# PRESS RELEASE

**FOR IMMEDIATE RELEASE**
**Embargoed until**: pending Trellison Institute methodology rating + LedgerWell evidence-chain certification.
**Contact**: [email protected]

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## The Mental Health Access Gap is Two Problems, Not One: Trellison Institute Working Paper Maps the U.S. at the Census-Tract Level

**A new methodology-rated study from Trellison Institute joins federal mental-health prevalence data to the national provider registry and finds that 91.3% of U.S. adults live within 30 minutes of a licensed mental-health provider — and the policy levers for the two populations who can't are completely different.**

**Trellison Institute** today released the V1 draft of *The Mental Health Access Gap in the United States Divides into Two Distinct Problems*, an open-source working paper that maps mental-health provider access across 78,815 census tracts and 244.5 million American adults. The study uses CDC PLACES tract-level prevalence estimates, the CMS National Provider Identifier registry, and the 2024 Census Gazetteer ZIP-centroid file to compute a drive-time-to-nearest-provider for every U.S. census tract.

The headline finding splits the public-health access conversation into two distinct problems with different policy answers:

- **6.3 million Americans (2.6%) live more than 60 minutes from any licensed mental-health provider.** They cluster in three regions: the Texas-Mexico border, interior Alaska, and the rural Mountain West. Brewster County, Texas is five hours and twenty-one minutes from the nearest provider. *Their problem is geographic*. The policy lever is telehealth expansion, mobile crisis teams, the federal Mental Health Professional Shortage Area program, and HRSA loan-repayment incentives.

- **238 million Americans live within a 30-to-60-minute drive of a provider but cannot reliably get an appointment.** Their problem is not distance — it is workforce capacity, payment-model adequacy, and insurance-network access. The policy lever is BHWET workforce expansion, the Certified Community Behavioral Health Clinic (CCBHC) payment model, Medicaid network-adequacy enforcement, and parity-law enforcement under MHPAEA.

**"Conflating the two has stalled the policy conversation,"** said the project research team. **"Separating them clarifies the levers. Telehealth investments don't reach the 6.3 million who need them most; network-adequacy rules don't address the 238 million who can't get an appointment. The data says these are different gaps that need different policies."**

The study introduces a methodological signal — a **college-town capacity-gap pattern** — that the framework identifies systematically. In Cabell County, West Virginia (home to Marshall University), the nearest psychiatrist is 0.7 minutes away by car and the local frequent-distress prevalence is 36.9% — more than double the national average. By every other input, the area should have manageable access. The data says the gap is among the worst in the country. Eight college towns across eight states show the same pattern.

The study also identifies **replication candidates** — places where the gap is better than the demographic model predicts. Wayne County, Michigan (Detroit), Kent County, Michigan (Grand Rapids), and Jackson County, Missouri (Kansas City) all show this signature. The common policy stack: state Medicaid expansion + federally-designated CCBHC payment model + a real network-adequacy regime.

## The Methodology Audit

The Mental Health Access Gap study is also the first published application of the **Need-vs-Access Framework v1**, a reusable methodology that Trellison Institute is releasing under CC-BY-4.0. The framework is designed to apply the same analytical pipeline to other access domains: poverty safety net, English-language acquisition, jobs vs job seekers, postsecondary access, library access, police per capita, maternal care, dental care, broadband, oncology, and crisis response. Each domain swap is a data-input change; the framework code does not change.

The framework is a registered DB-native tool in the DaedArch platform and is fully reproducible from authoritative federal data sources (CDC PLACES, CMS NPPES, ACS, Census Gazetteer). The methodology supplement, dataset CSV (78,815 rows × 27 fields), per-tract dartboard case studies, and replication package are published as a single content arsenal at:

**https://trellison.com/research/mental-health-supply-demand-gap**

## About Trellison Institute

Trellison Institute is the methodology-audit arm of the DaedArch platform. Its work product is the audit: rating the methodology of public research, mapping authoritative data, and publishing transparent reproducible analyses that researchers, policymakers, and journalists can verify. Trellison does not influence research; it is the audience. It rates methodology, not conclusions. The Mental Health Access Gap V1 is its first published audited research output.

## About LedgerWell

LedgerWell Corporation provides the evidence-chain certification substrate that backs each Trellison Institute publication. Every analytical step in the Mental Health Access Gap V1 — data source, transformation, output — is cryptographically attested and verifiable.

## About DaedArch

DaedArch Corporation is the public-facing operating entity for the Icarus Flew research mission. The DaedArch platform integrates analysis, methodology audit, evidence-chain certification, and publication into a single end-to-end pipeline. DaedArch is led by Rob Stillwell with DaedArch AI as operational partner.

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**For methodology inquiries**: [email protected]
**For data and replication**: [email protected]
**For press**: [email protected]
**Working paper DOI**: pending Zenodo registration

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