Mental health of Californians- Find out what factors put you at risk. By Dr. Christina Villarreal

Researchers from UCLA have determined that 4.9 million people in California believe they need help for a mental or emotional health problem. So why are so many of us suffering without getting the treatment we need? Part of the problem may be stigma. It’s hard for many Californians to acknowledge they need help — to their family, friends or their doctor. The goal and challenge for policymakers and mental health care providers is to both target appropriate services to those in need, and to reduce people's fear of seeking help.

“There’s a lot of need, but also a lot of obstacles connecting those in need to the services that can help them,” stated David Grant, Ph.D., lead author and director of the California Health Interview Survey (CHIS).“The recession has created even more stress for people,” he acknowledged. As a result, this study “is probably an underestimate of the true level of mental health need in California right now.

Researchers from the UCLA Center for Health Policy Research also determined that approximately one in 25, or more than 1 million, reported symptoms associated with serious psychological distress (SPD), which includes the most serious kinds of diagnosable mental health disorders. Of those adults with either “perceived need” or SPD, only one in three reported visiting a mental health professional for treatment, a factor potentially attributable to fear of stigmatization, as well as lack of insurance coverage, the researchers said. The study draws on data from the 2005 California Health Interview Survey (CHIS), which is administered by the UCLA Center for Health Policy Research.

What factors put you, or others you know at risk?

Women at risk
Women were nearly twice as likely as men (22.7 percent vs. 14.3 percent) to say they needed help for a mental or emotional health problem (“perceived need”), such as feeling sad, anxious or nervous.

Working-age adults at risk
The prevalence of perceived need was twice as high for adults under 65 as for those 65 and older (20.2 percent vs. 9.2 percent).

Income a significant factor
The poorest adults — those living below 100 percent of the federal poverty level — were much more likely to report symptoms associated with SPD than those with incomes that were even just slightly higher. The poorest were more than five times as likely to report SPD as those living at or above 300 percent of the federal poverty level.

Distress pervasive regardless of race or ethnicity
Although racial and ethnic disparities in mental health were found in the study, those differences diminished when adjusted for income. These findings suggest that mental health status is more closely related to socioeconomic status than ethnicity or place of birth.

Insurance coverage improves access to services
Adults with health insurance coverage were almost twice as likely to have received mental health services during the previous 12 months as adults without health insurance.

Stigma, cultural factors may impede access to services
Men, adults aged 65 or older, and Latino and Asian immigrant groups were far less likely to seek help with a mental health professional than other groups. The authors note that these findings suggest that stigma and cultural factors may pose a significant barrier to care.

So how do Californians compare to the rest of the country with regards to our mental health? California ranks at # 15th on overall occurrence of depression compared to other American states, according to the study "Ranking the States: An Analysis of Depression Across the States", which was researched and written by Mental Health America and Thomson Healthcare. It looks at data from 2002-2006 and was conducted from July to November 2007. The report compares depression levels and suicide rates in all 50 states and the District of Columbia and uses the information to highlight solutions to improve states' mental health status.

Composed by Dr. Christina Villarreal, Clinical Psychologist in Oakland, CA

Sources: UCLA, NMHA