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RI is #1 in mental illness UPDATED

October 6, 2011

New data out today from the National Survey on Health and Drug Use- Rhode Island ranks number one when it comes to the percentage of residents with mental illness.

According to data collected from 2008-2009, 24.2% of people in Little Rhody experienced some type of mental illness during the course of the year. We also had the highest rate of people with serious mental illness- 7.2%.

Rhode Island’s rate of mental illness is nowhere near the rates in our neighboring states. Check out these maps- RI is a vibrant dot of red in a sea of light blue and gray.

Here’s the map on Serious Mental Illness in Past Year among Persons Aged 18 or Older

And here’s the one on Any Mental Illness in Past Year among Persons Aged 18 or Older

What is up with Rhode Island? Does living in the nation’s smallest state make us especially anxious or depressed?  Remember, we also rank number 1 in illicit drug and alcohol use, another sign of the Ocean State’s sad state of mind.

I’ll be talking to Dr. Peter Delany, the Substance Abuse and Mental Health Services Administration‘s lead data person, to learn more about mental health in Rhode Island. What would you ask him?

UPDATED-

Felice Freyer from the Providence Journal made a good point on Twitter-

A high rate of diagnoses is not the same as a high rate of illness. There is heavy usage of many kinds of care in RI.

That made me wonder- does this survey  show that more Rhode Islanders seek treatment or that more of us experience mental illness?  I asked Dr. Peter Delany to explain how the Substance Abuse and Mental Health Services Administration (SAMHSA) collected its data. Did it ask residents if they’d been diagnosed with mental illness or actually assess their mental health? This is what he wrote back-

The survey provides incidence and prevalence rates rather than clinical diagnosis which would come from a mental health professional and would identify a specific disorder.  We do provide rates of depression among adults 18 and older but not other specific disorder rates.

So, what does that mean? If you dig into the actual report you can look at the study’s methodology. Go to page 79 to see how it assessed mental illness. Wade through the technical language and you’ll see that SAMHSA used two short interviews to
measure

…psychological distress and functional impairment that could be used in a statistical model to accurately predict whether a respondent had mental illness.

Here are the questions used to determine “psychological distress”-

During the past 30 days, how often did you feel nervous?

  • All of the time
  • Most of the time
  • Some of the time
  • A little of the time
  • None of the time
  • Don’t know/Refused

The same  answers were available for these questions-

  •  During the past 30 days, how often did you feel hopeless?
  •  During the past 30 days, how often did you feel restless or fidgety?
  • During the past 30 days, how often did you feel so sad or depressed that nothing could cheer you up?
  • During the past 30 days, how often did you feel that everything was an effort?
  • During the past 30 days, how often did you feel down on yourself, no good or worthless?

SAMHSA measured “functional impairment” by asking how much “emotions, nerves, or mental health interfered with their daily activities over the past year.”  The questions covered four categories- home management, work, close relationships with others, and social life.

For each of the four items, respondents were asked to select a number from 0 to 10 on a visual analog scale, where 0 means no interference, 1 to 3 means mild interference, 4 to 6 means moderate interference, 7 to 9 means severe interference, and 10 means very severe interference. Responses of “don’t know” or “refused” were coded as 0. Summing across the responses for the four items resulted in a total score with a range from 0 to 40.

Researchers also conducted in-depth interviews with 1,500 people to create a “statistical model” for interpreting the shorter interview data.

That’s a long way of saying  yes, the study actually evaluated mental health; it didn’t rely on data about how many people had been diagnosed with a problem.

Of course you could say, Rhode Island is a small state; what about sampling errors? Dr. Peter Delany of SAMHSA says he’s confident in the study’s methodology.

We’ve been doing the study since 1972 and we’ve been doing it annually since the 1990s. We’re fairly confident that the design we have is representative of each state as well as the nation as a whole…We’re 95% sure it’s within that rate.

I’m out of statistical/methodological explanations for Rhode Island’s high rate of mental illness. Did I miss anything? Or is it actually true?

5 Comments leave one →
  1. William permalink
    October 6, 2011 7:27 pm

    Given that RI’s rankings in both substance abuse and mental illness come from teh same survey (NSDUH), couldn’t the result have something to do with data collection and reporting?

  2. October 6, 2011 10:14 pm

    Good point William. Or it could reflect a correlation between mental health and substance abuse.

  3. nalani permalink
    October 7, 2011 2:35 am

    what about the population to treatment/facility ratio?

Trackbacks

  1. RI- first in things that are hard to put in a headline « The Pulse: health care in RI
  2. Suicide now kills more people than car wrecks « The Pulse: health care in RI

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