HealthNews Dozen: U.S. States Get Graded on Mental Health Care

Most surveys that rank states according to various criteria come up with those that excel and others that fail. But when the entire United States performs poorly in a study, one that ranks the care of its citizens with mental health concerns, and not one state was able to receive an overall A grade, it speaks volumes about the subject. That subject being mental health, a disorder that affects 57.7 million Americans each year. The results of the study are startling and expose the need for urgent change.

The dozen states ranked above were the worst on the list of 50. Though typically it is best to focus on those that performed best rather than those at the bottom end of the spectrum, the results of this survey were so disappointing that it seemed appropriate to highlight those states which scored the very lowest, many of them actually receiving failing grades.

The National Alliance on Mental Illness (NAMI) is painfully aware of the underperformance of the United States in acknowledging and giving proper consideration to mental illnesses and those who suffer from them. The nonprofit organization set out to reproduce a study that they originally conducted in 2006, so as to compare those grades to the 2009 numbers in the report entitled “Grading the States: A Report on America’s Health Care System for Serious Mental Illness.” And what the authors discovered was very little improvement had taken place over the past three years. Grades rose for 14 states but dropped for 12 others, and the overall national grade for the United States remained a D.

States were ranked through a comprehensive view of each one’s mental health care systems in four categories. Health promotion and measurement was 25 percent of the total grade, which concentrated on the number of programs delivering evidence-based practices, emergency room wait times, and the quantity of psychiatric beds. Financing and core treatment and recovery services made up 45 percent of the grade, as it looked at financing measures for evidence-based practices. The third category was consumer and family empowerment, which was 15 percent of the overall score and included access to essential information from the state, promotion of consumer-based programs, and family and peer education and support programs. Lastly, the final 15 percent was in the community integration and social inclusion category that measured activities that required collaboration among state mental health agencies and other agencies and programs.

The worst state on the list was West Virginia, but six of the twelve listed states received an F for their mental health care. The next 21 states, only some of which made it into the HealthNews Dozen list, received D grades. There were 18 C grades given, and only six B grades.

The B grades deserve mention because of their significantly higher rating than so many others in the U.S., and they were—starting with the highest score—Connecticut, Maine, Maryland, Massachusetts, New York, and Oklahoma. Connecticut was the only state to receive an A in any category, which it did in the consumer and family empowerment ratings category.

NAMI is concerned about the results, as stated in the first sentences of the overview of the report: “Our national mental health care system is in crisis. Long fragile, fragmented, and inadequate, it is now in serious peril.”

That peril pertains to one in four adults experiencing a mental health disorder each year. One in 17 lives with a constant serious mental illness, such as schizophrenia, major depression, or bipolar disorder. One in 10 children has a serious mental or emotional disorder. But less than 1/3 of adults and only with said disorders actually receive any mental health services.

While the statement regarding the report results from NAMI Executive Director Michael J. Fitzpatrick discusses the seriousness of the grades, which he predicts could slide even further due to the ongoing economic crisis and the subsequent cutting of state mental health budgets, he came through with some optimism. He wrote, “Crisis creates opportunities. Publication of this report coincides with the inauguration of a new President who sees health care reform as part of the nation’s broader economic challenge. Of course, mental health is part of health care… Together, at every level, we must advance, not retreat.”