America's mental health ranked

Nov 29 2007

Mental Health America has released its report, "Ranking America's Mental Health: An Analysis of Depression Across the States," a first-of-its-kind study examining state and national data for statistical associations between factors that govern access to mental health care and actual mental health outcomes, including suicide rates.

Included in the study is a ranking of the 50 states and the District of Columbia based on rates of depression and suicide. South Dakota is found to lead the nation with the best depression status while Utah ranks last. For the complete rankings, visit www.mentalhealthamerica.net.

"It is important to note that regardless of where each state ranks, there is much room for improvement," said Dr. David Shern, PhD, president and CEO of Mental Health America. "While a number of factors including biology and environment affect 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 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 healthcare 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 healthcare needs, the better the state's depression status.
• Mental health treatment utilization - The higher the percentage of the population receiving mental health treatment, 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 - Parity exists when state and/or federal law(s) require health insurers to provide mental benefits equivalent to those provided for other health conditions. The more generous a state's mental health parity coverage, the greater the number of people in the population that receive mental health services.

"The findings of this study underscore the critical need to monitor the mental health status of Americans by examining depression and the states' policies that may impact it," said Shern. "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."

In developing the state rankings of depression status, Mental Health America examined four measures: 1) the percentage of the adult population experiencing at least one major depressive episode in the past year, 2) the percentage of the adolescent population experiencing at least one major depressive episode in the past year, 3) the percentage of adults experiencing serious psychological distress, and 4) the average number of days in the last 30 days in which the population reported that their mental health was not good.

This report found significant variation among the states in the levels of depression and in its most tragic consequence: suicide. Rates of depression among the states vary from around seven percent in the least depressed states to over 10 percent in states where residents reported the highest levels of depression. This difference represents a nearly 40 percent variation from the least to the most depressed states.

To achieve top ranking in the country, South Dakota yielded the best results for the four measures used to develop a composite depression status indicator. Among adults, 7.31 percent experienced a major depressive episode in the past year and 11.16 percent experienced serious psychological distress. Among adolescents, 7.4 percent had a major depressive episode in the past year. On average, South Dakotans reported 2.41 poor mental health days per month. Even though South Dakota ranked well in overall depression status, it is also important to note that the state had an age-adjusted suicide rate of 14.85, ranking South Dakota 40th in the nation, which is 300 percent higher than the District of Columbia, which has the lowest suicide rate.

Utah ranked 51st in depression status. For both adults and adolescents, 10.14 percent reported experiencing a major depressive episode in the past year. Among adults, 14.58 percent experienced serious psychological distress. On average, residents of Utah reported 3.27 poor mental health days per month.

"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."

The top ten "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 ten "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.

Mental Health America (formerly known as the National Mental Health Association) is the country's leading nonprofit dedicated to helping all people live mentally healthier lives. With our more than 320 affiliates nationwide, we represent a growing movement of Americans who promote mental wellness for the health and well-being of the nation.

"Ranking America's Mental Health: An Analysis of Depression Across the States" was supported through an unrestricted educational grant from Wyeth Pharmaceuticals.