The risk factors contributing to maternal mental health disorders are complex, and access to mental health care is essential for timely diagnosis and treatment. In 2023, the first analysis of the county-level distribution of maternal mental health risk and availability of providers and community-based resources in the United States was produced. This month—Maternal Mental Health Awareness Month—a newly updated report highlights changes in risk and resources by county since the inaugural report.
The new report from the Policy Center for Maternal Mental Health and the George Washington University Milken Institute School of Public Health includes an interactive map tracking where in the United States women are at the greatest risk for maternal mental health disorders (through purple shading) and where providers and community-based organizations offer support (illustrated by circles that vary in size, representing higher or lower numbers of providers/programs).
County-level maternal mental health “risk” was assessed by using Census data and predictors of maternal mental health, such as intimate partner violence and poor mental health days. Maternal mental health “resources” include community-based organizations providing services, psychiatrists who self-certify as having expertise in maternal mental health, and perinatal mental health certified (PMH-C) providers.
The report’s key findings are:
- Risk for maternal mental health disorders is rising in the United States, with the number of counties with “severe risk” increasing threefold since 2023.
- 84% of birthing-aged women live in maternal mental health professional shortage areas, even as the number of maternal mental health providers has doubled since 2023.
- Nearly 150 counties are Maternal Mental Health “Dark Zones,” with Texas, Alabama, Louisiana, Oklahoma and Tennessee having the largest populations facing the highest risk and resource gaps.
“This analysis is critical for those aiming to target support in the most high-need areas of their states, and for national leaders to understand the states with the greatest need,” said Joy Burkhard, CEO of the Policy Center for Maternal Mental Health. “Specifically, the report highlights the states with the highest risk: Oklahoma, Arkansas and Alaska, while highly populated counties in Texas, California and New York face the largest provider shortages. The “Dark Zone” counties facing the highest risk and largest provider gaps fall within Texas, Alabama, Louisiana, Oklahoma, and Tennessee. The Policy Center will be prioritizing these counties and states working in partnership with others who hold our commitment to closing these gaps,” said Burkhard.
“The 2025 Maternal Mental Health County Level Risks & Resources map helps illustrate the depth of maternal mental health needs in the United States. We’re seeing important growth in the availability of maternal mental health providers and community-based supports, but the number of counties at high risk is actually rising,” said Caitlin Murphy, a research scientist at the GW Milken Institute School of Public Health, who co-authored the report. “This report helps states home in on those counties with the deepest, compounding stressors known to contribute to poor maternal mental health."