SALT LAKE CITY (ABC4 News) – Utah ranks last in the country when it comes to mental health, according to a new report released last month by the Kem C. Garden Policy Institute at the University of Utah.

“The lifestyle and economic pressures here contribute to the epidemic. We have two-income families where the mom’s working, the kids are under pressure with daycare, and everybody wants to do well in school,” said Utah Hospital Association CEO and President Greg Bell. “There’s a lot of peer pressure, social media, bullying. These issues have emerged and they’re becoming more intense than there used to be.”

In the study titled ‘Utah’s Mental Health System,’ researchers assessed the current state of mental health services in Utah, highlighted gaps in services, identified barriers to providing and accessing care, and made suggestions for improving the system. The report noted, however, that it did not look into mental health services provided by county jails and Native American tribes.

“Utah’s hospitals see the mental health crisis mostly in their emergency rooms. We’re one of the first lines of contact when people are in distress, whether it be an overdose, whether it be acute mental health episode, people find their way to the emergency room,” said Bell on why they sponsored the report.

Key Findings

According to the report, one in five adults in Utah experiences poor mental health. Between 2015 and 2017, 15 percent of males and 28.5 percent of females aged 15 to 17 seriously considered suicide. Other key statistics include:

Utah ranks last in the country for adult mental health

Suicide is the leading cause of death for Utahns ages 10 to 24

Almost 40 percent of Utah’s depressed youth ages 12 to 17 did not receive treatment for depression

66 Utahns sustain a traumatic brain injury every day, which increases the risk for mental health issues

Veteran suicides account for at least 13 percent of all suicides in Utah

About 15 percent of new mothers experience postpartum depression symptoms. The percent increases to 21 percent for low-income mothers

More than half of Utah adults with mental illness did not receive mental health treatment or counseling

More than 100,000 adults in Utah experience serious mental illness

Gaps and Barriers in Utah’s Mental Health

Kinzey Cross, a Carbon County resident, said she battled depression as a teen and attempted suicide for the first time at 14 years old.

“I grew up with an abusive father, Every day, things start to get worse and worse. Even when my mom, brother, and I were able to leave the situation, it didn’t get better. When I started junior high, I was a complete outcast,” she said.

Cross said she sought treatment from the only resource center in her county at the time and met with approximately five therapists over the course of three years.

“Of those five therapists, they either left, took over a drug class, had too big of a caseload, or wouldn’t have an open appointment. So they couldn’t help me. I was struggling so badly. That resource center let me down so many times. After struggling for so long, my mom was worried that she would lose her daughter,” she said. “Finally, I was admitted to the psychiatric unit at the University of Utah Neuropsychiatric Institute. I received amazing treatment. They changed me for the better. I am now proud to say I am living a wonderful life and I have a bright future ahead of me.”

The Kem G. Gardner Policy Institute’s report said the ratio of child psychiatrists per 100,000 children in Utah is particularly low but even lower in rural areas.

“Most counties have no access to a practicing child and adolescent psychiatrist unless they travel to a different county for services,” the study said. “Utah’s rural areas particularly struggle with provider shortages. The shortage is particularly acute in rural areas where it is difficult to attract people to live, some positions are funded with intermittent grant funding, and some positions require being on-call for long periods of time.”

Rising Demand and Growing Shortages

The study found that the demand for mental health care in Utah is increasing and the state’s shortage of mental health providers could worsen over time. Researchers said the state experiences shortages in all of its counties and falls below the national average when it comes to the number of provides per 100,000 residents.

“A newly expanded Medicaid program couples with a rapidly growing state population will intensify the effects of existing shortages,” the report stated.

Group discussion participants expressed that an ideal mental health system would provide integrated mental and physical health services in a timely manner. They said mental health screenings should be conducted to assess individuals, identify risks, and allow for early interventions that prevent escalation.

“There’s no doubt that the need is increasing. Utahns have a great need for mental health services,” said Bell. “We don’t have the range of services and the availability of services that Utahns need.”

The Stigma of Mental Health

Jessica Hayes, a Salt Lake County resident, has battled suicidal thoughts since she was 12 years old and survived three attempts over the past 18 years. She said the stigma surrounding mental illness and suicide hindered her from pursuing and receiving treatment.

“For whatever reason, we have this attitude of ‘You should stick it out. You should do it by yourself. If it’s not a major emergency, then you’re fine. You don’t need to bother anyone else,'” said Hayes. “I feel like teens get it in their head that they’re just making things a bigger deal than they actually are when it could be an undiagnosed mental health issue.”

As an adult, Hayes was diagnosed with depression and borderline personality disorder. It gave her some answers, but she said it shouldn’t have taken that long to reach that point.

“I think it would have made a world of difference if there wasn’t a stigma because I was struggling. I was struggling really hard and I wasn’t turning to the resources I had because I felt isolated. I felt alone,” she said.

Hayes said mental illness is a medical condition and should be treated as such by employers, school administrators, and community leaders.

“When people get days off for sickness, I think that mental health needs to be included in that. There are people who have depression and it knocks them off their feet,” she said. “There are days when they cannot get out of bed, they struggle to get food to eat, they struggle with something as simple as going to the gas station.”

Most importantly, Hayes emphasized that suicide has no specific look and that anyone could fall victim to mental illness.

“It could be the most successful CEO. It could be a child. Anyone you pass on the street could be struggling and you would have no idea,” she said.

Funding for Mental Health Services

Researchers said chronic disease and poor mental health are closely related, but funding for Utah’s public mental health system is divided across different systems, making it difficult for people with both conditions to access timely care.

“People need service when they need it. Antidepressants don’t start working for 4 to 6 weeks. You can’t get an appointment with a psychiatrist when you’re in crisis,” said Bell.

Additionally, the authors behind the study note that not all commercial health insurance plans are required to cover mental health services, which can result in high out-of-pocket costs. Even if they do, there are still applicable co-pays and deductibles, which can prevent access to care.

Suggestions for System Improvement

The study highlighted several bills passed in the 2019 legislative session to improve Utah’s mental health system. One of those bills is H.B. 373 (Student Support Amendments) to provide state funding to increase the number of mental health provides in local schools (K-12) as well as increase resources for the SafeUT Crisis Line and youth suicide prevention programs.

S.B. 106 (Mental Health Services in School) requires the Utah Department of Health to develop a proposal to allow the state Medicaid program to reimburse a local education agency, local mental health authority, or private provider for covered mental health services provided at schools, their facilities, or by an employee or contractor of a local education agency.

Based on the study’s results, researchers made the following recommendations for improving Utah’s mental health system:

Continue mental health public education efforts

Continue to increase primary and specialty provider training on identifying, understanding, and addressing mental health issues

Continue increasing availability of emergency team/mobile crisis services

Continue increasing funding for school-based mental health provides

Continue expanding use of tele-health and tele-psych services

Continue supporting universities in increasing program slots as well as providing incentives for students to stay in state

Continue increasing Medicaid coverage of school-based services

Continue developing written guidelines or policies for people transitioning from child to adult mental health services

Increase number of receiving centers designed specifically for youth

Promote the physical co-location of mental and physical health care services so that patients seeking mental health services can access care at the same practice or building

Provide resources or match funds to help health systems in underserved or rural areas better leverage existing federal workforce development grant and loan repayments programs

Bell said their team will approach state leaders with their findings and recommendations. To view the report in its entirety, click here.