Why Are Utahns So Depressed?
Posted by Andrew on March 26, 2008
A recent news article cites a study that portrays Utah as the most depressed state in the U.S. The article suggests Mormon culture is at least partly to blame for Utahns’ depression, and features photos of a pill bottle and a depressed-looking woman superimposed over the Salt Lake temple.
A post by Kaimi Wenger at T&S touched off a flurry of debate and speculation about whether Utahns are, in fact, more depressed than their fellow Americans and, if so, whether Mormon culture is at least partly to blame. The most common theories and conclusions were:
Conclusion #1: Utahns are not significantly more depressed than anyone else. The main theories advanced to support this conclusion are:
a. Utahns are simply more honest in reporting their depression.
b. Utahns report more depression than non-Utahns because they are not self-medicating with alcohol to mask their depression from themselves.
c. The high amount of anti-depressant prescriptions in Utah exists, not because Utahns are more depressed than anyone else, but because Utah has an excellent mental health care system that provides treatment to those who need it.
Conclusion #2: Utahns are significantly more depressed than others, but Mormon culture has nothing to do with it. The main theories advanced to support this opinion are:
a. Lower education levels correlate with higher depression levels, and Utahns have comparatively lower education levels.
b. Utahns have less available mental health care facilities and professionals.
c. Utahns cannot afford to use the mental health care that is available to them, perhaps because of a lack of health insurance coverage.
d. Utah has a smaller gene pool than other states, which can result in higher depression rates.
Conclusion #3: Utah is significantly more depressed than other states, and Mormon culture is at least partly to blame. The overall theory behind this conclusion is that Mormons, who comprise 70% of Utah’s population, have a Church culture that is demanding, emphasizes perfection, obedience and conformity, and creates an undercurrent of competition that leads to feelings of inadequacy, depression, and suicide.
Over the past week or so, I’ve been able to digest the study and its underlying data, and to compare it against the theories outlined above. I was quite surprised by what I learned, and thought you might be interested to hear about it. But first, I should make an important disclaimer: I have absolutely no formal training whatsoever in psychology, statistics, or any other discipline that would qualify me to write this post. However, to be fair to myself, I should mention that I am a Doctor of Metaphysics, as well as a Certified Jedi Knight, so that ought to more than make up for it.
The Key Findings
The key findings reported by the Mental Health America study are as follows:
- Utah has the highest percentage of adults reporting a major depressive episode from 2004-05. (10.14%)
- Utah has the 3rd-highest percentage of adults reporting serious psychological distress from 2004-05 (14.58%)
- Utah has the 4th-highest percentage of adolescents reporting a major depressive episode from 2004-05. (10.14%)
- Utah has the 7th-highest suicide rate in the nation.
When these factors are combined and compared to others states, Utah comes out as the most depressed state in the U.S.
Some Interesting Correlations on a National Level
The study states that depression and suicide rates are generally influenced by three factors: biology, environment, and access to mental health care. When it comes to access to mental health care, some interesting correlations on a national level were noted:
- On average, the higher the number of psychologists, psychiatrists, and social workers per capita in a state, the lower the state’s suicide rate.
- The lower the percentage of a state’s population reporting they could not obtain mental health care because of cost, the lower the depression and suicide rates.
- The lower the percentage of a state’s population reporting unmet mental health care needs, the lower the depression rates.
- The higher the number of anti-depressant prescriptions per capita in a state, the lower the suicide rate.
- The higher the percentage of population covered by health insurance, the lower the suicide rate.
- The more educated a state’s population is, the lower the depression and suicide rates.
Utah: A Peculiar State
Based on the documented correlations listed above, one would expect Utah’s high depression and suicide rates to be easily explained by low numbers of mental health care professionals, low anti-depressant prescriptions, low education levels, low health insurance coverage levels, and high numbers of people reporting unmet health care needs and an inability to obtain mental health care due to cost. But Utah is not the worst when it comes to any of those factors.
Here is how Utah ranks in comparison to other states when it comes to the availability of mental health care (including the District of Columbia, so all the ranks below are out of 51):
- State mental health authority expenditures per capita: 26th
- No. of specialty mental health organizations providing 24 hr. treatment: 38th
- No. of specialty mental health organizations providing less than 24 hr. treatment: 45th
- No. psychiatrists per 100,000 population: 44th
- No. psychologists per 100,000 population: 24th
- No. socialworkers per 100,000 population: 23rd
As you can see, Utah has mid-to-low rankings when it comes to the availability of mental health care, but it is by no means the worst. As an example, Texas ranks even lower than Utah in all but one of the categories above, and yet still manages to be in the top 10 least-depressed states. So the availability of mental health care doesn’t seem to be what’s driving Utah’s depression numbers.
When it comes to the affordability of mental health care, Utah ranks mid-to-low again:
- Percent of population reporting could not get health care because of cost: 23rd
- Percent of population with health insurance: 35th
But Utah is by no means the worst in these categories either. Again, by way of comparison, Texas ranks even lower than Utah on both these factors, but still falls within the top 10 least-depressed states.
And despite any shortcomings in the availability and affordability of mental health care in Utah, Utah has the 4th highest percentage of population receiving mental health care treatment (17.4%). And Utah ranks above-average (18th) in anti-depressants prescribed per-capita, which one would expect to correlate with lower suicide rates in Utah, but for some reason does not.
What is more perplexing is that even though Utah ranks 4th-highest in percentage of population receiving mental health care treatment, somehow Utah also has the highest percentage of population reporting unmet needs for mental health care treatment in the past year (8.2%). One would expect a state with high percentage of population receiving treatment (like Utah) to have a correspondingly low amount of unmet treatment needs. But not in Utah. This gives you an idea of how great the demand is for mental health care treatment in Utah.
Why would Utah’s demand for mental health care treatment be so high? It is unclear. But we can also probably rule out economic and educational factors, because Utah has the 8th-highest median household income in the nation, and 24th-highest percentage of population with a college degree.
So What Is Behind Utah’s Depression?
The data above suggest there is something strange going on in Utah. When it comes to depression and suicide, Utah just doesn’t “act like” other states. It defies most of the correlations that exist on a national level. Which leads to the obvious question: if Utah’s depression numbers don’t seem to be driven by the “normal” factors, what is behind Utah’s depression and suicide numbers? What makes Utah so peculiar?
In my next post, I will address two peculiar theories about Utah’s depression and suicide numbers: the “Shrunken Gene Pool” theory, the “Lack of Alcoholic Self-Medication” theory, as well as the 2,000 pound elephant in the room: Mormon culture.
(P.S. For any readers who actually are qualified to analyze these matters, please feel free to completely rip my amateur analysis to shreds.)