Issue Category: Substance Misuse and Mental Health

Minority Mental Health Awareness Month

Health is a combination of physical and mental wellness. According to the National Alliance on Mental Illness, one in five U.S. adults will experience a mental illness this year.  Dealing with stereotypes, bias, discrimination, and racism creates unique stressors in the lives of people of color and other marginalized groups including immigrants and members of the LGBTQ community – stressors that can have negative impacts on mental, emotional and physical health.  Additionally, poverty and lack of health insurance – two realities in many minority communities – create substantial barriers to care when people need help with a mental health or substance misuse issue. While overall rates of mental disorders for most communities of color are largely similar to those for Whites, numerous studies have found that racial and ethnic minorities are less likely than Whites to seek mental health treatment, often due to factors such as lack of health insurance and sometimes due to stigma. People of color are also more likely to face barriers such as lack of available mental health services, poorer quality of care, and lack of culturally and linguistically appropriate care within treatment settings.

There is overwhelming evidence that inequitable social, economic and environmental factors— such as, poverty, discrimination, and lack of access to educational opportunities, jobs and affordable housing —contribute to disparities in health including mental health.

For Minority Mental Health Awareness Month, Trust for America’s Health (TFAH) is sharing the following information on what communities can do to support the mental and emotional health of all residents and to reverse the inequities that often lead to poorer health outcomes in communities of color.

Pain in the Nation Update: While Deaths from Alcohol, Drugs, and Suicide Slowed Slightly in 2017, Rates Are Still at Historic Highs:  More than 150,000 Americans died from alcohol- and drug-induced causes and suicide in 2017—more than twice as many as in 1999—according to analysis by TFAH and Well Being Trust of mortality data from the U.S. Centers for Disease Control and Prevention. In 2017, synthetic-opioid deaths were highest among males, Blacks, Whites, adults ages 18–54, and those living in urban areas. Between 2007 and 2017, drug deaths among Blacks increased by 101 percent and alcohol deaths were up 49 percent.  For Latinos during the same period, drug deaths were up 78 percent and alcohol deaths were up 48 percent. Over the past decade (2008–2017), suicide increased in nearly every state. However, there were substantial variations by demographics —with larger proportional increases among younger people and racial and ethnic minorities.

Pain in the Nation Issue Brief – Alcohol and Drug Misuse and Suicide and the Millennial Generation – a Devastating Impact: The impact of the national epidemics of alcohol, drug and suicide deaths has been especially pronounced amongst Millennials.  Millennials, people born between 1981 and 1996, faced and continue to face a mix of challenges unique to their generation including the opioid crisis, the skyrocketing costs of education and housing, and entering the job market during the great recession. Between 1999 and 2017, opioid overdose death rates among 18- to 34-year-olds increased by more than 500 percent. During the same period, the increase in synthetic opioid death rates among young adults increased by a staggering 6,000 percent.

The millennial generation is a more diverse generation than are baby boomers, therefore the need for culturally and linguistically appropriate mental and substance misuse treatment services for today’s young adults has grown significantly. This report includes policy recommendations on ways to prevent substance misuse and suicide among Millennials.

Racial Healing and Achieving Health Equity in the United States: Health equity is the   opportunity for everyone to have a fair chance of achieving optimal health. This 2018 issue brief highlights and acknowledges health inequities, the factors that influences them and highlights policy recommendations that can help the nation achieve health equity.

Advancing Health Equity: What We Have Learned from Community-based Health Equity Initiatives: On March 1, 2018, TFAH, with support from The California Endowment, held a convening Advancing Health Equity: What We Have Learned from Community-based Health Equity Initiatives in to identify and examine promising practices from existing initiatives. The resulting convening summary outlines core strategies of successful community-based health equity initiatives and recommendations for next steps in creating and advancing a policy agenda to promote community-based health equity.

Taking Action to Promote Health Equity – Using the Lessons from Cutting-Edge Practices to Improve Health and Well Being: TFAH’s Fall 2018 4-part health equity webinar series features public health practitioners and community leaders sharing their experiences shaping and implementing programs to advance health equity in their communities.  The webinar series informed a broad, national audience about compelling and replicable health equity initiatives and how to address the grass roots issues that will impact their success.

