SUICIDE RATE REMAINS LARGELY UNCHANGED
Mental health disorders are among the most common causes of disability. According to the National Institute of Mental Health, more than one-in-five adults live with a mental illness (59.3 million in 2022), and an estimated one-in-17 adults have a serious mental illness that substantially interferes with major life activities (15.4 million).[1] These statistics are even higher for adolescents, where half of teens have had a mental disorder in their lifetimes and 22% have had a severe impairment. Suicide is the second leading cause of death in the United States for adolescents and young adults up to age 34, and the 11th leading cause overall, accounting for 49,400 deaths nationwide in 2022.[2] This indicator measures the number of poverty-level residents estimated to be in need of mental health services, the number of clients served by publicly funded County mental health programs, and suicide rates overall and by subgroups. This indicator also measures feelings of loneliness, which is a strong predictor of depression, anxiety and other mood disorders[3] and, as research shows, can be as bad for health as smoking 15 cigarettes a day and has a higher mortality risk than obesity.[4]
Department of Behavioral Health (DBH) Services
DBH provides Specialty Mental Health Services, also referred to as Tier 3 services. These Specialty Mental Health Services are for those experiencing major mental illnesses such as children/youth who may be seriously emotionally disturbed and adults with a serious and persistent mental illness. Clients provided Tier 3 services may have difficulty with daily living skills, prior encounters with law enforcement, may experience challenges with developing or maintaining relationships due to mental illness, and may experience difficulty becoming gainfully employed.
TREND
Treatment
Following six years of decline, the number of clients receiving public mental health services increased in 2022/23 and again in 2023/24. However, the gap between the need for mental health care and the number receiving treatment declined in 2023/24. Of the estimated 59,229 poverty-level residents in need, 43,875 clients were served, leaving 15,354 low-income residents in need of mental health services in 2023/24 who did not get care. This gap between need and receipt of services was lower in 2023/24 than the past 10-year average.
DECREASING GAP BETWEEN NEED FOR MENTAL HEALTH CARE AND NUMBER RECEIVING IT
Unduplicated Count of Clients Served by the County Mental Health Plan and the Estimated Number of Poverty-Level Residents in Need of Mental Health Services in San Bernardino County, 2015-2024
Over the past 10 years, mental health care for adults ages 65 and older has seen the largest increase, growing 60% since 2014/15, followed by adults ages 25 to 44, growing 6%. Mental health services for children aged 12 to 17 remain relatively unchanged. All other age groups saw a decline in mental health services during the same period. Overall, 39% of clients served in 2023/24 were children and youth ages 0-17 years, including 2,441 children aged 0-5 years (6% of all clients), 5,335 children aged 6-11 (12% of all clients), and 9,131 children aged 12-17 years (21% of all clients).
NUMBER OF OLDER ADULTS RECEIVING MENTAL HEALTH SERVICES INCREASED SUBSTANTIALLY OVER 10 YEARS
Unduplicated Count of Clients Served by County Mental Health Plan by Age in San Bernardino County, 2015-2024
Suicide
The overall rate of suicide deaths in San Bernardino County has stayed relatively unchanged since 2019. The suicide rate among 10-19-year-old residents has increased the fastest between 2019 and 2023, rising an estimated 33%. At 18.3 per 100,000, residents 65 years of age and older had the highest rate of suicide in 2023. Firearms, the most frequently used method, were used in 49% of San Bernardino County suicide deaths.
SUICIDE RATE AMONG 10-19 YEAR OLDS HAS INCREASED THE FASTEST OVER TIME
Suicide Rate (Deaths per 100,000) by Age in San Bernardino County and California, 2019-2023
The Mental Health-Physical Health Connection
Mental health and physical health are closely connected. Mental illnesses, such as depression and anxiety, reduce one’s ability to participate in health-promoting behaviors such as eating right, exercising, and minimizing use of alcohol and tobacco. In turn, problems with physical health, such as chronic diseases (see Chronic Disease), can have a serious impact on mental health and decrease a person’s ability to participate in treatment and recovery. Mental health and substance abuse also tend to be closely linked (see Substance Abuse).
RACE/ETHNICITY DETAIL
Treatment
Of the clients served by county mental health services during 2023/24, 56% were Latino, 24% were White, 9% were Asian or Pacific Islander, and 7% were Black. In the accompanying chart, the race and ethnic distribution of the total San Bernardino County population is provided for context.
LATINO RESIDENTS COMPRISE THE MAJORITY OF CLIENTS SERVED BY COUNTY MENTAL HEALTH PLAN
Distribution of Clients Served and Population by Race/Ethnicity in San Bernardino County, 2023/24
Suicide
White residents made up half of all suicides, followed by Latinos (43%). Men were more than four times as likely as women to die by suicide in 2022. In the accompanying chart, the race and ethnic distribution of the total San Bernardino County population is provided for context.
WHITE RESIDENTS MAKE UP THE GREATEST SHARE OF SUICIDES IN SAN BERNARDINO COUNTY
Distribution of Suicides and Population, by Race/Ethnicity in San Bernardino County, 2023
The Relationship Between Firearms and Suicide Deaths
While firearms are used in less than 10% of suicide attempts, they account for nearly half of all suicide deaths due to their lethality. Research has shown that policies that regulate access to guns, at least temporarily, can reduce suicide rates. These policies include permit-to-purchase laws, waiting periods, child access prevention laws, and extreme risk protection orders. The vast majority of people who survive a suicide attempt do not go on to die of suicide in the future, pointing to the value of prevention in times of crisis.
GEOGRAPHIC COMPARISON
Suicide
Overall, in 2023, San Bernardino County had a higher rate of suicides per 100,000 residents (11.2 per 100,000) than the statewide average (10.7 per 100,000). The rate of suicide among residents ages 45-64 is slightly lower in San Bernardino County than the state overall.
SAN BERNARDINO COUNTY OVERALL SUICIDE RATE SLIGHTLY HIGHER THAN STATE
Suicide Rate (Deaths per 100,000) by Age in San Bernardino County and California, 2023
Loneliness
In San Bernardino County, 35% of adults reported that they always, usually, or sometimes feel lonely. This rate is similar to the California average of 33% and other Southern California neighboring counties.
SAN BERNARDINO COUNTY’S RATE OF LONELINESS SIMILAR TO PEER COUNTIES AND THE STATE
Percentage of Adults Reporting that they Always, Usually, or Sometimes Feel Lonely, County Comparison, 2022
[1] National Institute of Mental Health (https://www.nimh.nih.gov/health/statistics/mental-illness)
[2] National Institute of Mental Health (https://www.nimh.nih.gov/health/statistics/suicide)
[3] Cacioppo JT, & Cacioppo S (2018) Loneliness in the modern age: an evolutionary theory of loneliness (ETL). Advances in Experimental Social Psychology, 58, 127–197. https://doi.org/10.1016/bs.aesp.2018.03.003
[4] Holt-Lunstad J, Smith TB, Layton JB (2010) Social Relationships and Mortality Risk: A Meta-analytic Review. PLOS Medicine 7(7): e1000316. https://doi.org/10.1371/journal.pmed.1000316