the same authoritative sources: the state mental health authority website, the state Medicaid behavioral health portal, the National Alliance on Mental Illness (NAMI), Mental Health America (MHA), the local 211 information and referral line, and the federal SAMHSA FindSupport.gov treatment locator. The format is identical on every page so it's easier to compare states and easier to find what you need.

What you'll find on each state page

Each state page leads with what is specific to that state: state and regional crisis and warm lines, the state behavioral health agencies, crisis care and community mental health programs, the local NAMI helplines listed in NAMI's own directory, the state Medicaid program, and academic psychiatry departments. Where shrinkMD is licensed, the page says so. It closes with a short FAQ built on that state's data and links to neighboring states and to the matching page on our sister site, AnxietyResource.org. Resources that work the same in every state are listed once, below.

National lines that work in every state

• SAMHSA National Helpline. 1-800-662-HELP (4357). Free, confidential treatment referral and information, 24/7, 365 days a year, in English and Spanish. The same agency runs the FindSupport treatment locator.
• NAMI HelpLine. 1-800-950-NAMI (6264), or text "NAMI" to 62640. Monday to Friday, 10am to 10pm Eastern, closed federal holidays. Peer support and information, not a crisis line. Local chapters are at nami.org/find-your-local-nami.
• 211. Dial 211 for the local information and referral line, which covers behavioral health along with housing, food, and transportation. 211.org.
• Mental Health America affiliates. Screening, support groups, and referral where a local affiliate exists. mhanational.org/affiliates.
• Veterans. Call 988 and press 1, or text 838255, for the Veterans Crisis Line. The VA facility locator finds the nearest VA medical center and mental health clinic.

How national crisis lines work in every state

988 reaches the Suicide and Crisis Lifeline from any state in the United States, by call or text, around the clock. The chat option is at 988lifeline.org. Calls connect to a trained counselor, usually at a crisis center in the 988 network near the caller, who often knows the local mobile crisis and walk-in options. Press 2 for Spanish; TTY users can dial 711, then 988. The Crisis Text Line (text HOME to 741741) is also national. The Veterans Crisis Line is reached by calling 988 and pressing 1, or by texting 838255. None of these change by state. They're always the right call when there's immediate concern about safety, and they'll stay on the line while a person figures out the next step.

What varies by state

Three things vary the most from one state to another and they shape what care a person can actually get. The first is Medicaid expansion status. States that expanded Medicaid under the Affordable Care Act cover adults up to 138 percent of the federal poverty level, which dramatically widens access to behavioral health for working-poor adults. States that didn't expand have a coverage gap in which adults below the poverty line often don't qualify for Medicaid and can't afford marketplace plans, even with subsidies. The Kaiser Family Foundation maintains a current map at kff.org. The second is telepsychiatry infrastructure. Some states participate in the Psychology Interjurisdictional Compact (PSYPACT), which allows licensed psychologists to practice telehealth across member-state lines. Other states require a separate state license for every patient location. The Counseling Compact and Social Work Compact extend similar mobility to those professions in participating states. Physicians, psychiatrists included, can use the Interstate Medical Licensure Compact to get licensed faster in member states, but a psychiatrist still needs a license in each state where a patient is physically located at the time of the visit. The third is the crisis system itself. Some states have built statewide mobile crisis teams that respond in person within an hour, plus 988-routed crisis stabilization centers and 23-hour observation units. Other states still rely heavily on emergency departments and law enforcement. The state page for each state notes which of these resources exist locally and which don't.

How telepsychiatry rules work state to state

Telepsychiatry is legal in every state when the clinician holds an active license in the state where the patient is physically located at the time of the appointment. Ask any practice to confirm it is licensed in your state before booking.

Federal and state rules for prescribing controlled substances by telemedicine are complex and may change, and clinicians must follow current law. Controlled substances include benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan), and stimulants such as methylphenidate and the amphetamine salts used for ADHD. Antidepressants (SSRIs, SNRIs, bupropion, mirtazapine, and others) aren't controlled substances and aren't subject to those rules. A telepsychiatry clinician should explain which medications they can and can't prescribe in your state before treatment begins.

Practices that offer telepsychiatry for depression include, alphabetically, Brightside Health, Cerebral, shrinkMD, and Talkspace Psychiatry. None is endorsed by this site. State availability, insurance coverage, and clinical scope vary, so confirm directly with each practice.

Disclosure (FTC 16 CFR Part 255). shrinkMD is a multistate telepsychiatry practice operated by an affiliate of shrinkMD Publishing, LLC, which publishes this site. The editor of this site, Shariq Refai, MD, MBA, is the founder of shrinkMD and has a financial interest in it. shrinkMD is listed as one of several resources, not as a recommendation. The site receives no fee, commission, or referral revenue for listing shrinkMD or any other practice.