 

More Millennials Are Dying ‘Deaths of Despair,’ as Overdose and Suicide Rate Climb

Time
by Jamie Ducharme
June 13, 2019

There’s been a marked uptick in so-called deaths of despair—those involving drugs, alcohol or suicide—among millennials over the last decade, according to a new report released by public-health groups Trust for America’s Health and Well Being Trust.

Drug, alcohol and suicide deaths have risen in nearly every age group over the last decade, but the increase has been especially pronounced for younger Americans. Between 2007 and 2017, drug-related deaths increased by 108% among adults ages 18 to 34, while alcohol-related deaths increased by 69% and suicides increased by 35%, according to the report, which drew on Centers for Disease Control and Prevention data. All together, about 36,000 millennials died “deaths of despair” in 2017, with fatal drug overdoses being the biggest driver.

Read the full article.

 

 

Millennial Generation Deaths Due to Drug Misuse up 400 percent since 1999; Deaths from Drugs and Suicide at All-time Highs

New issue brief provides solutions for stopping deaths of despair among Millennials

(Washington, DC and Oakland, California June 13, 2019 ) – Young adult deaths due to alcohol and drug misuse and suicide have increased precipitously among 18- to 34-year-olds during the last two decades, including a 400 percent increase in drug-related deaths, fueled in large part by the opioid crisis, according to a new issue brief released today by Trust for America’s Health and Well Being Trust.

The report, which analyzed CDC data, found that between 1999 and 2017, opioid overdose death rates among Millennials increased by more than 500 percent. During the same period, synthetic opioid death rates increased by a staggering 6,000 percent.  The age group’s overall increase in drug deaths between 1999 and 2017 was 400 percent.

During the past decade (2007 – 2017), among people 18-34, alcohol-induced deaths increased by 69 percent, drug induced deaths increased by 108 percent and suicide deaths increased by 35 percent.

And, from 2016-2017, for 18- to 34-year-olds, drug-induced deaths increased 10 percent and suicide deaths were up 7 percent.  Alcohol-induced deaths for the year were down by 4 percent but as noted above are up sharply for the decade.

“The huge increases in the numbers of Millennials being lost to substance misuse and suicide is a national tragedy,” said John Auerbach, President and CEO of Trust for America’s Health. “As a nation, we need to pay particular attention to the lived experience of the Millennial generation.  They are young parents, many have burdensome levels of educational debt, they are more than one-third of today’s workforce and comprise the largest proportion of Americans serving in the military. Unfortunately, they also comprise the largest portion of people in prison.  They are grappling with economic, health and social challenges unique to their generation.  There is a critical need for targeted programs that address Millennials’ health, well-being and economic opportunity.”

The issue brief focuses on five issues areas that must be considered in any efforts to stem the tide of deaths of despair among young adults, they are the need to: 1) prioritize childhood risk and protective factors and emphasize prevention in the developmental years in order to put today’s children on a pathway that will allow them to become thriving adults, 2) ensure access to mental health and substance misuse treatment services, 3) address health inequities, 4) recognize the multigenerational impact of alcohol and drug misuse and suicide and 5) improve substance use disorders treatment within the criminal justice system.

The Millennial generation, typically defined as people born between 1981 and 1996 are today 23 to 38 years of age.  Millennials continue to face a mix of challenges unique to their generation including the exploding costs of education and housing and beginning and growing their careers during the great recession and the opioid crisis.  Another critical element of the issue brief’s focus on Millennials is the fact that many are parents of young children and their alcohol or drug misuse or poor mental health often has serious impacts on multiple generations of their family.

“There’s not a segment of the population that isn’t experiencing loneliness and despair,” said Benjamin F. Miller, PsyD, chief strategy officer, Well Being Trust. “We must address issues that matter– tackling the obstacles that prevent people from having a healthy and fulfilling life and upholding our responsibility to improve the health and well-being of our communities. No place is this more apparent than with Millennials—those who have and are about to have families of their own. If we fail Millennials, we’re failing the next generation and we’ll not break this cycle of despair.”

