Healthiest Wisconsin 2020 Baseline and Health Disparities Report
Healthiest Wisconsin 2020 Baseline and Health Disparities Report Mental Health Wisconsin Department of Health Services January 2014 P-00522 J
MENTAL HEALTH Chapter outline Chapter Outline Background • Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report • Healthiest Wisconsin 2020 objectives and indicators • Rationale • Key points Data • Mental health among adults • Mental health among youth • Access to services References Links to additional reports and resources Contacts 2
MENTAL HEALTH Report overview Report Overview • This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW 2020) and identify health disparities in the state. The full report is available at: http: //www. dhs. wisconsin. gov/publications/P 0/p 00522. pdf • The report is designed to address the Health Focus Areas in HW 2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included. • Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations. • Technical notes are available at: http: //www. dhs. wisconsin. gov/publications/P 0/p 00522 y. pdf 3
MENTAL HEALTH Report Format Report overview Sample annotated slide Full Report • Format: PDF • Intended use: reference document Chapters • Format: Annotated Power. Point slide set • Intended uses: presentations to – – Decision-makers Service providers Community leaders The public 4
MENTAL HEALTH Report overview Report Outline Executive Summary Section 1: Introduction Section 2: Demographic overview Section 3: Health focus areas Section 4: Infrastructure focus areas Section 5: Data summaries by population Section 6: Technical notes 5
MENTAL HEALTH Report overview Report Outline: Detail Section 3: Health focus areas • • • Alcohol and other drug use Chronic disease prevention and management Communicable diseases Environmental and occupational health Healthy growth and development Injury and violence Mental health Nutrition and healthy foods Oral health Physical activity Reproductive and sexual health Tobacco use and exposure Section 4: Infrastructure focus areas • Access to health care 6
MENTAL HEALTH Report overview Report Outline: Detail Section 5: Data summaries by population Racial/ethnic minority populations o American Indians o Asians o Blacks o Hispanics People of lower socioeconomic status People with disabilities Lesbian, gay, bisexual, and transgender populations Geography 7
MENTAL HEALTH Report overview Data notes • Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http: //www. dhs. wisconsin. gov/publications/P 0/p 00522 y. pdf • The 95% confidence intervals are denoted by error bars. Where confidence intervals do not overlap, as shown in the example on the right, differences are statistically significant. Larger confidence intervals may indicate less reliable estimates that should be interpreted with caution. • Population estimates that are considered unreliable are excluded. • Misclassification of racial/ethnic groups may affect the accuracy of rates. • Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non. Hispanic. 8
MENTAL HEALTH Report overview Factors that influence health Social determinants of health Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http: //www. countyhealthrankings. org/our-approach 9
MENTAL HEALTH HW 2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 1 By 2020, reduce smoking and obesity (which lead to chronic disease and premature death) among people with mental health disorders. Objective 1 Indicators • Smoking and obesity rates among people with depression or serious psychological distress. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Mental Health Focus Area Profile. 10
MENTAL HEALTH HW 2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 2 By 2020, reduce disparities in suicide and mental health disorders for disproportionately affected populations, including those of differing races, ethnicities, sexual identities and orientations, gender identities, educational or economic status. Objective 2 Indicators • Prevalence of mental health disorders in these population groups. • Suicide rates in these populations. • Mental health provider capacity indicating access to mental health services. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Mental Health Focus Area Profile. 11
