Despite being the smallest state, Rhode Island leads the country
in a concerning area: major depression diagnoses. While the national depression
diagnosis rate averages 4.4 percent, Rhode Islanders are diagnosed at a rate of
This is according to the Health of America report issued by the
Blue Cross Blue Shield Association, titled, “Major
Depression: The Impact on Overall Health.” The study examined
diagnosed major depressive disorder using the Blue
Cross Blue Shield Health Index – a first-of-its-kind
measurement of health for nearly every county in America – and found that major
depression is the second most impactful condition on overall health for insured
Americans, outranked only by high blood pressure.
In Rhode Island, women and millennials (aged 18-34) feel the
impact most seriously, with diagnosis rates at 8.5 percent and 6.3 percent,
respectively. It is worth noting that these rates are increasing quickly around
the nation – particularly among adolescents and millennials, which could have a
substantial health impact on our nation for decades to come.
For Rhode Islanders – and particularly those in the Rhode Island
medical community – these numbers are further confirmation that we must
effectively address and support the mental health needs of our community,
particularly when considering the impact mental health diagnoses have on the
greater healthcare system. The Health of America report finds:
Those diagnosed with major depression are nearly 30 percent less
healthy on average than those not diagnosed. This decrease in overall health
translates to nearly 10 years of healthy life lost for both men and women.
Similarly, chronic conditions are strongly linked to major
depression, as 85 percent of people who are diagnosed with major depression
also have one or more serious chronic health conditions.
Blue Cross members diagnosed with major depression use health
care services more than those without a depression diagnosis. This results in
two times the health care spending (about $10,673 compared to $4,283,
Blue Cross & Blue Shield of Rhode Island is working
alongside our states leaders to address this crisis with our members,
specifically with innovative programs to improve access and care coordination
and to remove barriers and stigma. Solutions we are putting in place include
Changes: BCBSRI is implementing changes to remove barriers to
high-quality, affordable healthcare. We will remove our prior approval
requirement, known as a utilization review, for in-network mental health or
substance use disorder services. And copay/coverage for these outpatient visits
will now be equal to copay/coverage for primary care visits.
Teen: In collaboration with Bradley Hospital, BCBSRI is promoting
alternatives to inpatient hospitalization for children and teens facing mental
In collaboration with Continuum Behavioral Health, HealthPath offers patients
better continuity and outcomes, and reduces overall behavioral health spending
by providing BCBSRI members with access to comprehensive, coordinated,
community-based treatment and support services.
Ultimately, though, this is a problem with significant impact on
Rhode Islanders, and it is only by working collaboratively throughout our
communities and our state that we can improve outcomes for those who are
diagnosed – or will be diagnosed – with major depression. For individuals, that
means scheduling their annual checkups to identify any issues and quickly seek
care, if needed. For healthcare providers, that means being attentive to signs
of mental health issues in patients and supporting them through the process of
seeking care. For our policy makers and industry organizations, that means
identifying barriers to diagnosing and supporting treatment in Rhode Islanders,
and finding new solutions and programs to break down those barriers. And –
perhaps most importantly – for all Rhode Islanders, it means reducing the
stigma associated with mental health so that those affected feel more
comfortable seeking treatment.
I believe that working together, we will address these
staggering numbers so that Rhode Island no longer stands out for its high rate
of major depression, but rather for all the things that make us proud.
Matt Collins, M.D., is the vice president
of clinical integration at BCBSRI.