According to the issue brief, new and specific interventions aimed at reducing these deaths of despair amongst young adults are critically needed, notably including these 10:

  1. Ensuring behavioral healthcare, including screenings, are a routine part of primary care and that everyone has access to such care. Care must be culturally competent.
  2. Barriers to treatment like the lack of providers in rural areas or the need for more residential treatment programs for pregnant and postpartum women should be addressed by growing the Federal Behavioral Workforce Education Program, greater use of telemedicine and increasing student loan repayment programs for practitioners working in underserved areas.
  3. Behavioral health screening and referral services should be readily available at all colleges, universities, technical training facilities and reproductive health clinics.
  4. Health insurance and Medicaid coverage for medication-based treatments for substance misuse disorders should be increased.
  5. Wider implementation of suicide prevention programs, such as the Zero Suicide Initiative, is needed throughout the healthcare system. All hospitals should ensure that any patient in crisis is connected with behavioral health services in a timely manner.
  6. States and localities should use pricing strategies to limit the consumption of alcohol by adolescents and young adults.
  7. Federal and state governments should prioritize the implementation of the Family First Prevention Services Act to support prevention services for families in crisis and to reduce foster care placements.
  8. Hospitals and birthing centers should screen new mothers for substance misuse disorders at delivery.
  9. Drug and mental health courts should be created in all states and federal districts. When appropriate, people with substance misuse disorders should receive mandatory treatment as part of their incarceration and be connected to in-community treatment services upon their release.
  10. Transition programs to assist veterans returning to civilian life should be readily available.

The Trust for America’s Health/Well Being Trust Pain in the Nation publication series was launched in 2017 and examines substance misuse and suicide trends and evidence-based policies and programs in an effort to promote a comprehensive approach to solving the nation’s deaths of despair crisis.  The issue brief series is designed to focus attention on the need for a national resilience strategy.

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @healthyamerica1

Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust

 

 

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May is Mental Health Month

Mental Health Month is an appropriate time to talk about programs and policies that support the health and well-being of Americans throughout the year.  TFAH reports focus on evidence-based programs and policies that, if enacted or expanded, will help all residents enjoy optimal health and well-being.

Pain in the Nation is a series of reports created by TFAH and the Well Being Trust to call attention to the tragic epidemics of alcohol, drug and suicide deaths – and suggest solutions. More than 150,000 Americans died from alcohol- and drug-induced causes and suicide in 2017—more than twice as many as in 1999 – including sharp increases in synthetic opioid deaths.  Policy action on these deaths of despair epidemics is imperative. Read more.

Promoting Health and Cost Control in States. This new report considers the important ways life circumstances outside the healthcare sector impact health.  It recommends 13 policy actions that data show if enacted by states would improve health and well-being for all residents. Read more.

Health Equity is the equal opportunity for everyone to enjoy optimal health. TFAH has identified programs and policy recommendations that if enacted in more communities would help address the disparities that are barriers to healthy living for too many people. Read more.

 

Number of Americans Dying Due to Alcohol, Drugs, and Suicide is at an All-time High

Synthetic Opioid Deaths Rose 45 Percent Between 2016 And 2017,
Have Increased 10-fold In The Last Five Years

(Washington, DC and Oakland, CA – March 5, 2019) – More than 150,000 Americans—the most ever—died from alcohol and drug-induced fatalities and suicide in 2017 – more than twice as many as in 1999 – according to a new analysis released today by Trust for America’s Health (TFAH) and Well Being Trust (WBT).

The TFAH and WBT analysis of Centers for Disease Control and Prevention data found that between 2016 and 2017, the national rate for deaths due to alcohol, drugs, and suicide increased 6 percent from 43.9 to 46.6 deaths per 100,000.  While the increase is lower than the prior two years, it is higher than the 4 percent average annual increase since 1999.

According to the analysis, the number of Americans dying due to substance misuse and suicide is at an all-time high.

Synthetic opioids continue to drive increases in deaths

Synthetic opioid deaths rose 45 percent between 2016 and 2017 and have increased 10-fold in the last five years.  Americans are now dying at a faster rate from overdoses involving synthetic opioids than they did from all drugs in 1999.

