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Mental Health Statistics Reveal a Crisis in America

County officials are asking Congress for more funding and to change a pair of Medicaid rules that will allow governments to provide more mental health services.

As part of Mental Health Awareness month, organizations and governmental bodies are releasing reports with astounding statistics about the state of mental health in the U.S..

Perhaps the most tragic number is the 48,000 people who died by suicide in 2021, according to a report by Pew Charitable Trusts. It was the 11th leading cause of death that year. Furthermore, Pew reports, 5% of the world’s population is suffering from depression.

Although Americans are spending billions each year on mental health—$280 billion in 2020 alone—Pew reports that in 2019, 57% of Americans with mental illnesses didn’t get the care they needed.

The two main places where untreated people are landing is in prisons and in clogged emergency rooms, where those in need of help sometimes spend days before they’re evaluated, according to leaders of the National Association of Counties. So last Thursday, a group of NACo leaders met with congressional committees to argue for several remedies that will allow governments to get more help to people struggling with mental illness.

Specifically, the association is advocating for Congress to change two Medicaid rules to help address the mental health crisis in communities.  

NACo is asking for Congress to amend the Medicaid Inmate Exclusion Policy, which prohibits the use of Medicaid to pay for the treatment of prisoners even if they haven’t been convicted of a crime. NACo wants the rule to be revised to allow Medicaid to pay for the treatment of prisoners before they’re convicted and beginning again at least a month before they’re released from prison. 

They also want to see the elimination of the Medicaid rule prohibiting payment to residential psychiatric treatment centers that have more than 16 beds. The Institutions for Mental Disease exclusion needs to be “modernized,” according to NACo, in order to expand the capacity of county-operated hospitals and other treatment facilities.

“These are more than numbers on a page,” said Denise Winfrey, NACo’s president and a Will County, Illinois, board member, just before she and her colleagues made their way over to Capitol Hill. “Counties are uniquely positioned,” to argue for remedies, she said. “We know what is at stake.”

As part of the county officials’ push to rally for more services and funding for mental health, NACo surveyed its members all over the country to get a full measure of the problem’s dimensions. The responses told of desperate crises in every corner.

Pierce County, Washington, for example, reported increased violence among youth, including murders, suicides and substance use. A survey of 10th graders showed that 18 percent did not feel safe at school.

In Roscommon County, Michigan, providers are overloaded. It takes two to three months for a mental health care appointment, there is a waitlist for beds and a quarter of those in jail are waiting for medication.

In Tulare County, California, clinicians are carrying 100 or more caseloads, making it  impossible to see patients as often as needed, and the two managed care plans in the  county have neither the capacity nor the infrastructure to take any clients with mild or moderate behavioral health issues.

In Texas County, Missouri, residential facilities are full.

And Matin County, Kentucky, is struggling with a lack of facilities that can deal with both substance abuse and mental health issues.

The reasons for the high number of people suffering with mental health are varied, including generational trauma, financial and social troubles, the years of fear and isolation that came with the Pandemic, and more, experts say. But the key to helping people before they become desperate, according to researchers, is to identify them and refer them to mental health experts who can help them.

Pew researchers working on a suicide risk reduction project found statistics that show more than half of all people who kill themselves have seen a medical provider of some kind within a month of ending their lives. This information provides an opportunity to identify those grappling with suicidal thoughts and refer them to experts who can help them, said Kristen Mizzi Angelone, director of Pew’s suicide risk reduction project. 

Pew is encouraging hospitals to screen every person who comes in for any kind of medical help. The suicide risk reduction project is focusing on the hospitals because of the broad cross section of people who visit for medical help, Mizzi Angelone said.

A video about suicide screening produced by Pew featured the experience of Hennepin Healthcare in Minneapolis, the hospital with the busiest level one trauma center in the region. In the first two years that nurses screened the roughly 80,000 patients the hospital treats a year, they identified 2,000 people at moderate to high risk of suicide with an average of two to three patients identified each day.

Pregnant or postpartum women represent a group of people who are particularly vulnerable to suicide. A Pew report on pregnancy-related suicide reported that “the overall U.S. maternal mortality rate has increased, in part because of the suicide rates among pregnant and postpartum people.”

The Pew report went on to cite a study relying on Centers for Disease Control and Prevention data that found “suicide deaths among pregnant and postpartum individuals were higher than specific obstetric causes of maternal mortality, such as hemorrhage (severe bleeding) or hypertensive disorders.”

“This is a crucial area where the health care system can make progress,” Mizzi Angelone said. “There are many walking among us every day who are experiencing suicidal thoughts. So many of these people are not identified. We want to make sure our health care systems are capturing these people.”

Winfrey, the NACo official from Illinois, said it’s critical that this nation’s leaders help people get the mental health treatment that they need. “The head is part of the body and the mind drives the body,” she said. Solving this crisis “is vital to the health and well-being of the nation.”