Behavioral Health

Treatment Continues to Rise for Youth and Fall for Adults

Mental disorders are among the most common causes of disability. According to the National Institute of Mental Health, nearly one in five adults live with a mental illness (51.5 million in 2019) and an estimated one in 20 adults have a serious mental illness (13.1 million) that substantially interferes with major life activities. These statistics are even higher for adolescents, where half of teens have had a mental disorder in their lifetimes and 22 percent have had a severe impairment. Suicide is the 2nd leading cause of death in the United States for adolescents and young adults up to age 34, and the 10th leading cause overall, accounting for 48,000 deaths nationwide in 2018.1 This indicator measures the number of poverty-level residents estimated to be in need of mental health services and the number of clients served by publicly-funded County mental health programs. It also measures suicide rates overall and by subgroups.

Mental Health Treatment Rises for Children and Youth.

How is San Bernardino County Doing?

TREND

Treatment
The gap between the need for mental health care and the number receiving treatment grew again in 2019/20. After several years of steadily increasing numbers of clients served, the number of clients receiving public mental health services fell in 2016/17 and continued to fall through 2019/20. There were an estimated 26,506 low-income residents in need of mental health services in 2019/20 who did not get care. This gap between need and receipt of services is higher than the past 10-year average.

GROWING GAP BETWEEN NEED FOR MENTAL HEALTH CARE AND NUMBER RECEIVING IT

Unduplicated Count of Clients Served by the Public Mental Health System and the Estimated Number of Poverty-level Residents in Need of Mental Health Services in San Bernardino County, 2011-2020

Note: Residents in need is estimated based on adjustments to 2007 California Department of Mental Health figures.

Sources: County of San Bernardino, Department of Behavioral Health, Client Services Information System; California Department of Mental Health, Persons in Need Tables

Over the past 10 years, mental health care for children ages 0-5 has witnessed the largest increase, growing 160% since 2010/11, followed by seniors ages 65+, growing 56%, and children ages 6-11, growing 29%. Overall, 41% of clients served in 2019/20 were children and youth ages birth through 17 years, including 2,767 children ages 0-5 (7% of all clients) and 9,071 adolescents (21% of all clients).

NUMBER OF CHILDREN AND YOUTH RECEIVING MENTAL HEALTH SERVICES IS INCREASING

Unduplicated Count of Clients Served by the Public Mental Health System by Age in San Bernardino County, 2010-2020

Source: County of San Bernardino, Department of Behavioral Health, Client Services Information System

Suicide
While suicide deaths fluctuate annually, general trends can be observed.2 The absolute number of suicide deaths in San Bernardino County has increased in the 10-year period between 2008 and 2017, but the rate has remained relatively flat due to population increases over the same period. The suicide rate among 25-44-year-old residents has increased the fastest between 2008 and 2017, rising an estimated 39%. Residents 65 years of age and older had the highest rate of suicide in 2017. Firearms, the most common cause, were used in 46% of San Bernardino County suicide deaths.

SUICIDE RATE AMONG 25-44 YEAR OLDS HAS INCREASED THE FASTEST OVER TIME

Suicide Rate by Age in San Bernardino County, 2008-2017

Note: Data reflect rolling three-year averages, where “2017,” for example, is an average of the suicide rates from 2015, 2016, and 2017, and “2016” is an average of suicide rates from 2014, 2015, and 2016, and so on.

Source: California Department of Public Health, Vital Statistics Death Statistical Master Files (http://epicenter.cdph.ca.gov)

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

Source: Healthy People 2020 (www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=28)

RACE/ETHNICITY DETAIL

Treatment
Of the clients served by County mental health services during 2019/20, 43% were Latino, 27% were White, 15% were Black, 2% were Asian or Pacific Islander, 1% were Native American, and 11% were some other race or ethnic group, or unreported.

MAJORITY OF PUBLIC MENTAL HEALTH CLIENTS ARE LATINO OR WHITE

Distribution of Unduplicated Count of Clients Receiving Public Mental Health Services by Race/Ethnicity in San Bernardino County, 2019/20

Source: County of San Bernardino, Department of Behavioral Health, Client Services Information System, 2019/20

Suicide
White residents had both the highest count and rate of suicide deaths in San Bernardino County in 2017, at 140 and per 100,000, respectively. Men were nearly four times as likely as women to commit suicide in 2017.

WHITE RESIDENTS MAKE UP THE GREATEST SHARE OF SUICIDES IN SAN BERNARDINO COUNTY

Suicide Count by Race/Ethnicity, in San Bernardino County, 2017

Source: California Department of Public Health, Vital Statistics Death Statistical Master Files (http://epicenter.cdph.ca.gov)

Note: The data source combines White with Other/Unknown

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 reduce 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.

Source: John Hopkins, Bloomberg School of Public Health

GEOGRAPHIC COMPARISON

Suicide
Overall, in 2017, San Bernardino County had a slightly lower rate of suicides per 100,000 residents (10.4 per 100,000) than the statewide average (10.9 per 100,000). The rate of suicide among residents ages 25-44 is higher in San Bernardino County than the state.

CALIFORNIA SUICIDE RATE IS SLIGHTLY HIGHER THAN SAN BERNARDINO COUNTY

Suicide Rate by Age in San Bernardino County and California, 2017
1National Institute of Mental Health (www.nimh.nih.gov/health/statistics/index.shtml)   2Note that due to data reporting delays stemming from the COVID-19 pandemic, 2017 suicide data presented are the most recent available to date. Rate of change is calculated on three-year rolling average suicide rates.