Special Report

12 States Struggling With Mental Illness

Close to 10 million Americans suffer from chronic depression, bipolar disorder, or another serious mental illness. Depression alone is the leading cause of disability worldwide. In the United States, mental illness — including depression — takes an enormous toll on health outcomes, quality of life, and economic productivity.

Despite its importance, mental illness is often poorly understood and subject to misperceptions by the general population, government officials, and even those who suffer from mental illness. Partially as a consequence, just under one-third of individuals with serious mental illness — defined as diagnosable mental, behavioral, or emotional disorders that result in functional impairment — are untreated in the United States. In 2014, an estimated 44.7% of the 43.6 million adults with any mental illness, and 68.5% of the 9.8 million adults with serious mental illness received mental health services in the past year.

24/7 Wall St. reviewed the 12 states where the highest shares of the adult population suffers from serious mental illness.

Click here to see the 12 states struggling with mental illness.

Depression and mental disorders are treatable psychiatric illnesses. Therapy, as well as many prescription drugs such as anti-depressants, anti-psychotics and mood stabilizers are used to treat serious mental illnesses. Because of this, states with a high share of adults with serious mental illness also tend to have more psychiatric drugs prescribed per capita. The number of these and other kinds of retail drugs prescribed exceeded the national average of 12.7 prescriptions per capita in all but four of these 12 states. In West Virginia and Kentucky, more than 20 drugs are prescribed per person each year.

While the 12 states struggling the most with mental illness do not necessarily have the nation’s highest poverty rates, mental illness is far more common among people living in poverty. Of adults living in poverty, 8.7% report serious psychological distress, in contrast with 1.2% of adults with incomes at least four times higher than the poverty level, according to the CDC.

A number of socioeconomic factors are associated with mental illness, either as contributors or outcomes. People with mental illnesses are more likely than others to abuse alcohol or illicit drugs. Residents of states struggling the most with mental illness are not necessarily among the most likely to abuse drugs and alcohol. However, in the majority of states with the highest prevalence of serious mental illness, higher shares of adults report needing, but not receiving, treatment for drug use than the 2.2% national average.

States assign different levels of importance to mental illness. Budget allocation for mental health issues varies considerably between states. Only 12 states have increased their respective mental health authority’s budget in each of the past three years. Idaho is the only state with a disproportionately high share of mentally ill residents to have increased its mental health budget annually over this period. Meanwhile North Carolina, which is also home to one of the highest shares of mentally ill adults, is one of just three states to have reduced its mental health budget every year since 2013.

Several states with a relatively high share of adults with mental illness are implementing progressive policies to better address societal issues associated with mental illness. Indiana, for instance, implemented a policy last year requiring state police academies to provide a crisis intervention overview to all police trainees for emergency situations involving the mentally ill.

To determine the 12 states struggling the most with mental illness, 24/7 Wall St. reviewed the share of the adult population with a serious mental illness in each state based on surveys conducted between 2013 and 2014 from the Substance Abuse and Mental Health Services Administration (SAMHSA). Serious mental illness is defined as “having, at any time during the past year, a diagnosable mental, behavioral, or emotional disorder that causes serious functional impairment that substantially interferes with or limits one or more major life activities.” The prevalence of any mental illness, including serious mental disorders that may not have impaired life activities for example, also came from SAMHSA. The percentage of adults reporting at least one major depressive episode in the past year, the share of adults who had suicidal thoughts in the past year, and alcohol and illicit drug abuse rates also came from SAMHSA. Per capita drug prescription rates came from the Kaiser Family Foundation. State mental health legislation and spending was compiled by the National Alliance on Mental Illness. We also considered poverty rates, uninsured rates, and educational attainment rates from the Census Bureau’s American Community Survey (ACS) as well as 2015 annual unemployment rates from the Bureau of Labor Statistics.

These are the 12 states struggling the most with mental illness.

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