MENTAL HEALTH HW 2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 3 By 2020, reduce the rate of depression, anxiety and emotional problems among children with special health care needs (CSHCN). Objective 3 Indicators • Percent of children who have depression, anxiety or emotional problems. • Percent of children who needed but did not receive mental health services in the previous year. • Percent of CSHCN/non-CSHCN who received mental health treatment/counseling in the past year. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Mental Health Focus Area Profile. 12
MENTAL HEALTH Rationale • “Mental health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community. ” 6 • Mental illness is the leading cause of disability in the United States; one out of five people will experience a mental health problem of some type during a one-year period. 7 • Mental health disorders are associated with an increased risk of physical illness; more specifically, with increased rates of chronic health problems and risk factors such as smoking, physical inactivity, obesity, and substance abuse and dependence. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Mental Health Focus Area Profile. 13
MENTAL HEALTH Key points: Trends • Adults o From 2000 to 2010, suicide rates in Wisconsin increased by 26% in males and by 21% in females. The greatest increases occurred among people ages 45 -64. • Youth o From 2001 to 2011, the total number of Wisconsin high school students reporting suicidal ideation declined. The most significant decreases in suicidal ideation were among White and Hispanic youth. • Children o From 2003 to 2012, the percentage of children at high risk of developmental, behavioral and social delays declined both in Wisconsin and nationally. o From 2007 to 2012, the percentage of children receiving medications for ADHD, emotions, concentration, or behavior significantly increased both in Wisconsin and nationally. 14
MENTAL HEALTH Key points: Adults The prevalence of factors related to mental health varies among Wisconsin adult populations. • Frequent mental distress: * Females, Blacks, Hispanics, low-income people, Milwaukee County residents, people who are obese, and smokers, report higher rates of frequent mental distress. • Adverse Childhood Experiences (ACEs): People with low household incomes and those with disabilities had significantly higher rates of experiencing four or more ACEs. • Insufficient sleep and poor emotional support: Milwaukee County residents, people with low household incomes, people with a disability had higher rates of insufficient sleep and lack of emotional support. *Frequent mental distress is defined as 14 or more days of poor mental health in the past 30 days. 15
MENTAL HEALTH Key points: Youth The prevalence of factors related to mental health varies among Wisconsin high school students. • Sexual minority youth, Black youth, and Asian youth had higher rates of depressive symptoms than their peers. • Rates of suicidal ideation and behavior were higher among Black and American Indian youth and among sexual minority youth than other youth. • Mental health protective factors were highest among White and sexual majority youth. 16
MENTAL HEALTH Key points: Children The prevalence of factors related to mental health varies among Wisconsin children. • A higher percentage of Wisconsin children receive medications for ADHD, emotions, concentration, or behavior, compared to children nationwide. • Adverse Childhood Experiences (ACEs): o The deeper the level of poverty, the greater the percentage of children who had experienced two or more ACEs. o Black children experienced two or more ACEs at a higher rate compared to White and Hispanic children. o Children with special health care needs experienced two or more ACEs at a higher rate compared to children with no special health care needs. 17
MENTAL HEALTH Mental health among adults 18
MENTAL HEALTH Mental health among adults Frequent mental distress among Wisconsin adults, by sex, 2009 -2011 40% Total 35% Male Female 30% 25% 20% 15% 10% 5% 0% 11% 8% 13% Frequent mental distress Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009 -2011 landline-cellphone combined dataset. 19
MENTAL HEALTH Mental health among adults Frequent mental distress among Wisconsin adults, by age, 2009 -2011 40% 18 - 24 25 - 44 45 - 64 65+ 35% 30% 25% 20% 15% 10% 5% 0% 11% 10% 13% 10% Frequent mental distress Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009 -2011 landline-cellphone combined 20 dataset.
