Leading Health-Care Indicators and Related Public Health Program in Florida
Mental health is a leading health indicator included in the Healthy People 2020 national plan. Various mental disorders can equally affect individuals of differing multicultural backgrounds, and the prevalence of severe mental illnesses remains high in the United States. According to the Office of Disease Prevention and Health Promotion (ODPHP, 2014a), nearly 1 in 4 adult persons in the country has a mild form of a mental disorder, while 1 in 17 adults has a serious one. Considering the many potential profound negative effects of mental illnesses, state-level programs have been launched across the United States with an aim to promote psychological well-being in community members and improve their ability to lead healthy, productive lives. The state of Florida has also enacted related initiatives. For example, the Florida Substance Abuse and Mental Health Plan offers a comprehensive list of objectives that local government and organizations are seeking to achieve in the sphere of mental health. These include community-based health promotion, child welfare, improvement of access to mental health services, and more. Linking Actions for Unmet Needs in Children’s Health (LAUNCH) is one example of the projects realized under this plan.
Statistics
Two mental health–related objectives established by Healthy People 2020 are preventing suicide attempts in adolescents (MHMD-2) and reducing the rate of major depression across various population groups, including children and teenagers (MHMD-4; ODPHP, 2014b). Recent statistics indicate that the incidence of major depression episodes (MDE) among individuals aged 12–17 in Florida remains similar to the national percentage. In the period between 2012 and 2013, Florida’s MDE rate was 9.6%, compared to 9.9% in the United States in general (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). The data reveal a slight increase in the incidence of depression among adolescents since 2009, when it equaled 8.8% (SAMHSA, 2014). Moreover, the rate continued to increase from that point, reaching 11.9% in 2015 (SAMHSA, 2015). Suicide, also a concern in adolescents, was the 11th most common cause of death in the overall state population and the third most common in individuals aged 10–24 in 2016 (Carroll & Scott, 2018). The total number of deaths due to suicide in youth and young adults that year comprised 296 cases per 100,000 population (Carroll & Scott, 2018). Such statistics may indicate that access to treatment and counseling among youth who suffer from mental disorders in Florida is limited.
Program Evaluation
The state’s vital statistics make it clear that mental health problems are currently on the rise, both in Florida in particular and in the United States in general. For example, Carroll and Scott (2018) noted that the suicide rate has increased by over 2% since 2006 and has continued to fluctuate over the years. In comparison, the desired objectives in the leading health indicator under discussion would involve a decrease in the incidence of MDE and cases of suicide by at least 10% (ODPHP, 2014b). Such a reduction in the prevalence of these adverse mental health outcomes is currently not the case in Florida. For example, the state has failed to reduce the suicide rate to 10.2 cases per 100,000 general population, an essential target in the national health promotion endeavors (ODPHP, 2014b). However, Florida does meet the MHMD-2 target, namely, keeping the number of suicide attempts below the rate of 1.7 per 100 adolescent population (ODPHP, 2014b). Overall, this means that improvements in the state’s disease prevention activities are still needed.
The Florida Substance Abuse and Mental Health Plan and related projects and programs are aligned with the Healthy People 2020 goals. The LAUNCH project initiated in Florida is “a five-year, $4 million cooperative agreement funded by SAMHSA that aims to prevent youth emotional and behavioral disorders by improving family function and the quality of the parent–child relationship” (Carroll & Scott, 2016, p. 25). This program strives to integrate behavioral and mental health services in primary care settings, strengthening families by providing psychological consultation and education to both parents and their children. In this way, LAUNCH may be regarded as part of a community-based health promotion that specifically targets youth and their immediate environment.
Florida is also implementing a suicide prevention plan aiming to educate the public and help those at high risk of suicide by initiating multiple programs. An example of an active suicide-prevention strategy is Florida’s Implementation of the National Strategy for Suicide Prevention (FINS) Project, developed within the state’s suicide-prevention infrastructure. This program primarily targets improving opportunities for health recovery in adults and providing them all necessary support through education, high-quality counseling and treatment, and more (Suicide Prevention Resource Center, 2018). Previously, in addition to its focus on assisting adults, this program aimed to “decrease the incidence of teen suicide in Florida” in the period between 2007 and 2010 (University of South Florida, n.d., para. 4). However, evidence does not indicate whether the project still directly addresses the problem of adolescent suicidal behaviors.
Morbidity and Mortality Rates: Adolescents with MDE in the Past 12 Months
Nine major symptoms of major depression are currently recognized, including diminished interest in regular activities, unhealthy dieting, insomnia and hypersomnia, reduced energy level, low self-esteem, inability to concentrate, suicidal ideation, and more (U. S. Department of Health & Human Services [HSS], 2017). These symptoms have a cumulative effect on health and on individuals’ health-related behaviors, consequently increasing the risk of morbidity and mortality. On this note, Gilman et al. (2017) stated that “depression is associated with poor quality of diet, infrequent exercise, smoking and excessive alcohol use” (p. E1307). Therefore, this disorder may lead to death not only from suicide but alternatively because of related adverse chronic conditions over time.
In adolescents, one of the most common depression-linked behaviors is substance abuse. For example, the rate of binge alcohol use among teenagers (aged 12–20) in Florida in 2013 was 13.1%, while the percentage of illicit drug abuse among adolescents of 12–17 years old equaled 9.4% (SAMHSA, 2014). Notably, the latter number is slightly above the national average at the time. It is apparent that many substances are highly addictive, and their use correlates with the development of adverse behavioral patterns that may induce progression of multiple chronic disorders. Thus, it is essential to address the problem through community-based intervention programs.
Conclusion: Program Gaps
Florida currently lacks a comprehensive program to address the problem of MDE-linked morbidity in adolescents, along with youths’ engagement in risk-taking behaviors in particular. The major initiatives in place either focus on younger children and their parents (the LAUNCH project) or improving the quality of care for youth with mental disorders (the program by Georgetown University Center for Child and Human Development). Seeking to strengthen families and creating support sources under these initiatives can provide multiple advantages; however, neither addresses ways to eliminate the problem of depression-associated substance abuse in teenagers. Therefore, the. need is clear for designing a strategy to decrease the percentage of drug and alcohol abuse in individuals aged 12–18 years specifically and to integrate this strategy in an MDE prevention program in schools or other community-based settings.
References
Carroll, M., & Scott, R. (2016). Florida substance abuse and mental health plan. Web.
Carroll, M., & Scott, R. (2018). 2017 Annual report suicide prevention coordinating council. Web.
Gilman, S. E., Sucha, E., Kingsbury, M., Horton, N. J., Murphy, J. M., & Colman, I. (2017). Depression and mortality in a longitudinal study: 1952-2011. CMAJ: Canadian Medical Association Journal, 189(42), E1304-E1310.
Office of Disease Prevention and Health Promotion. (2014a). Mental health.
Office of Disease Prevention and Health Promotion. (2014b). Mental health and mental disorders.
Substance Abuse and Mental Health Services Administration. (2014). Behavioral health barometer: Florida, 2014.
Substance Abuse and Mental Health Services Administration. (2015). Behavioral health barometer: Florida, volume 4.
Suicide Prevention Resource Center. (2018). Florida – University of Central Florida.
U. S. Department of Health & Human Services. (2017). Florida adolescent mental health facts.
University of South Florida. (n.d.). Suicide stops here: Florida Suicide Prevention Implementation Project.