According to a new study by Mental Health America, Iowans are fourth in the nation when it comes to depression status.
The report, “Ranking America’s Mental Health: An Analysis of Depression Across the States,” examined state and national data for statistical associations between access-to-care factors and actual health outcomes, such as a state’s mental health status and suicide rate. South Dakota was found to lead the nation with the best depression status while Utah ranked last.
“It is important to note that regardless of where each state ranks on our mental health scale, 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 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.”
The researchers 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 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 — 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 health insurance parity to be significantly associated with the level of mental health service utilization in a state.
“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.
Iowa fell statistically lower than the national average of 3.31 poor mental health days. Only 8 percent of adolescents and 7.35 percent of adults in Iowa had major depressive episodes between 2004 and 2005, the time limit studied for the report. National percentages were 8.95 percent and 8.05 percent, respectively. Overall, the state received 2.52 poor mental health days.
The only part of the survey where Iowans ranked higher than the national average was on the percentage of adults with serious psychological distress during 2004 and 2005. Nationally the states averaged to 11.63 percent of the population. In Iowa, the percentage was 11.75.
The 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.
Iowa could also stand to improve its suicide rate. Nationally, the state ranks 24th with an overall percentage of 11.61 and an age-adjusted suicide rate of 11.46 percent.
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 11.6 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% 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,” Shern said. “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, 
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.
In Iowa, state mental health expenditures per capita were $76.14. The state has nearly 7 psychiatrists, 22 psychologists and 113 social workers for every 100,000 people. Roughly 8 percent of Iowans report they could not get health care because of the cost. In addition, 4.5 percent indicated an unmet need for mental health care treatment or counseling in the past year.
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. The report was supported through an unrestricted educational grant from Wyeth Pharmaceuticals.