MENTAL HEALTH Mental health among adults Age-adjusted rate of frequent mental distress among Wisconsin adults, by race/ethnicity, 2009 -2011 40% White Black Hispanic American Indian 35% 30% 25% 20% 15% 10% 5% 0% 9% 18% 11% Frequent mental distress Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Question asked in 2009 -2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. 21
MENTAL HEALTH Mental health among adults Age-adjusted rate of frequent mental distress among Wisconsin adults, by household income, 2009 -2011 40% Low income (<$20, 000) 35% Middle income ($20, 000 -$74, 999) High income ($75, 000+) 30% 25% 20% 15% 10% 4% 5% 0% 24% 10% Frequent mental distress Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Question asked in 2009 -2011. 22
MENTAL HEALTH Mental health among adults Age-adjusted rate of frequent mental distress among Wisconsin adults, by level of urbanization, 2009 -2011 40% Milwaukee County 35% Smaller metropolitan counties Non-metropolitan counties 30% 25% 20% 15% 10% 5% 0% 14% 9% 9% Frequent mental distress Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Question asked in 2009 -2011. 23
MENTAL HEALTH Mental health among adults Frequent mental distress among Wisconsin adults ages 18 -64, by disability status, 2009 -2011 40% No disability 35% Disability 30% 25% 20% 15% 10% 5% 0% 7% 29% Frequent mental distress Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Question asked in 2009 -2011. 24
MENTAL HEALTH Mental health among adults Frequent mental distress among Wisconsin adults, by sexual orientation, 2009 -2011 50% Heterosexual 45% Lesbian, gay, bisexual 40% 35% 30% 25% 20% 15% 10% 5% 0% 9% 14% Frequent mental distress Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Question asked in 2009 -2011. 25
MENTAL HEALTH Mental health among adults Smoking and obesity among Wisconsin adults with and without frequent mental distress, 2009 -2011 70% Absence of frequent mental distress Frequent mental distress 60% 50% 40% 30% 20% 10% 0% 20% 41% Currently smoke 39% 27% Obese Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009 -2011 landline-cellphone combined dataset. Note: Days of poor mental health question asked in 2009 -2011. 26
MENTAL HEALTH Mental health among adults Four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by sex, 2010 and 2011 40% Total 35% Male Female 30% 25% 20% 15% 10% 5% 0% 14% 15% Four or more ACEs Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009 -2011 landline-cellphone combined dataset. Note: Question asked in 2010 and 2011. 27
MENTAL HEALTH Mental health among adults Four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by age, 2010 and 2011 40% 18 - 24 25 - 44 35% 45 - 64 65+ 30% 25% 20% 15% 10% 5% 0% 21% 20% 12% 5% Four or more ACEs Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009 -2011 landline-cellphone combined dataset. Note: Question asked in 2010 and 2011. 28
MENTAL HEALTH Mental health among adults Age-adjusted rate of four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by race/ethnicity, 2010 and 2011 40% White Black Hispanic 35% 30% 25% 20% 15% 10% 5% 0% 15% 23% 21% Four or more ACEs Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset Note: Question asked in 2010 and 2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. 29
MENTAL HEALTH Mental health among adults Age-adjusted rate of four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by household income, 2010 and 2011 40% Low income (<$20, 000) 35% Middle income ($20, 000 -$74, 999) High income ($75, 000+) 30% 25% 20% 15% 10% 5% 0% 30% 16% 10% Four or more ACEs Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Question asked in 2010 and 2011. 30
MENTAL HEALTH Mental health among adults Age-adjusted rate of four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by level of urbanization, 2010 and 2011 40% Milwaukee County 35% Smaller metropolitan counties Non-metropolitan counties 30% 25% 20% 15% 10% 5% 0% 17% 16% 13% Four or more ACEs Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Question asked in 2010 and 2011. 31
MENTAL HEALTH Mental health among adults Four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by disability status, 2010 and 2011 50% No disability 45% Disability 40% 35% 30% 25% 20% 15% 10% 5% 0% 14% 29% Four or more ACEs Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 land-line only dataset. 32
