Treatment Finder Research · August 2026
The State of Treatment Access in America
What 20,334 behavioral health facilities across 5,362 US cities reveal about where intensive care actually exists — and where it doesn't.
Key findings
of US cities with a treatment facility have no residential option — 3,427 of 5,345 cities.
facilities offers residential care (21%). Partial hospitalization is rarer still, at 16.5%.
the per-capita spread between the best- and worst-served states: Alaska has 15.7 facilities per 100k residents; Texas has 2.4.
of California facilities list Medicaid — the lowest rate in the nation, and the only state below 60%. Eleven states are above 95%.
of Idaho facilities offer residential treatment — the thinnest residential system of any state.
of West Virginia facilities offer partial hospitalization — the step-down level between inpatient and outpatient barely exists there.
The residential gap
Residential treatment is the level families most often search for in a crisis — and the level the system offers least. Nationally, 4,212 of 20,036 facilities with level-of-care data (21%) offer any residential program. In the thinnest states, fewer than one facility in eight does.
Thinnest residential systems
Share of facilities offering residential care — lowest first
- Idaho8.2%
- South Carolina10.2%
- Wisconsin10.6%
- New Jersey12.7%
- Oklahoma12.8%
- Michigan13%
Strongest residential systems
Share of facilities offering residential care — highest first
- California35.8%
- South Dakota35.7%
- Puerto Rico35.6%
- Utah32.8%
- North Dakota32.6%
- Rhode Island30.9%
Treatment deserts: cities with no residential option
A city can have a dozen outpatient providers and still leave a family driving hours for a residential bed. Of the 5,345 US cities with at least one facility reporting its levels of care, 3,427 — 64.1% — have no residential option at all. In Wisconsin, New Mexico and Michigan, roughly four cities in five are in that position.
Most treatment-desert cities
Share of a state's facility cities with zero residential care
- Wisconsin80.5%
- New Mexico79.6%
- Michigan78.8%
- New Jersey77.6%
- South Carolina77.5%
- Idaho75%
Fewest treatment-desert cities
States where residential care reaches the most cities
- Washington, DC0%
- Vermont33.3%
- Utah34.5%
- Rhode Island38.1%
- Puerto Rico38.7%
- California41.9%
The Medicaid picture
Nationally, Medicaid acceptance is broader than its reputation: 83.5% of facilities with payer data list it. But the floor matters more than the average — in California, barely half of facilities list Medicaid, twenty points below any other state, while eleven states sit above 95%.
Lowest Medicaid listing rates
Share of facilities listing Medicaid among those reporting payers
- California53.8%
- Florida63.9%
- Georgia67.5%
- Texas71.8%
- New Jersey73.1%
- Illinois75.1%
Fewest facilities per capita
Facilities per 100,000 residents — lowest first
- Texas2.4
- Puerto Rico2.7
- South Carolina3.2
- Georgia3.4
- Florida3.8
- Alabama3.9
Every state, every metric
Click any column to sort. State names link to live facility listings where available.
| Alabama | 202 | 3.9 | 22.8% | 14.4% | 15.3% | 84.2% | 62.3% |
|---|---|---|---|---|---|---|---|
| Alaska | 116 | 15.7 | 29.3% | 7.8% | 25.9% | 93.8% | 65.5% |
| Arizona | 593 | 7.8 | 21.5% | 20.6% | 31% | 86% | 56% |
| Arkansas | 139 | 4.5 | 23.7% | 36.7% | 32.4% | 82% | 65.7% |
| California | 1,864 | 4.7 | 35.8% | 19.3% | 22.2% | 53.8% | 41.9% |
| Colorado | 341 | 5.7 | 15.3% | 15.3% | 36.5% | 79.2% | 61.4% |
| Connecticut | 265 | 7.2 | 21.6% | 20.1% | 30.1% | 90.3% | 57.1% |
| Delaware | 66 | 6.3 | 19.7% | 6.1% | 34.8% | 91.7% | 64.3% |
| Florida | 880 | 3.8 | 25.7% | 20.8% | 21.6% | 63.9% | 50.6% |
| Georgia | 375 | 3.4 | 21.7% | 24.1% | 26% | 67.5% | 67.7% |
| Hawaii | 99 | 6.8 | 14.1% | 15.2% | 55.6% | 77.6% | 69% |
| Idaho | 250 | 12.5 | 8.2% | 13.1% | 26.9% | 96.8% | 75% |
| Illinois | 829 | 6.5 | 15.7% | 15.2% | 37% | 75.1% | 75% |
| Indiana | 529 | 7.6 | 18.9% | 10.6% | 25.6% | 90.1% | 68.1% |