Two decades ago, fentanyl and synthetic opioids were associated with less than 1,000 annual deaths nationwide.  In 2017, more than 1,000 Americans died from synthetic-opioid overdoes every two weeks.

In 2017, synthetic-opioid deaths were highest among males, Blacks, Whites, adults ages 18-54 and those living in urban areas. Synthetic-opioid deaths were concentrated in Northeastern and Midwestern states.

Suicide deaths growing at fastest pace in years

Deaths from suicides also rose faster between 2016 and 2017 than in previous years, increasing four percent from 13.9 to 14.5 deaths per 100,000.  The 2017 increase was the largest since the data collection began in 1999. For the previous decade, between 2008 and2017, suicide rates increased an average of 2 percent per year, a 22 percent total increase.

The highest rates of suicide continue to occur among Whites, males and people living in rural areas. Increases in suicide were geographically widespread but increases were proportionally greater among certain demographic groups including young people (particularly children and adolescents), Blacks and Latinos. Between 2016 and 2017, suicide death rates for children and adolescents increased by 16 percent from 2.1 deaths per 100,000 to 2.4 per 100,000.

“It is important to see hope in the slowing of rates—but it’s not nearly enough. We should not be satisfied at all. Too many of us are dying from preventable causes, and each time we make progress—like with prescription opioids—new problems—like synthetic opioids—appear,” said Benjamin F. Miller, Chief Strategy Officer, WBT. “Tackling such a complex problem is not about adding up small changes – but really about transformation at a systems level.”

Age and Gender Differences

The 2017 rate of death by alcohol, drugs, and suicide among all adults ages 35-54 was 72.4 deaths per 100,000, for all males it was 68.2 per 100,000, for all females it was 25.7 deaths per 100,000.

Regional Differences

While most states saw increases in deaths due to alcohol, drugs and suicide, the trends are worst in certain states:

  • West Virginia had the highest rate of death from alcohol, drugs, and suicide in the nation (91 deaths per 100,000).
  • New Mexico was second with 77 deaths per 100,000.
  • Ohio was third with 69.4 deaths per 100,000.
  • Alaska (67.6 per 100,000) and New Hampshire (66.0 per 100,000) were fourth and fifth respectively.

Overall, 43 states and the District of Columbia had higher rates of deaths from alcohol, drugs and suicide between 2016 and 2017. Five states—Massachusetts, Oklahoma, Rhode Island, Utah, and Wyoming—had lower rates.

 “We need a comprehensive approach with attention to the upstream root causes – like childhood trauma, poverty and discrimination —and the downstream life-saving efforts – like overdose reversal and access to treatment—and everything in between,” said John Auerbach, President and CEO of the Trust for America’s Health.  “A focus on only one or two approaches won’t work with complex and widespread epidemics like these. As a nation, we need to better understand and to systematically address the factors that drive these devastating deaths of despair.”

The TFAH/WBT brief recommends several policy actions to prevent deaths from alcohol, drugs, and suicide, including:

  • Increasing funding and support for programs that reduce risk factors and promote resilience in children, families and communities. Exposure to trauma and adverse experiences at young ages increase the potential for substance misuse and suicide.  Programs that reduce community violence, address poverty and discrimination, create safe, supportive schools and quality learning experiences and promote access to secure housing and employment opportunities all reduce adverse experiences and build resilience.
  • Providing more resources to programs that promote harm reduction and access to treatment for individuals with substance use disorders including access to mental health services covered by insurance on par with coverage for physical health care. Increased access to programs for communities and population groups at the highest risk for substance misuse and suicide are particularly critical.
  • Supporting policies that limit access to the lethal means of suicide by promoting safe storage of medications and firearms and encouraging responsible opioid prescribing practices.

The TFAH/WBT Pain in the Nation publication series was launched in 2017 and examines substance misuse and suicide trends and evidence-based policies and programs in an effort to promote a comprehensive approach to solving the nation’s deaths of despair crisis.  The report series is designed to focus attention on the need for national resilience strategy.

# # #

Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.

Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust