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9 Minnesota 1 Maine 2 Massachusetts 3 New Jersey 4 Vermont 5 Connecticut 6 Iowa 7 North Dakota 8 Hawaii 9 New Hampshire 10 Illinois 11 New York 12 Maryland 13 Pennsylvania 14 Michigan 15 Delaware 16 Rhode Island 17 South Dakota 18 Ohio 19 Wisconsin 20 Georgia 21 District of Columbia 22 Nebraska 23 Kansas 24 California 25 Kentucky 26 Oklahoma 27 North Carolina 28 Colorado 29 Missouri 30 New Mexico 31 Florida 32 Virginia 33 Washington 34 West Virginia 35 Alabama 36 Arkansas 37 Louisiana 38 Arizona 39 Montana 40 South Carolina 41 Indiana 42 Texas 43 Utah 44 Tennessee 45 Wyoming 46 Alaska 47 Mississippi 48 Oregon 49 Idaho 50 Nevada
10 Rank State 1 Maine 2 Hawaii 3 Iowa 4 Minnesota 5 New Jersey 6 Illinois 7 Massachusetts 8 Rhode Island 9 Michigan 10 Maryland 11 North Dakota 12 New York 13 Wisconsin 14 Delaware 15 Connecticut 16 South Dakota 17 Alabama 18 West Virginia 19 Nebraska 20 Ohio 21 Pennsylvania 22 California 23 Vermont 24 Oklahoma 25 Texas 26 Florida 27 New Hampshire 28 Kansas 29 Missouri 30 Arizona 31 Georgia 32 Colorado 33 New Mexico 34 North Carolina 35 Virginia 36 Kentucky 37 Mississippi 38 Washington 39 District of Columbia 40 Arkansas 41 South Carolina 42 Tennessee 43 Wyoming 44 Indiana 45 Montana 46 Louisiana 47 Utah 48 Nevada 49 Alaska 50 Idaho 51 Oregon 10
11 Rank State 1 Minnesota 2 Vermont 3 New Hampshire 4 Massachusetts 5 Connecticut 6 Pennsylvania 7 New Jersey 8 North Dakota 9 Maine 10 New York 11 Georgia 12 Maryland 13 Ohio 14 South Dakota 15 Illinois 16 Delaware 17 District of Columbia 18 Iowa 19 Kentucky 20 Michigan 21 Kansas 22 North Carolina 23 Virginia 24 Hawaii 25 Rhode Island 26 Wisconsin 27 Missouri 28 Nebraska 29 Indiana 30 Louisiana 31 Washington 32 Florida 33 Colorado 34 California 35 Alabama 36 Montana 37 New Mexico 38 South Carolina 39 Arkansas 40 Utah 41 Oklahoma 42 West Virginia 43 Arizona 44 Oregon 45 Tennessee 46 Texas 47 Alaska 48 Mississippi 49 Wyoming 50 Idaho 51 Nevada 11
12 Rank State 1 New Jersey 2 Georgia 3 Hawaii 4 Texas 5 Alabama 6 Mississippi 7 South Carolina 8 Louisiana 9 Florida 10 Illinois 11 New York 12 North Dakota 13 Maryland 14 North Carolina 15 Pennsylvania 16 South Dakota 17 Oklahoma 18 Delaware 19 Michigan 20 Tennessee 21 Kansas 22 Virginia 23 California 24 Missouri 25 Arizona 26 Nebraska 27 Connecticut 28 Iowa 29 Maine 30 Arkansas 31 Kentucky 32 Minnesota 33 District of Columbia 34 Ohio 35 West Virginia 36 New Hampshire 37 New Mexico 38 Utah 39 Massachusetts 40 Wisconsin 41 Indiana 42 Washington 43 Wyoming 44 Nevada 45 Vermont 46 Montana 47 Rhode Island 48 Colorado 49 Idaho 50 Alaska 51 Oregon 12
13 Rank State 1 Massachusetts 2 Vermont 3 Minnesota 4 Maine 5 Rhode Island 6 New Hampshire 7 Connecticut 8 Iowa 9 Ohio 10 Colorado 11 Wisconsin 12 North Dakota 13 Pennsylvania 14 Maryland 15 Michigan 16 Oregon 17 New York 18 Illinois 19 Alaska 20 Delaware 21 South Dakota 22 Washington 23 District of Columbia 24 New Mexico 25 Montana 26 Kentucky 27 New Jersey 28 Nebraska 29 Hawaii 30 West Virginia 31 California 32 Kansas 33 Indiana 34 Oklahoma 35 Utah 36 Missouri 37 Wyoming 38 North Carolina 39 Idaho 40 Virginia 41 Arkansas 42 Arizona 43 Florida 44 Georgia 45 Tennessee 46 Louisiana 47 Nevada 48 Alabama 49 South Carolina 50 Texas 51 Mississippi 13