| Iowa | 275 | 8.5 | 19.7% | 9.1% | 30.7% | 96.7% | 73.8% |
| Kansas | 204 | 6.9 | 21.6% | 6.4% | 37.3% | 88.1% | 72% |
| Kentucky | 585 | 12.7 | 19.2% | 12% | 30.7% | 92.7% | 66.2% |
| Louisiana | 251 | 5.5 | 20.7% | 16.7% | 38.2% | 91.3% | 59% |
| Maine | 199 | 14.1 | 18.6% | 3% | 13.6% | 95.5% | 67.2% |
| Maryland | 680 | 10.9 | 23.6% | 19.9% | 29.5% | 93.8% | 53.2% |
| Massachusetts | 482 | 6.8 | 27.6% | 19% | 14.6% | 88.8% | 53.3% |
| Michigan | 577 | 5.7 | 13% | 6.6% | 21.7% | 90.6% | 78.8% |
| Minnesota | 550 | 9.5 | 25.1% | 20.2% | 41.9% | 93.4% | 52.6% |
| Mississippi | 158 | 5.4 | 22.2% | 29.1% | 20.3% | 82.1% | 68.7% |
| Missouri | 366 | 5.9 | 19.4% | 18% | 34.7% | 84.3% | 72.2% |
| Montana | 119 | 10.5 | 20.2% | 9.2% | 18.5% | 95.8% | 72.7% |
| Nebraska | 163 | 8.1 | 27% | 6.7% | 23.3% | 93.8% | 71.1% |
| Nevada | 187 | 5.7 | 20.4% | 14% | 22.6% | 88% | 65.2% |
| New Hampshire | 116 | 8.2 | 17.2% | 12.1% | 19.8% | 85.2% | 67.4% |
| New Jersey | 672 | 7.1 | 12.7% | 31.3% | 43.1% | 73.1% | 77.6% |
| New Mexico | 164 | 7.7 | 13.4% | 5.5% | 23.2% | 98.1% | 79.6% |
| New York | 1,469 | 7.4 | 17.5% | 7.3% | 11.4% | 96.3% | 65.7% |
| North Carolina | 596 | 5.4 | 18% | 18.5% | 24.3% | 82.3% | 62.2% |
| North Dakota | 86 | 10.8 | 32.6% | 23.3% | 39.5% | 86.4% | 57.1% |
| Ohio | 913 | 7.7 | 17.5% | 25.4% | 33.7% | 96.2% | 65.3% |
| Oklahoma | 203 | 5 | 12.8% | 3.9% | 25.1% | 94.4% | 73.8% |
| Oregon | 282 | 6.6 | 17.7% | 12.1% | 30.1% | 90.3% | 66.3% |
| Pennsylvania | 861 | 6.6 | 20.1% | 18.5% | 30.8% | 87.4% | 61.9% |
| Puerto Rico | 87 | 2.7 | 35.6% | 24.1% | 6.9% | 94% | 38.7% |
| Rhode Island | 68 | 6.1 | 30.9% | 11.8% | 26.5% | 95.6% | 38.1% |
| South Carolina | 176 | 3.2 | 10.2% | 6.3% | 19.3% | 92.4% | 77.5% |
| South Dakota | 70 | 7.6 | 35.7% | 5.7% | 31.4% | 91.3% | 44% |
| Tennessee | 428 | 5.9 | 15.9% | 13.6% | 37.7% | 77.8% | 75% |
| Texas | 745 | 2.4 | 16.8% | 18.2% | 28.7% | 71.8% | 69% |
| Utah | 457 | 13 | 32.8% | 36.5% | 33.5% | 76.2% | 34.5% |
| Vermont | 85 | 13.1 | 26.2% | 8.3% | 11.9% | 94% | 33.3% |
| Virginia | 434 | 4.9 | 17.6% | 17.4% | 22.2% | 88% | 65.9% |
| Washington | 430 | 5.4 | 15.6% | 7.5% | 42% | 89% | 70% |
| Washington, DC | 36 | 5.1 | 13.9% | 19.4% | 36.1% | 97.1% | 0% |
| West Virginia | 181 | 10.2 | 25.4% | 2.2% | 13.8% | 96.1% | 71.6% |
| Wisconsin | 367 | 6.2 | 10.6% | 12.5% | 13.9% | 95.6% | 80.5% |
| Wyoming | 57 | 9.7 | 29.8% | 5.3% | 59.6% | 96.4% | 73.3% |
Methodology
Source. SAMHSA N-SUMHSS 2025 National Directories (substance use and mental health facilities), as processed and deduplicated by treatmentfinder.co. Population: US Census Bureau 2024 estimates. Snapshot taken 2026-08-12.
What was counted. 20,334 substance use and mental health treatment facilities after deduplication. Individual clinician records, duplicate records and records held for data review were excluded. National figures include all US jurisdictions; the state table shows the 50 states, Washington DC and Puerto Rico (Guam, CNMI and USVI have 7 facilities combined — too few to rate).
Denominators. Level-of-care percentages use only facilities that report their levels of care (20,036 of 20,334); payer percentages use only facilities that report accepted payers (19,570). A facility that reports nothing is treated as unknown, never as a no. A "city without residential care" has at least one facility reporting levels of care and none offering a residential program.
What this measures. Whether a facility offers a level of care or lists a payer category — not bed availability, wait times, network status or treatment quality. A facility listing Medicaid may still be out of network for a specific plan; always confirm coverage directly.
Citing this report. This report may be cited freely with attribution and a link: Treatment Finder, "The State of Treatment Access in America," treatmentfinder.co, August 2026. For questions or the underlying state-level figures, use the contact page.
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