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August 2014
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Overview
Mental health disorders are among the most common causes of disability. The disease burden resulting from mental illness is among the highest of all diseases.1 According to the National Institute of Mental Health (NIMH), in 2012, there were an estimated 43.7 million adults aged 18 years or older in the United States with any mental illness in the past year. This represented 18.6% of all U.S. adults.2
People, including children and adolescents, with untreated mental health disorders are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior, including suicide.3 In 2011, nearly 40,000 people died by suicide in the United States.4 More than twice as many people die by suicide each year as by homicide.5
Assessing and addressing the Nation’s mental health remains important to ensure that all Americans lead longer, healthier lives.

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Mental Health and the Affordable Care Act
The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage in a generation by requiring that health insurance plans on the Health Insurance Marketplace cover mental health and substance use disorder services. These new protections build on the Mental Health Parity and Addiction Equity Act to expand mental health and substance use disorder benefits and federal parity protections for behavioral health to 62 million Americans.
Because of the law, health plans must now cover preventive services like depression screening for adults and behavioral assessments for children at no cost. And as of 2014, most plans cannot deny you coverage or charge you more due to pre-existing health conditions, including mental illnesses. To learn more about mental health and the Affordable Care Act, please visit healthcare.gov.
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Leading Health Indicators
Leading Health Indicators (LHIs) are critical health issues that – if tackled appropriately – will dramatically reduce the leading causes of death and preventable illnesses. The Mental Health LHIs are:
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Where We’ve Been and Where We’re Going
From 2001 to 2011, the suicide rate increased 15.0%, from 10.7 per 100,000 population (age adjusted) in 2001 to 12.3 in 2011. Suicide rates varied by factors such as race/ethnicity, age, country of birth, and marital status. In 2012, 9.1% of adolescents aged 12 to 17 years reported having had a major depressive episode (MDE) in the past 12 months. The rate of MDE varied by sex, race/ethnicity, and age.
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Who’s Leading the Leading Health Indicators?
The Senior Connection: Improving social connectedness and social integration to address suicide attempts in older adults
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Suicide is a serious public health problem, particularly among older adults. In 2011, the rate of suicide among adults aged 65 years and older was 15.3 per 100,000. However, suicide is a preventable public health challenge. The Centers for Disease Control and Prevention (CDC) proposed a strategic direction focused on building and strengthening social and emotional connections as a means for suicide prevention.6 This strategy is based on evidence that social connectedness and social integration are protective against suicidal thoughts and behaviors, including in older adult populations.7
In 2010, the University of Rochester Medical Center (URMC), in partnership with Lifespan, a local aging service agency, received a grant from CDC to implement The Senior Connection (TSC), a program for older adults that aims to reduce their risk of suicide. Based on CDC’s strategic direction to promote social connectedness, TSC matches volunteer peer companions with older adults in the community (“care receivers”) who have reported feeling lonely and/or as if they are considered a burden on others.

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