May News: Mental Health by Numbers

Mental health is an oft-stigmatized issue that impacts and discriminates against millions of individuals across the United States. It is estimated by the National Institute of Mental Health (NIMH) that one in five adults in the U.S. live with mental illness, and one in 25 live with a serious mental illness.

Mental illness is placed into two categories by NIMH: Any Mental Illness (AMI) and Serious Mental Illness (SMI). AMI references all recognized mental illnesses, while SMI recognizes mental illnesses that cause a significant functional impairment.

In Colorado specifically, the National Alliance on Mental Illness (NAMI) estimated in 2021 that 924,000 adults in Colorado live with a mental health condition. NAMI also found that 41.4% of adults in Colorado reported having symptoms of depression or anxiety in February 2021.

A reported 242,000 adults in Colorado have a serious mental illness, and one in four unhoused individuals suffer from a serious mental illness, according to NAMI.

These numbers only account for the adult population, and NAMI reports that 47,000 youth age 12 to 17 in Colorado have depression.

According to a 2023 Mental Health America report, Colorado is ranked near the bottom at 45th place due to its higher prevalence of mental illness coupled with lower rates of access to care. The state also exhibits elevated rates of substance use disorders and suicidality.

The MHA takes multiple factors into account when creating these rankings, including all adults with AMI, youth with at least one major depressive episode in a year, access to healthcare, and percentages of adults with AMI who are uninsured. 

Statistics about the prevalance of substance use disorders and serious suicidal thoughts are also included in these rankings.

“In the face of Colorado’s complex mental health landscape, it’s crucial to recognize the human stories behind the statistics. Each data point represents an individual navigating their own unique behavioral health challenges. Community mental health centers, such as WellPower and others across the state, play a vital role in supporting those with the most pressing needs,” said Jody Ryan, MD, chief medical officer at WellPower.

Mental health is clearly a nationwide issue as well as an at-home issue for Coloradans. Since the COVID-19 pandemic in 2020, sources such as NAMI have begun taking into account the exacerbation of mental illness the pandemic caused. 

COVID-19 brought up issues of unemployment, unstable housing, medical bills, financial insecurity, mortality rates, isolation, and many other factors that had a negative effect on the population both nationwide and in Colorado. 

NAMI reports that more than half of Americans said COVID-19 had a significant negative impact on their mental health. 

Despite the clearly increasing need for mental health services since 2020, NAMI reports that Coloradans are nine times more likely to be forced out-of-network for mental health care than for primary care. 

According to the Colorado Health Institute, stigma still prevents many from receiving needed mental health care. Nearly one in 10 Coloradans says there was a time they didn’t receive needed mental health care. Of those, more than one in four said it was because they were worried about what would happen if others found out. The numbers are even higher for the LGBTQ+ community, where nearly half report experiencing difficulty finding an affirming mental health care provider.

In 2023, the MHA reported that 23.13% of Coloradans suffering from 14+ mentally unhealthy days a month were unable to visit a doctor and access care because of costs. 

The MHA notes that frequent mental distress (14 or more mentally unhealthy days in a month) often leads to the development of chronic conditions and increased mortality. 

The access to affordable healthcare is yet another divisive issue across the United States, and lack of access to mental health care providers puts many adults at a disadvantage, leading to substance misuse issues, houselessness, and increased risk of suicide. 

The KFF reports that Colorado’s suicide rate in 2021 was higher than the national average, with a 22.8 as opposed to the national average of 14.1.

Since 2010, over half a million lives have been lost to suicide in the U.S., highlighting a significant public health challenge. Although the number of suicide deaths peaked in 2018 (48,344 deaths) and slightly declined in 2019 and 2020, it increased again in 2021 (48,183 deaths). Particularly concerning is the disproportionate rise in suicide deaths among people of color, younger individuals, and those residing in rural areas. Throughout the pandemic, suicidal ideation has been prevalent, with 4.8% of adults and 12.7% of adolescents (ages 12-17) reporting serious thoughts of suicide in 2021. Firearms accounted for 55% of all suicide deaths nationally in 2021.

While mental health conditions are often associated with suicide, other factors contribute as well, such as isolation, relationship difficulties, financial insecurity, housing instability, and physical health issues.

Though facing an increase in worsening levels of mental health and treatment, Colorado ranks at number two for providing consistent treatment for youth with severe major depressive episodes. There is also a ratio of 250 healthcare providers for every one person in Colorado as of 2023. Both of these statistics are as reported by the MHA.

However, the MHA points out that a prevalence of mental healthcare providers does not mean everybody suffering from a mental illness has the opportunity to pursue care. As mentioned above, monetary factors are often a barrier to receiving care. 

Other factors blocking access to care include health insurance status and whether providers are accepting new patients.

Though not as highly reported on as other forms of legislation are, there have been pieces of legislation relating to mental health issues passed recently.

In 2019, Colorado passed HB19-1044, “Concerning advanced behavioral health orders determining the scope of treatment an adult wishes to receive under certain behavioral health circumstances,” as reported by the State of Colorado.

The same year, Colorado also passed HB19-1193 “Concerning behavioral health supports for high-risk families, and, in connection therewith, making an appropriation,” as reported by the State of Colorado.

In 2023, 18 bills were brought to the legislative session regarding behavioral health. 

Among these bills included House Bill 23-1269, which enacted measures to provide and maintain better levels of care for youth’s behavioral health.

Another bill was Senate Bill 23-176, which addressed disordered eating and created prohibitions and requirements for healthcare providers, such as prohibiting the use of the body mass index scale.

At the national level, the Pursuing Equity in Mental Health Act was introduced to Congress in May 2023. The act seeks to address racial and ethnic mental health disparities in the United States. 

The More Behavioral Health Providers Act was introduced to Congress in October 2023 and seeks to “provide additional Medicare payments to health care practitioners who provide services in mental health professional shortage areas” according to the bill.

There is an overlap between LGBTQ individuals (particularly youth) and mental health issues that are exacerbated by unsupportive families and communities, bullying, a lack of access to gender-affirming care, and increasing hate crimes directed at LGBTQ+ people.

The Trevor Project reported that 41% of young LGBTQ people seriously considered attempting suicide in the 2022-2023 year, and one in three  said their mental health was adversely affected by anti-LGBTQ legislation and policies. 

There has been a significant uptick in anti-transgender legislation being passed in the last year. 21 anti-transgender bills have been passed in 2024 already, most of which include the censoring of transgender topics from schools, bathroom bans, and the severe restriction or total banning of gender affirming care for minors. 

As more anti-transgender and anti-LGBTQ legislation is passed, the trend of decreasing mental health among LGBTQ individuals will only continue. 

Colorado is considered a sanctuary state for transgender individuals due to its legislative protections on gender-affirming care, but there are still issues of access based on healthcare status, monetary access, and racial factors which can still lead to poor mental health among LGBTQ individuals in Colorado.

As lawmakers attempt to solve the mental health issue, the reality remains that mental illness is still stigmatized or seen as a lesser concern, though it is clear that mental health is a pressing issue for both the nation and those right at home.