Want to improve Louisiana’s economy? Tackle the state’s mental health crisis

Mental health concerns cost the United States more than $300 billion annually, predominantly from lost wages and lost productivity. But unlike crime and taxes, mental health has yet to receive a focused special session of the Louisiana Legislature with the goal of improving the state’s economy, safety and health.

It is long past time for our state to focus on this issue.

Concerns regarding escalation in suicide are well documented, with increased incidences of suicide seen at both the state and national levels over the past 20 years. Recognized risk factors include economic stress, substance use issues and trauma exposures, but two of the strongest are  depression/anxiety and the contemplation of suicide.

The Newcomb Institute conducted a statewide survey in 2023 that included assessment of mental health and suicidality in Louisiana to try to understand how pervasive these concerns are and who is most affected. The findings are disconcerting.

First, mental health is at epidemic proportions, with 1 in 9 Louisiana adults – or almost 400,000 men and women in the state – living with severe depression and/or anxiety. The same number have contemplated suicide in the past year.

Second, working age adults (age 18-44) are at high risk for severe depression, anxiety and suicidality. When looking at the different age groups, we found the highest risk for severe depression and anxiety among 30- to 44-year-olds, reported by 16% of this age group, with a comparable prevalence for women and men, and the highest risk for suicidality reported by 18- to 29-year-olds, reported by 16% of this age group, again with a comparable prevalence for women and men.

Third, suicidality is higher for men than women, reported by 11% of men and 7% of women. This  finding contrasts with older data from Louisiana as well as national data, which show a higher prevalence of suicidality for women compared with men, though men are more likely to die from suicide as they rely more on highly fatal means such as guns where women rely more on less fatal means such as pills.

Fourth, urban men and men aged 30-44 show exceptionally high risk for suicidality. Suicidality is slightly higher in urban than rural Louisiana and higher for men than women, such that 11% of urban men compared with 5% of rural women reported suicidality in the past year. Among those aged 30-44, we also found that men were twice as likely as women to report past year suicidality (16% versus 8%).

Overall, these findings tell us that we are not just facing a mental health crisis at epidemic proportions, but that the issue is compromising our working age population and disproportionately affecting men. The mental health burden on men corresponds with state shifts showing men falling behind relative to women in terms of both education and employment.

While we are in crisis, we are not without recourse, especially if we can gain priority focus from government, industry and non-governmental service organizations in our state.

Some recommendations:

1. Support the Louisiana Department of Health proposal to increase the availability of mental health providers via expansion of Medicaid reimbursement eligibility to provisionally licensed mental health professionals while they seek full licensure. Ensure we have sufficient mental health provider training programs, and ensure we provide market value salaries for mental health service providers in our state.
2. Help normalize and reduce stigma in terms of accessing mental health services and facilitate access via telemedicine to ensure reach to those with limited transport. This will be particularly important for men, who have greater stigma and are less likely to access care. Veterans are at particularly high risk for mental health crisis and potentially can harm others as well as themselves, as seen from the recent attack in New Orleans. Mental health support for veterans must be prioritized.
3. Support men’s opportunity for entry into employment without higher education. Vocational programs and two-year college programs may be useful. Also, given the stronger employment growth in more traditionally women-dominated sectors (health care and social services, for example) compared with traditionally men-dominated sectors (manufacturing, construction), there is a need to open men’s minds to entry into those sectors with greater opportunity.
4. Don’t leave women out of the mental health support efforts simply because they are more likely than men to seek care. Childcare and domestic responsibilities disproportionately burden women and can impede uptake of care. Again, telemedicine offers an important means of supporting uptake of mental health services for those with limited time.

We can tackle the mental health crisis in our state, improving health, well-being, family cohesion, survival and our economic strength as a state. But we have to prioritize mental health to achieve these goals. We also can do this because mental health receives bipartisan support, helping communities and families as well as our economic positioning as a state. So let’s move this forward.

The views and opinions expressed in this piece are the author’s and do not reflect the position of Tulane University.