14 Rank State % # 1 New Jersey ,062,000 2 Hawaii ,000 3 Illinois ,526,000 4 Texas ,196,000 5 Maryland ,000 6 North Dakota ,000 7 California ,072,000 8 Florida ,769,000 9 Louisiana , Michigan ,320, Mississippi , Arizona , New York ,692, Maine , Delaware , Iowa , Georgia ,341, South Dakota , Connecticut , Missouri , South Carolina , Kansas , Minnesota , Nevada , Nebraska , Alabama ,000 Rank State % # 27 Wisconsin , Pennsylvania ,861, District of Columbia , Oklahoma , North Carolina ,440, New Mexico , Rhode Island , Massachusetts ,034, New Hampshire , Wyoming , Tennessee , Ohio ,741, Indiana , Virginia ,261, Alaska , Colorado , Montana , Washington ,139, Vermont , West Virginia , Arkansas , Idaho , Kentucky , Utah , Oregon ,000 National ,035,000 14
15 Rank State % # 1 West Virginia ,000 2 Utah ,000 3 New Jersey ,000 4 Georgia ,000 5 Alabama ,000 6 Mississippi ,000 7 Texas ,382,000 8 Arkansas ,000 9 North Carolina , Kansas , Tennessee , Oklahoma , Hawaii , Florida ,176, Indiana , Nevada , Virginia , Arizona , Illinois , Pennsylvania , Maine , Idaho , Missouri , Minnesota , Iowa , Michigan ,000 Rank State % # 27 South Carolina , Kentucky , Nebraska , Ohio , Delaware , New York ,278, Wyoming , Washington , Louisiana , Maryland , New Hampshire , Colorado , California ,603, North Dakota , New Mexico , Wisconsin , Montana , Rhode Island , South Dakota , Vermont , Connecticut , Alaska , Oregon , Massachusetts , District of Columbia ,000 National ,313,000 15
16 Rank State % # 1 Florida ,000 2 Missouri ,000 3 Texas ,000 4 Alabama ,000 5 New Jersey ,000 6 South Carolina ,000 7 Maine ,000 8 Connecticut ,000 9 Oklahoma , Mississippi , Hawaii , South Dakota , Maryland , Illinois , Michigan , New York , Iowa , Georgia , California ,173, Virginia , Massachusetts , Arizona , Wyoming , Minnesota , North Dakota , District of Columbia ,000 Rank State % # 27 North Carolina , Louisiana , New Mexico , Nevada , West Virginia , Delaware , Pennsylvania , Wisconsin , Nebraska , Arkansas , Ohio , Rhode Island , Tennessee , Indiana , Kansas , Washington , Idaho , Colorado , New Hampshire , Oregon , Kentucky , Alaska , Montana , Vermont , Utah ,000 National ,860,000 16
17 Rank State % # 1 District of Columbia ,000 2 Georgia ,000 3 Louisiana ,000 4 New Jersey ,000 5 Mississippi ,000 6 South Carolina ,000 7 Hawaii ,000 8 Alabama ,000 9 North Dakota , Arizona , North Carolina , Kentucky , South Dakota , New York , Delaware , Texas , Tennessee , Pennsylvania , Vermont , Illinois , Connecticut , Kansas , Virginia , New Mexico , Maryland , Florida ,000 Rank State % # 27 California , Nebraska , Arkansas , Washington , Michigan , Minnesota , New Hampshire , Oklahoma , Montana , Massachusetts , Rhode Island , Utah , West Virginia , Ohio , Iowa , Maine , Missouri , Wisconsin , Colorado , Indiana , Wyoming , Alaska , Oregon , Nevada , Idaho ,000 National ,144,000 17
18 Rank State % # 1 Pennsylvania ,000 2 Virginia ,000 3 Georgia ,000 4 New Jersey ,000 5 Alabama ,000 6 Mississippi ,000 7 Maryland ,000 8 Tennessee ,000 9 Kentucky , North Carolina , Utah , Arkansas , Indiana , Hawaii , Ohio , South Carolina , Florida , Delaware , Louisiana , Oklahoma , Nebraska , Missouri , New York , Texas , Massachusetts , New Hampshire ,000 Rank State % # 27 Michigan , Iowa , Kansas , Minnesota , West Virginia , Connecticut , Maine , California , Wisconsin , Illinois , Idaho , Vermont , North Dakota , Washington , Nevada , Arizona , Rhode Island , District of Columbia , South Dakota , Oregon , Wyoming , Montana , Colorado , New Mexico , Alaska ,000 National ,148,000 18
19 Rank State % # 1 New Jersey ,000 2 North Dakota 6.2 3,000 3 South Dakota 6.2 4,000 4 Georgia ,000 5 Kentucky ,000 6 Hawaii 7.1 7,000 7 Montana 7.1 5,000 8 New Mexico ,000 9 Louisiana , New York , South Carolina , District of Columbia 7.6 2, Texas , Vermont 7.9 3, California , Connecticut , Kansas , Alabama , Nebraska , Illinois , Tennessee , Michigan , Delaware 8.7 6, Pennsylvania , Mississippi , New Hampshire 8.9 9,000 Rank State % # 27 Utah , Florida , Iowa , Oklahoma , Arkansas , Ohio , Maryland , North Carolina , Virginia , Minnesota , Wyoming 9.7 4, Colorado , Arizona , Missouri , Maine , Washington , Alaska , Wisconsin , Massachusetts , West Virginia , Idaho , Rhode Island , Oregon , Indiana , Nevada ,000 National 8.7 2,096,000 19
20 Rank State % # 1 Maine ,000 2 Minnesota ,000 3 Vermont ,000 4 Iowa ,000 5 New Hampshire ,000 6 Rhode Island ,000 7 Delaware ,000 8 Massachusetts ,000 9 North Carolina , Kentucky , West Virginia , Missouri , Michigan , Wisconsin , South Dakota , Ohio , Colorado , Illinois , Montana , Connecticut , Virginia , Washington , Pennsylvania , Oregon , Oklahoma , Indiana ,000 Rank State % # 27 Idaho , Wyoming , New Mexico , Kansas , Nebraska , Maryland , Tennessee , Arkansas , New York ,493, New Jersey , Utah , Mississippi , North Dakota , District of Columbia , Alabama , Georgia , South Carolina , Louisiana , Florida ,643, Alaska , Texas ,925, California ,157, Arizona , Nevada , Hawaii ,000 National ,663,000 20
21 Rank State % # 1 Hawaii ,000 2 Alabama ,000 3 Texas ,000 4 Nebraska ,000 5 Maine ,000 6 Rhode Island ,000 7 Wisconsin ,000 8 Alaska ,000 9 Florida , Massachusetts , North Dakota , Vermont , Iowa , Louisiana , Michigan , New Jersey , Oklahoma , California ,009, New York , Kentucky , South Dakota , Ohio , Tennessee , Montana , Connecticut , Delaware ,000 Rank State % # 27 Georgia , Utah , Kansas , Wyoming , Arizona , South Carolina , Illinois , Pennsylvania , New Mexico , Colorado , Maryland , West Virginia , Minnesota , Mississippi , Arkansas , Virginia , Missouri , North Carolina , Washington , Indiana , Idaho , Oregon , New Hampshire , Nevada , District of Columbia ,000 National ,024,000 21
22 Rank State % # 1 Massachusetts ,000 2 District of Columbia 4.3 4,000 3 Rhode Island 5.1 9,000 4 Minnesota ,000 5 Hawaii 5.6 9,000 6 Maryland ,000 7 Connecticut ,000 8 Kentucky ,000 9 Vermont 6.6 7, Wisconsin , Colorado , Washington , West Virginia , Iowa , New Hampshire , Ohio , New Mexico , Pennsylvania , Michigan , New York , New Jersey , Arizona , Oregon , North Dakota , California , Delaware ,000 Rank State % # 27 Arkansas , Illinois , South Dakota , Indiana , Maine , Alaska , Montana , Virginia , Nebraska , Utah , North Carolina , Nevada , Oklahoma , Kansas , Missouri , Idaho , South Carolina , Tennessee , Alabama , Mississippi , Georgia , Florida , Louisiana , Wyoming , Texas ,000 National ,359,000 22
23 1 2 Rank State % # 1 Hawaii ,535 2 Iowa ,455 3 Vermont ,144 4 North Dakota ,981 5 New Hampshire ,019 6 Massachusetts ,320 7 District of Columbia ,597 8 Minnesota ,523 9 Illinois , Maine , South Dakota , Rhode Island , Washington , Colorado , Connecticut , Wisconsin , Ohio , Montana , Maryland , California ,006, New York , Kansas , Oregon , Nebraska , Delaware , West Virginia ,178 Rank State % # 27 Pennsylvania , Idaho , Alaska , New Mexico , Kentucky , Wyoming , Michigan , Virginia , Utah , New Jersey , Indiana , Missouri , Arkansas , Arizona , Nevada , Tennessee , North Carolina , Oklahoma , Alabama , Georgia , Florida , South Carolina , Louisiana , Texas , Mississippi ,133 National ,663, Peterson-Besse, Jana J. MPH, PhD*; Walsh, Emily S. MPH ; Horner-Johnson, Willi PhD ; Goode, Tawara D. MA ; Wheeler, Barbara PhD Medical Care: October Volume 52 - Issue - p S51 S63 doi: /MLR Literature Review 23
24 Rank* State % # 1 Connecticut ,000 2 Minnesota ,000 3 Maine ,000 4 New Hampshire ,000 5 Ohio ,000 6 Massachusetts ,000 7 Oregon ,000 8 Alaska ,000 9 Vermont , Colorado , Wyoming , Maryland , North Dakota , Idaho , Rhode Island , Georgia , Iowa , West Virginia , Illinois , New York , Nevada , Pennsylvania , New Jersey , Indiana , Washington , North Carolina ,000 Rank* State % # 27 District of Columbia , Florida , Oklahoma , Delaware , Virginia , Montana , Louisiana , South Dakota , Utah , Arizona , Michigan , Missouri , California , Kansas , Arkansas , Wisconsin , Mississippi , New Mexico , Alabama , Nebraska , Hawaii , Kentucky , South Carolina , Tennessee , Texas ,000 National ,809,000 Due to data limitations, figures were taken from two sets of data: annual averages from and Data set denoted for each state in the Appendix-Table 1 24
25 High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes. Rank* State % # 1 Minnesota ,000 2 Maine ,000 3 New Hampshire ,000 4 Massachusetts ,000 5 Ohio ,000 6 Alaska ,000 7 North Dakota ,000 8 Colorado ,000 9 Michigan , Rhode Island , Iowa , Oregon , Illinois , Pennsylvania , Vermont , Maryland , West Virginia , New York , Missouri , Kansas , South Dakota , Delaware , Arkansas , Oklahoma , Connecticut , New Jersey ,000 Rank* State % # 27 North Carolina , Washington , California , Indiana , New Mexico , Utah , Wisconsin , Alabama , Louisiana , Arizona , Florida , Montana , Nebraska , Wyoming , Virginia , Idaho , Hawaii , Kentucky , Nevada , District of Columbia Texas , Georgia , Mississippi , Tennessee , South Carolina ,000 National ,000 Due to data limitations, figures were taken from three sets of data: annual averages from , , , Data set denoted for each state in the Appendix-Table 2 25
26 26 Massachusetts 3.2 9,000 Connecticut 4.1 7,000 Washington ,000 New Hampshire 4.3 3,000 Wisconsin ,000 New Mexico 4.7 3,000 Michigan ,000 South Dakota 5.1 2,000 Minnesota ,000 Kansas 5.5 7,000 Delaware 5.7 2,000 Indiana ,000 Vermont 5.7 1,000 Alaska 5.8 1,000 Maryland ,000 Pennsylvania ,000 Missouri ,000 Colorado ,000 Montana 6.2 2,000 Oregon 6.3 8,000 Rhode Island 6.3 3,000 Illinois ,000 New York ,000 Kentucky ,000 New Jersey ,000 District of Columbia 7.5 1,000 Maine 7.5 4,000 Iowa ,000 Tennessee ,000 Idaho 7.7 5,000 North Dakota 8.0 2,000 Georgia ,000 North Carolina ,000 California ,000 Utah ,000 Virginia ,000 Ohio ,000 West Virginia 9.0 5,000 Arkansas 9.2 8,000 Nebraska 9.4 7,000 South Carolina ,000 Florida ,000 Arizona ,000 Hawaii ,000 Nevada ,000 Texas ,000 Wyoming ,000 Oklahoma ,000 Alabama ,000 Louisiana ,000 Mississippi ,000 National ,000
27 3 3 High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes. Vermont ,071 Minnesota ,192 Massachusetts ,593 Wisconsin ,217 Pennsylvania ,033 Maine ,243 Indiana ,698 District of Columbia Iowa ,680 New Hampshire ,052 Rhode Island ,574 Connecticut ,440 Illinois ,623 Ohio ,172 New York ,924 South Dakota ,148 North Dakota Oregon ,944 Nebraska ,489 Virginia ,470 Michigan ,144 Missouri ,554 Maryland ,239 Mississippi ,506 Delaware Kentucky ,495 Arizona ,315 Georgia ,090 Colorado ,535 Oklahoma ,038 Wyoming New Mexico ,897 Florida ,613 Montana New Jersey ,718 Hawaii Texas ,233 Alaska Kansas ,355 Idaho ,401 West Virginia ,232 Washington ,942 Nevada ,841 California ,460 North Carolina ,404 Tennessee ,258 South Carolina ,305 Utah ,813 Louisiana ,746 Arkansas Alabama ,333 National ,651 27
