MHA reports on state of mental health in America

By Phyllis Hanlon
August 20th, 2021

Since 2014, Mental Health America (MHA) has collected and published data related to the status of mental health in this country.

Theresa Nguyen, LCSW, chief program officer at MHA, explained that the data released, which generally has a two-year lag time, comes from federal sources, specifically the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the U.S. Department of Education.

“There is nothing reflective of 2020 in this report,” she said.

Nguyen added that the data collected, which covers all 50 states and Washington, DC for youth and adults regardless of whether private or public mental health systems were used, was publicly available and current as possible.

The report considered several measures to arrive at its findings. These included: adults with any mental illness (AMI), with substance use disorder in the past year, with serious thoughts of suicide, with AMI who did not receive treatment, with AMI reporting unmet need, with AMI who are uninsured and with disability who could not see a doctor because of costs.

The data also reflects the percentage of youth with at least one major depressive episode (MDE) in the past year, with substance use disorder in the past year, with severe MDE, with MDE who did not receive mental health services, and with severe MDE who received some consistent treatment.

Furthermore, the report captured the percentage of children with private insurance that did not cover mental or emotional problems; students identified with emotional disturbance for an individualized education program (IEP); and mental health workforce availability.

The report brings these measures together to arrive at the final outcome, according to Nguyen. “We do a policy analysis,” she said. “We look at trends and match them with the federal data.”

In general, the report indicated that approximately 10 percent of youth have severe depression; 57 percent of adults with mental illness and 60 percent of youth with depression received no mental health treatment; and just under 11 million people harbored serious thoughts of suicide.

In this year’s report, the northeast demonstrated the highest percentage of individuals who struggle with mental health issues, but, on the flip side, have the highest rates of access to mental health care.

In all New England states, the prevalence rankings for both adults and youth were relatively high: Connecticut, 20; Rhode Island, 28; Massachusetts, 30; New Hampshire, 33; Maine, 45; and Vermont, 50. (A prevalence ranking of 1 – 10 indicates a lower prevalence of mental health and substance use issues when compared to other states ranked 42 – 51).

However, access to mental health care for both adults and youth in the New England states ranked very high: Vermont, 1; Massachusetts, 2; Maine, 3; Rhode Island, 8; New Hampshire, 10; and Connecticut, 13.

While this region of the country showed favorable results regarding access, there are definite differences when comparing individual states. Nguyen indicated that knowledge of an area might provide enough insight to account for differences.

Additionally, state policies have implications that impact baseline health conditions, according to Nguyen. Access to care might be better in a small or homogenous state where it’s easier to pass legislation, she said, and speculated whether collaboration to pass meaningful legislation in the six New England states might explain the reason for better access.

“The government offers a safety net. It’s much harder to pass legislation in the south where there is lower prevalence but also low access,” Nguyen said.

She pointed out that some New England states begin offering easy access to mental health care for youth during puberty. “Outcomes are profound is treatment is begun early.”

For instance, 10 years ago, Maine was the leader in psychosis programs that provided strengths with a lens toward prevention. The results have been healthier overall outcomes, Nguyen noted.

Connecticut ranked approximately midway in the report and has several mental health resources, many of which are focused on children and youth. Connecticut’s Regional Behavioral Health Action Organizations (RBHOs) consolidate resources on a regional basis and offer a good way to network and address needs for both children and seniors, according to Sherry Skyler Kelly, Ph.D, private practitioner in West Hartford.

She said collaboration between several agencies and organizations has provided a number of important resources for families and children. “I believe there has been exceptional advocacy work and partnerships between the Department of Health, the Department of Education, Department of Children and Families, and the legislature of the past several years.”

According to Kelly, the 2-1-1 hotline also provides a bridge to resources, pointing individuals in the right direction for care.

Kelly added that more than 80,000 children in the state currently receive special education services and/or supports; the regional approach to care facilitates the identification process in each school district.

“In Connecticut, like in many other states, the schools have become the largest provider of mental health services for children.”

“Every student comes with a unique set of strengths and a complex constellation of challenges so needs a personalized approach,” said Kelly. She pointed out that the Connecticut House of Representatives recently passed a bill that will expand school-based mental health clinics across the state.

In spite of the plethora of resources, Kelly pointed out that finding a therapist can sometimes be extremely challenging as some practitioners do not accept insurance and other entities, such as UConn and Yale, only take patients in their system.

Ease of access to quality mental health programs in the New England states is cause for celebration, Nguyen noted. For both youth and adults, this area of the country is “doing something right,” she said. “The rest of the country should look to [New England] to learn how to manage mental health treatment and access. New England has consistently and historically been at the top. When you invest in infrastructure, the returns are healthier.”

Nguyen reported that the biggest takeaway from the report comes from comparing the data from one state with another. “Identify policy measures that support the outcomes and then look at the data,” she said. “Our hope is that people get the care they need.”

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