MENTAL HEALTH Mental health among adults Four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by sexual orientation, 2010 and 2011 50% Heterosexual 45% Lesbian, gay, bisexual 40% 35% 30% 25% 20% 15% 10% 5% 0% 15% 18% Four or more ACEs Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Question asked in 2010 and 2011. 33
MENTAL HEALTH Mental health among adults Insufficient sleep and poor emotional support among Wisconsin adults, by sex, 2009 -2011 50% Total 45% Male 40% Female 35% 30% 25% 20% 15% 10% 5% 0% 17% 16% Insufficient sleep 18% 20% 19% Sometimes, rarely, or never receive emotional support Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009 -2011 landline-cellphone combined dataset. Note: Questions were not asked in 2011. 34
MENTAL HEALTH Mental health among adults Insufficient sleep and poor emotional support among Wisconsin adults, by age, 2009 -2010 50% 18 - 24 25 - 44 45 - 64 65+ 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% 18% 22% 16% Insufficient sleep 8% 12% 20% 23% Sometimes, rarely, or never receive emotional support Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009 -2011 landline-cellphone combined dataset. Note: Questions were not asked in 2011. 35
MENTAL HEALTH Mental health among adults Age-adjusted rate of insufficient sleep and rate of poor emotional support among Wisconsin adults by race/ethnicity, 2008 -2010 50% White Black Hispanic American Indian 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% 23% 23% Insufficient sleep 18% 16% 27% 28% 23% Sometimes, rarely, or never receive emotional support Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Questions were not asked in 2011. Rates of insufficient sleep are age-adjusted; rates of poor emotional support are not ageadjusted. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. 36
MENTAL HEALTH Mental health among adults Age-adjusted rate of insufficient sleep and rate of poor emotional support among Wisconsin adults, by level of urbanization, 2008 -2010 50% Milwaukee County 45% Smaller metropolitan counties 40% Non-metropolitan counties 35% 30% 25% 20% 15% 10% 5% 0% 23% 20% Insufficient sleep 20% 22% 16% 17% Sometimes, rarely, or never receive emotional support Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Questions were not asked in 2011. Rates of insufficient sleep are age-adjusted; rates of poor emotional support are not ageadjusted. 37
MENTAL HEALTH Mental health among adults Age-adjusted rate of insufficient sleep and rate of poor emotional support among Wisconsin adults, by household income, 2008 -2010 50% Low income (<$20, 000) 45% Middle income ($20, 000 -$74, 999) 40% High income ($75, 000+) 35% 30% 25% 20% 15% 10% 5% 0% 27% 20% Insufficient sleep 19% 35% 18% 7% Sometimes, rarely, or never receive emotional support Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Questions were not asked in 2011. Rates of insufficient sleep are age-adjusted; rates of poor emotional support are not ageadjusted. 38
MENTAL HEALTH Mental health among adults Insufficient sleep and poor emotional support among Wisconsin adults ages 18 -64, by disability status, 2008 -2010 50% No disability 45% Disability 40% 35% 30% 25% 20% 15% 10% 5% 0% 20% 34% Insufficient sleep 14% 30% Sometimes, rarely, or never receive emotional support Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Questions were not asked in 2011. 39
MENTAL HEALTH Mental health among adults Insufficient sleep and poor emotional support among Wisconsin adults, by sexual orientation, 2008 -2010 50% Heterosexual 45% Lesbian, gay, bisexual 40% 35% 30% 25% 20% 15% 10% 5% 0% 28% Insufficient sleep 17% 21% Sometimes, rarely, or never receive emotional support Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008 -2011 landline-only dataset. Note: Questions were not asked in 2011. 40
MENTAL HEALTH Mental health among adults and youth Suicide deaths, age-adjusted rate per 100, 000, by race/ethnicity, Wisconsin, 2008 -2010 25 20 White Black Hispanic Asian American Indian Rate per 100, 000 15 10 5 0 13. 5 7. 3 5. 9 10. 1 16. 0 Suicide Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates. . 41