28 28 Massachusetts 180:1 District of Columbia 230:1 Maine 230:1 Oregon 230:1 Vermont 240:1 Oklahoma 260:1 New Mexico 270:1 Rhode Island 270:1 Alaska 280:1 Connecticut 290:1 California 320:1 Colorado 330:1 Washington 330:1 Wyoming 330:1 Utah 350:1 New Hampshire 370:1 Montana 380:1 New York 390:1 Louisiana 420:1 Nebraska 420:1 Delaware 430:1 Michigan 430:1 Hawaii 440:1 Maryland 460:1 North Carolina 460:1 Minnesota 470:1 Arkansas 490:1 Idaho 520:1 Kentucky 520:1 Illinois 530:1 New Jersey 530:1 Nevada 540:1 Kansas 560:1 Ohio 560:1 Pennsylvania 560:1 Wisconsin 560:1 Missouri 590:1 North Dakota 610:1 South Dakota 610:1 South Carolina 640:1 Virginia 680:1 Florida 700:1 Indiana 700:1 Tennessee 740:1 Iowa 760:1 Mississippi 760:1 Arizona 820:1 Georgia 830:1 West Virginia 890:1 Texas 1010:1 Alabama 1180:1
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34 Teicher MH, Anderson CM, Polcari A: Childhood maltreatment is associated with reduced volume in the hippocampal subfields CA3, dentate gyrus, and subiculum. Proc Natl Acad Sci USA 2012;
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36 4 Bussing, Regina et al. (2010) Self-Esteem in Special Education Children With ADHD: Relationship to Disorder Characteristics and Medication Use. Journal of the American Academy of Child & Adolescent Psychiatry, Volume 39, Issue 10,
37 5 Stefan G. Hofmann, Alice T. Sawyer, Angela Fang, Anu Asnaani. (2012). Emotion dysregulation model of mood and anxiety disorders. Depressed Anxiety. May; 29(5): Published online 2012 Mar 16. doi: /da
38 6 Nancy Eisenberg, Amanda Cumberland, Tracy L. Spinrad, Richard A. Fabes,Stephanie A. Shepard, Mark Reiser, Bridget C. Murphy, Sandra H. Losoya and Ivanna K.Guthrie. (2001). The Relations of Regulation and Emotionality to Children's Externalizing and Internalizing Problem Behavior. Child Development, Vol. 72, No. 4 (Jul. - Aug., 2001), pp Carliner, Hannah et al. (2017). Trauma Exposure and Externalizing Disorders in Adolescents: Results From the National Comorbidity Survey Adolescent Supplement. journal of the American Academy of Child & Adolescent Psychiatry, Volume 56, Issue 9, e3 38
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43 11 Fazel, M., Hoagwood, K., Stephan, S., & Ford, T. (2014). Mental health interventions in schools 1: Mental health interventions in schools in high-income countries. The Lancet. Psychiatry, 1(5),
44 12 Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D. & Schellinger, K. B. (2011), The impact of enhancing students social and emotional learning: A metaanalysis of school-based universal interventions. Child Development, 82:
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46 14 Angelique G. Day, Cheryl L. Somers, Beverly A. Baroni, Shantel D. West, Laura Sanders & Cynthia D. Peterson (2015) Evaluation of a Trauma-Informed School Intervention with Girls in a Residential Facility School: Student Perceptions of School Environment, Journal of Aggression, Maltreatment & Trauma, 24:10, , DOI: /
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50 Rank State % # Rank State % # * Measures collected from Annual Averages based on Unmarked states: measures collected from annual averages based on
51 *Measures collected from annual averages based on ** Measures collected from annual averages based on Unmarked states: measures collected from annual averages based on
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53 /data/nsduh/reports- detailed-tables NSDUH s/annual_data/annual_2 014.html /data/nsduh/reports- detailed-tables NSDUH /data/nsduh/reports- detailed-tables NSDUH 53
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3+ 3+ N = 155, 442 3+ R 2 =.32 < < < 3+ N = 149, 685 3+ R 2 =.27 < < < 3+ N = 99, 752 3+ R 2 =.4 < < < 3+ N = 98, 887 3+ R 2 =.6 < < < 3+ N = 52, 624 3+ R 2 =.28 < < < 3+ N = 36, 281 3+ R 2 =.5 < < < 7+
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