Mental Health America is calling for policy change with the release of its new report, "Ranking America's Mental Health: An Analysis of Depression Across the States," which for the first time links each state's mental health status and suicide rates to the ability of its residents to access care. First-ever report ranks states by depression status and calls for mental health monitoring system
In general, states that offer more access to mental health services have lower rates of depression and suicide than states with more limited access to care.
The study ranks all 50 states and the District of Columbia based on rates of depression and suicide using national data (see chart below).
1. South Dakota
2. Hawaii
3. New Jersey
4. Iowa
5. Maryland
6. Minnesota
7. Louisiana
8. Illinois
9. North Dakota
10. Texas
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11. Georgia
12. Vermont
13. Nebraska
14. Florida
15, California
16. Massachusetts
17. Pennsylvania
18. Virginia
19. New York
20. New Hampshire
21. Alaska
22. Michigan
23. District of Columbia
24. Delaware
25. Arizona
26. Alabama
27. North Carolina
28. South Carolina
29. Kansas
30. Wisconsin
31. Tennessee
32. Montana
33. Mississippi
34. Colorado
35. Washington
36. New Mexico
37. Oregon
38. Connecticut
39. Indiana
40. Arkansas
41. Maine
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42. Wyoming
43. Ohio
44. Missouri
45. Idaho
46. Oklahoma
47. Nevada
48. Rhode Island
49. Kentucky
50. West Virginia
51. Utah
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The top 10 "least depressed" states are 1) South Dakota, 2) Hawaii, 3) New Jersey, 4) Iowa, 5) Maryland, 6) Minnesota, 7) Louisiana, 8) Illinois, 9) North Dakota and 10) Texas. The bottom 10 "most depressed" states are 42) Wyoming, 43) Ohio, 44) Missouri, 45) Idaho, 46) Oklahoma, 47) Nevada, 48) Rhode Island, 49) Kentucky, 50) West Virginia and 51) Utah.
"The take-home message from this study is that access to care makes a difference," said Dr. David Shern, Ph.D., president and CEO of Mental Health America, at a Nov. 28 press briefing at the National Press Club in Washington, D.C. "One of our goals with this report is to close the gap between science and availability of services."
Despite significant improvements in depression treatments and their availability in the past decade, the level of unmet needs remains dangerously high, said Dr. Reef Karim, attending psychiatrist and addiction specialist at the UCLA Neuropsychiatric Institute, at the briefing.
On average, people living with depression go for nearly a decade before receiving treatment, and less than one-third of people who do seek help receive adequate care. The answer he said, is to provide affordable access to care as well as early intervention.
Shern added that "while a number of factors including biology and environment impact an individual's mental health, this study shows that states can significantly improve their populations' mental health status by adopting policies that expand access to mental health treatments."
In "Ranking America's Mental Health," Mental Health America found statistically significant associations between the following factors and better depression status and lower suicide rates:
Mental health resources: On average, the higher the number of psychiatrists, psychologists and social workers per capita in a state, the lower the suicide rate.
Barriers to treatment: The lower the percentage of the population reporting that they could not obtain health care because of costs, the lower the suicide rate and the better the state’s depression status. In addition, the lower the percentage of the population that reported unmet mental health care needs, the better the state’s depression status.
Mental health treatment utilization: Holding the baseline level of depression in the state constant, the higher the number of antidepressant prescriptions per capita in the state, the lower the suicide rate.
Socioeconomic Characteristics: The more educated the population and the greater the percentage with health insurance, the lower the suicide rate. The more educated the population, the better the state's depression status.
In addition, the report found the following factor to be significantly associated with the level of mental health service utilization in a state:
Health Insurance Parity: The more generous a state's mental health parity coverage— which ensures equal insurance coverage for general health and mental health treatment—the greater the number of people in the population that receive mental health services.
Shern called for a mental health "surveillance system" that will monitor Americans mental health status and state policies that affect their care. "Through regular and ongoing measurement of key indicators of depression, we will be able to understand how state public policies impact a population's depression level and suicide rate—and make adjustments to benefit the millions of American affected by depression," he said.
"Despite the fact that some states do better than others on rates of depression and suicide, no state can be satisfied with its current status," continued Shern. "These rates can be driven lower by encouraging state policies designed to improve coverage, end discriminatory practices in insurance, and assure that qualified mental health professionals are available to serve everyone in need."
To read the Executive Summary and view the full Report, visit www.mentalhealthamerica.net.
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Contributor's Note
I was prompted to research this topic based on a political conversation with my brother. He made a joke "... mental health couch on Washington..." - parity "March on Washington"
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