MENTAL HEALTH Mental health among adults and youth Suicide deaths, rate per 100, 000, by sex and age, Wisconsin, 2008 -2010 40 Male 35 Rate per 100, 000 population Female 30 25 20 15 10 5 0 2. 8 0. 7 22. 4 3. 8 24. 6 5. 8 26. 8 9. 2 30. 6 9. 9 28. 7 8. 6 21. 1 5. 0 30. 4 3. 6 0 - 17 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75+ Suicide rate Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates. 42
MENTAL HEALTH Mental health among adults and youth Suicide rates by county, age-adjusted rates per 100, 000, Wisconsin, Injury and violence 2008 -2010 Statewide rate = 13 per 100, 000 20 Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates. 43
MENTAL HEALTH Mental health among adults and youth Suicide deaths by underlying cause of injury, Wisconsin, 2008 -2010 Other 8% Suffocation 24% Firearms 47% Poisoning 21% Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates. 44
MENTAL HEALTH Mental health among youth 45
MENTAL HEALTH Mental health among youth Depression among Wisconsin high school students by race/ethnicity, 2007 -2011 60% 50% White Black Hispanic Asian American Indian 40% 30% 20% 10% 0% 28% 28% 32% Felt sad/hopeless for at least 2 weeks and stopped doing usual activities Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. 46
MENTAL HEALTH Mental health among youth Depression among Wisconsin high school students by sexual minority status, 2007 -2011 60% Sexual majority Sexual minority 50% 40% 30% 20% 10% 0% 25% 49% Felt sad/hopeless for at least 2 weeks and stopped doing usual activities Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. 47
MENTAL HEALTH Mental health among youth Suicide risk during past 12 months among Wisconsin high school students by race/ethnicity, 2007 -2011 50% White Black Hispanic Asian American Indian 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% 13% 17% 14% 20% 25% 10% 13% 22% Considered suicide Planned suicide 5% 12% 9% 16% Attempted suicide Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. 48
MENTAL HEALTH Mental health among youth Suicide risk during past 12 months among Wisconsin high school students by sexual minority status, 2007 -2011 60% Sexual majority Sexual minority 50% 40% 30% 20% 10% 2% 0% 15% 42% Considered suicide 11% 33% Planned suicide 7% 28% Attempted suicide 13% Injured in suicide attempt Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. 49
MENTAL HEALTH Mental health among youth Protective factors among Wisconsin high school students by race/ethnicity, 2007 -2011 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% White Black Hispanic Asian 65% 59% 57% 61% 56% 74% 62% 67% 66% Strongly agree teachers Strongly agree belong at care and give school encouragement 40% 28% 35% 41% 23% 89% 84% 85% 79% 73% Get mostly A's and B's Strongly agree loved by family and get support Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. 50
MENTAL HEALTH Mental health among youth Protective factors among Wisconsin high school students by sexual minority status, 2007 -2011 100% Sexual majority 90% Sexual minority 80% 70% 60% 50% 40% 30% 20% 10% 0% 60% 49% 70% 52% 37% 36% 87% 69% Strongly agree teachers Strongly agree belong Get mostly A's or B's Strongly agree loved by care and give at school family and get support encouragement Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. 51
MENTAL HEALTH Mental health among youth High risk of developmental, behavioral, or social delays among children ages 4 months to 5 years, Wisconsin and United States, 2011 -2012 20% United States 18% Wisconsin 16% 14% 12% 10% 8% 6% 4% 2% 0% 11% 6% High risk of developmental, behavioral, or social delays Source: 2011 -2012 National Survey of Children’s Health. 52
MENTAL HEALTH Mental health among youth Prevalence of medication use for ADHD, emotions, concentration, or behavior among children ages 2 -17, Wisconsin and United States, 2011 -2012 20% United States 18% Wisconsin 16% 14% 12% 10% 8% 6% 4% 2% 0% 8% 11% On medication for ADHD, emotions, concentration, or behavior Source: 2011 -2012 National Survey of Children’s Health. 53
MENTAL HEALTH Mental health among youth Percentage of children ages 2 -17 who needed but not did not receive mental health services, Wisconsin and United States, 2011 -2012 60% United States Wisconsin 50% 40% 30% 20% 10% 0% 39% 35% Needed but did not get mental health services Source: 2011 -2012 National Survey of Children’s Health. 54
