by David Shern, PhD

President and CEO, Mental Health America

Last month Mental Health America 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 several access-to-care factors (including access to mental health professionals) and actual health outcomes, namely a state’s depression status and suicide rate.

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 ranked last. The complete rankings and report are available on www.mentalhealthamerica.net.

In developing the state rankings of depression status, Mental Health America examined the following 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.

The report found significant variation among the states in the levels of depression and in 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.

In “Ranking America’s Mental Health,” Mental Health America also 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.

• Health Insurance parity—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. Regular and ongoing measurement of key indicators of depression will facilitate better understanding of how state public policies influence a population’s depression level and suicide rate and enable adjustments to benefit the millions of American living with depression.

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. These rates can be driven lower by encouraging state policies designed to improve coverage and ending discriminatory practices in insurance.

The findings also illustrate that the current number of practicing psychiatrists and other mental health professionals is inadequate to deliver high-quality care to everyone in need. To improve mental health status and lower suicide rates, workforce development must be a priority.

For the full report and ranking of the 50 states, please visit www.mentalhealthamerica.net.