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 6.4 percent.

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, nationally).

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 the following:
• Policy 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.
• Mindful Teen: In collaboration with Bradley Hospital, BCBSRI is promoting alternatives to inpatient hospitalization for children and teens facing mental illness.
• HealthPath: 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.

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To view the full report, visit https://www.bcbs.com/the-health-of-america/reports/major-depression-the-...

To view the Health Index, visit https://www.bcbs.com/the-health-of-america/health-index/national-health-...