MENTAL HEALTH Mental health among youth Percentage of children who have experienced two or more adverse childhood experiences (ACEs), Wisconsin and United States, 2011 -2012 60% United States Wisconsin 50% 40% 30% 20% 10% 0% 23% Two or more adverse childhood experiences Source: 2011 -2012 National Survey of Children’s Health. 55
MENTAL HEALTH Mental health among youth Percentage of children who have experienced two or more adverse childhood experiences (ACEs), by race/ethnicity, 2011 -2012 60% White Black Hispanic 50% 40% 30% 20% 10% 0% 20% 39% 19% Two or more adverse childhood experiences Source: 2011 -2012 National Survey of Children’s Health. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. 56
MENTAL HEALTH Mental health among youth Percentage of children who have experienced two or more adverse childhood experiences (ACEs), by federal poverty level (FPL), 2011 -2012 60% 0 - 99% FPL 100 - 199% FPL 50% 200 - 399% FPL 400% FPL or higher 40% 30% 20% 10% 0% 47% 30% 16% 9% Two or more adverse childhood experiences Source: 2011 -2012 National Survey of Children’s Health. 57
MENTAL HEALTH Mental health among youth Percentage of children who have experienced two or more adverse childhood experiences (ACEs), by disability status, Wisconsin, 2011 -2012 Children with no special health care needs 60% Children with special health care needs 50% 40% 30% 20% 10% 0% 19% 35% Two or more adverse childhood experiences Source: 2011 -2012 National Survey of Children’s Health. 58
MENTAL HEALTH Access to services 59
MENTAL HEALTH Access to services Number of full-time equivalent psychiatrists needed to remove significant shortages for the resident population, by county, 2011 Source: Wisconsin Department of Health Services, Primary Care Office, Shortage Designation Program. 60
MENTAL HEALTH References 1. University of Wisconsin Population Health Institute. County Health Rankings, 2013. http: //www. countyhealthrankings. org/our-approach 2. Center for Urban Population Health. Milwaukee Health Report, 2011. http: //www. cuph. org/mhr/2011 -milwaukee-health-report. pdf 3. La. Veist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. http: //www. jointcenter. org/sites/default/files/upload/research/files/The%20 Economic% 20 Burden%20 of%20 Health%20 Inequalities%20 in%20 the%20 United%20 States. pdf 4. Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7): 1057– 1059. http: //www. ncbi. nlm. nih. gov/pmc/articles/PMC 1447186/ 5. Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http: //www. dhs. wisconsin. gov/publications/P 00187. pdf 6. World Health Organization. Fact Sheet No. 220, Mental health: strengthening our response. http: //www. who. int/mediacentre/factsheets/fs 220/en/index. html 7. Substance Abuse and Mental Health Services Administration. Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings. http: //www. samhsa. gov/data/NSDUH/2 k 11 MH_Findingsand. Det. Tables/ 61
MENTAL HEALTH References 8. Centers for Disease Control and Prevention (CDC). Self-Reported Frequent Mental Distress Among Adults --- United States, 1993— 2001. http: //www. cdc. gov/mmwr/preview/mmwrhtml/mm 5341 a 1. htm 9. Institute of Medicine (2011). The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. http: //www. iom. edu/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and. Transgender-People. aspx 10. U. S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention. Top Health Issues for LGBT Populations Information & Resource Kit. http: //store. samhsa. gov/shin/content/SMA 12 -4684. pdf 11. Substance Abuse and Mental Health Services Administration (SAMHSA). Smoking rate among adults with serious psychological distress remains high. http: //www. samhsa. gov/data/spotlight/spot 120 -smoking. SPD. pdf 12. Mc. Clave AK, Dube SR, Strine TW, Mokdad AH (2009). Associations between healthrelated quality of life and smoking status among a large sample of U. S. adults. Preventive Medicine, 48 (2), 173 -9. 62
