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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.

Which other states have serious problems with depression? Which other states have relatively effective mental health care? Here are the top- and bottom-ten US states on several measures of public mental health.

The least depressed states in the USA are, in order from least depressed to more depressed:

  1. South Dakota
  2. Hawaii
  3. New Jersey
  4. Iowa
  5. Maryland
  6. Louisiana
  7. Minnesota
  8. Illinois
  9. North Dakota
  10. Texas

These states all have pro-active public mental care systems to make sure that people who need treatment for depression get it. The system in Texas is relatively rough and tumble, a policeman may escort you to a psychiatric evaluation if even a neighbor or email contact suspects you are seriously depressed, but even this relatively crude approach has its benefits.

The most depressed states in the USA tend to offer few public resources for people who suffer depression, in order from most depressed to less depressed:

  1. Utah
  2. West Virginia
  3. Kentucky
  4. Rhode Island
  5. Nevada
  6. Oklahoma
  7. Idaho
  8. Ohio
  9. Missouri
  10. Wyoming

These states tend to have high rates of unemployment, and severely stressed state budgets, permitting few public mental health services. West Virginia has had a state-sponsored risk pool for lower-cost health insurance for many years, as has Kentucky, but insurance in these states generally offer relatively little coverage for mental health care.

What about suicide rates by state?

These ten states have the lowest rates of suicide in the nation, beginning with the very lowest:

  1. District of Columbia (Washington, D.C.)
  2. New York
  3. Massachusetts
  4. New Jersey
  5. Connecticut
  6. Rhode Island
  7. Illinois
  8. Maryland
  9. Hawaii
  10. Nebraska

Other states in the top 10 list for lowest rates of depression mostly rank 11 to 20 in suicide prevention. Texas, for instance, ranks 14th lowest in suicide rates in the USA.

These ten states have the highest rates of suicide in the USA:

  1. Alaska
  2. Nevada
  3. New Mexico
  4. Montana
  5. Wyoming
  6. Idaho
  7. Utah
  8. Colorado
  9. Arizona
  10. West Virginia

All of these states are mountain states, where people can live in severe physical isolation, sometimes hundreds of miles from mental health professionals. Nevada, home of Reno and Las Vegas, has been suffering severe economic distress, but many people in Nevada live in very isolated locations.

Mental health days, however, differ widely by North and South. The states with the lowest rates of absenteeism due to mental health issues are all in the North or the colder reaches of the Rocky Mountains, Vermont, Connecticut, Minnesota, Iowa, North Dakota, South Dakota, Nebraska, Montana, Colorado, and Oregon. The states with the highest rates of absenteeism due to mental health issues are scattered across the United States, California, Ohio, West Virginia, Kentucky, Oklahoma, Mississippi, Alabama, and Indiana.

What Makes the Difference in Depression Rates?

What makes the difference between the most depressed states and not-so-depressed states of the United States? The US Centers for Disease Control believes that the answer is, and this answer won't surprise anyone, higher incomes.

Across the United States, the more money average earners have to spend, the less likely they are to be depressed.

Some other findings of studies by the Centers for Disease Control are not entirely expected.

The more prescriptions are written for antidepressants in a state, for example, the less likely the state is to have a high rate of depression.

Anti-depressants may not be perfect, the data show, but they do seem to work. And the easier it is for people to see mental health professionals, the lower the rates of depression and suicide. Urban states tend to be less depressed than rural states, because of travel distances (up to 250 miles/400 km to see a doctor in some parts of the western United States, even more in Alaska). Richer states such as Massachusetts and New Jersey tend to have better access to mental health care and lower rates of depression and suicide.

Should you pack up and move to get over your depression?

Maybe you should and maybe you shouldn't, but don't make your decision on the basis of these data. The decisive factor in an individual's recovery from depression is that individual's access to mental health care, never the state of the state in which he or she lives.

  • Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelvemonth DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun. 62(6):617-27.
  • 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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