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The 50 United States vary greatly in their rates of hospital admissions for depression, sick days for depression, and suicide. Do you live in a relatively happy or relatively depressed US state? The answer may surprise you.

Although the USA remains an economic giant and a global super-power, and American innovation is still a driving force for commercial activity around the world, living in the USA can be downright depressing.

In fact, depression is the most common disability among Americans aged 15 to 44. Over 21 million Americans suffer a major depressive episode every year, and the treatment of depression costs over $31 billion a year. Suicide is the leading cause of death among young adults in America, and millions of older Americans become clinically depressed when the are diagnosed with heart disease, cancer, or other chronic illnesses.

Rates of Depression, Psychological Distress, and Suicide Differ Widely State by State

Some of the US states, however, are remarkably less depressed than others. According to a report entitled Ranking America's Mental Health: An Analysis of Depression Across the States, in the "happiest" state in the United States, South Dakota, 7.31% of adults experienced a major depressive episode and 11.16% experienced significant psychological distress in the most recent year for which comprehensive statistics are available. In the most depressed state in the United States, Utah, 10.14% of adults experienced a major depressive episode and 14.58% experienced significant psychological distress in the same year.

Suicide rates also differ widely by state. The District of Columbia, New York, and Massachusetts have the lowest suicide rates in the United States. Alaska is followed by Nevada and New Mexico for the highest suicide rates in the United States. The suicide rate in Washington, D.C. is less than one-quarter of the suicide rate in Alaska.

Sick days for depression differ widely state by state, too. In South Dakota, the average adult suffers an average of 2.41 "mental health days" per year. In Utah, the most depressed state in the US, that average is 3.27 days per year. That may not sound like a lot, but multiplied by millions of people depression racks of costs of billions of dollars. And the toll in human suffering is especially high in the USA.

A Ten-Year Wait to Get Treatment

In the United States, almost all health insurance policies put a strict limit on mental health care costs. Visits to a psychologist or psychiatrist may be limited to 20 per year, and some plans do not offer mental health coverage at all. 

Uninsured people find it difficult to access mental health care unless they live in poverty. A marginally middle class family earning $20,000 a year, for example, might be asked to pay $150 to $200 in cash up front for each and every 50-minute visit with a counselor. Even sliding scale clinics seldom offer any kind of fee discount to patients who have total assets over $2,000 (patients who own a car or furniture, for example) and who have two members of the family working even 30 hours a week at minimum wage. 

Eventually, 80% of Americans who need mental health services get them, but the average wait between diagnosis and treatment, according to the Thompson Research Group, is 10 years.

Continue reading after recommendations

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  • Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, Mehlum L, Patton G, Phillips M, Rutz W, Rihmer Z, Schmidtke A, Shaffer D, Silverman M, Takahashi Y, Varnik A, Wasserman D, Yip P, Hendin H. Suicide prevention strategies: a systematic review. Journal of the American Medical Association. 2005 Oct 26. 294(16):2064-74.
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