MENTAL HEALTH References 13. CDC. Health Related Quality of Life. http: //www. cdc. gov/mentalhealth/about_us/hrql. htm 14. CDC. About BMI for Adults. http: //www. cdc. gov/healthyweight/assessing/bmi/adult_bmi/index. html#Definition 15. CDC. Adverse Childhood Experiences Study. http: //www. cdc. gov/ace/ 16. O’Connor C, Finkbiner C, & Watson L. (2012). Adverse Childhood Experiences in Wisconsin: Findings from the 2010 Behavioral Risk Factor Survey. Madison, Wisconsin: Wisconsin Children’s Trust Fund and Child Abuse Prevention Fund of Children’s Hospital & Health System. http: //wichildrenstrustfund. org/index. php? section=adverse-childhood 17. Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH (2009). Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine. http: //www. ncbi. nlm. nih. gov/pubmed/19840693 18. CDC. The state of mental health in aging America. http: //www. cdc. gov/aging/pdf/mental_health. pdf 19. CDC. Insufficient sleep is a public health epidemic. http: //www. cdc. gov/features/dssleep/ 20. CDC. Health-related quality of life: Well-being concepts. http: //www. cdc. gov/hrqol/wellbeing. htm#four 63
MENTAL HEALTH References 21. Wisconsin Department of Health Services; Injury Research Center at the Medical College of Wisconsin; Mental Health America of Wisconsin; Wisconsin Suicide Prevention Initiative (2008). The Burden of Suicide in Wisconsin. http: //www. dhs. wisconsin. gov/health/injuryprevention/pdffiles/bosfinal 9%205. pdf 22. CDC. Youth Risk Behavior Surveillance System. http: //apps. nccd. cdc. gov/youthonline/App/Default. aspx 23. Office of Adolescent Health. Mental Health. http: //www. hhs. gov/ash/oah/adolescenthealth-topics/mental-health/home. html 24. Keenan-Miller D, Hammen CL, Brennan PA. Health outcomes related to early adolescent depression. Journal of Adolescent Health. http: //www. ncbi. nlm. nih. gov/pmc/articles/PMC 2034364/ 25. CDC. Mortality Among Teenagers Aged 12 -19 Years: United States, 1999 -2006. http: //www. cdc. gov/nchs/databriefs/db 37. htm 26. Husky M, Olfson M, He J, Nock M, Swanson S, Merikangas K. Twelve-month suicidal symptoms and use of services among adolescents: results from the National Comorbidity Survey. Psychiatric Services in Advance. http: //ps. psychiatryonline. org/article. aspx? articleid=1333878 27. Birkett M, Espelage DL, Koenig B. LGB and questioning students in schools: The moderating effects of homophobic bullying and school climate on negative outcomes. J Youth Adolescence. http: //link. springer. com/article/10. 1007%2 Fs 10964 -008 -9389 -1 64
MENTAL HEALTH References 28. CDC. School Connectedness: Strategies for Increasing Protective Factors Among Youth. http: //www. cdc. gov/healthyyouth/adolescenthealth/pdf/connectedness. pdf 29. Data Resource Center for Child and Adolescent Health (DRC); National Survey of Children's Health. http: //www. childhealthdata. org/browse/survey? s=2 30. CDC. Visser SN, Blumberg SJ, Danielson ML, Bitsko RH, Kogan MD. State-Based and Demographic Variation in Parent-Reported Medication Rates for Attention. Deficit/Hyperactivity Disorder, 2007– 2008. http: //www. cdc. gov/pcd/issues/2013/12_0073. htm 31. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: American Journal of Preventive Medicine. http: //www. ncbi. nlm. nih. gov/pubmed/9635069? dopt=Abstract 32. Wisconsin Department of Health Services (DHS). Wisconsin Health Facts: Poverty and Health, 2010 Results from the Wisconsin Family Health Survey. http: //www. dhs. wisconsin. gov/publications/p 00381. pdf 33. Wisconsin Department of Health Services (DHS), Wisconsin Primary Care Office. Number of Psychiatrist FTEs Needed to Reduce Significant Shortages for the Resident Population: http: //www. dhs. wisconsin. gov/publications/p 00376. pdf 65
MENTAL HEALTH Links to additional reports and resources • Adverse Childhood Experiences in Wisconsin: Findings from the 2010 Behavioral Risk Factor Survey. http: //wichildrenstrustfund. org/files/Wisconsin. ACEs. pdf • Linking Mental and Physical Health: Results from the Wisconsin Behavioral Risk Factor Survey. http: //www. dhs. wisconsin. gov/stats/pdf/brfsmphreport 2009. pdf • Prevent Suicide Wisconsin: http: //www. preventsuicidewi. org • Centers for Disease Control and Prevention (CDC). Mental health. http: //www. cdc. gov/mentalhealth/ 66
MENTAL HEALTH Contacts Contact Julianne Dwyer Mental Health Promotion and Prevention Coordinator Bureau of Prevention, Treatment and Recovery Division of Mental Health and Substance Abuse Services Wisconsin Department of Health Services Email: Julianne. Dwyer@dhs. wisconsin. gov 67
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