- How many local youth struggle emotionally? Without data we don’t really know.
There’s the suicide rate: From 2013 to 2015, El Paso County’s stood at 23.1 per 100,000 residents compared to 19.1 statewide, according to Colorado Department of Public Health and the Environment (CDPHE) Vital Statistics. There’s the percentage of adults with diagnosed depression: 21.6 percent here compared to 19.3 statewide, according to Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. And there is this survey result: 12.1 percent of El Paso County residents reported eight or more days of poor mental health over a month in 2017 compared to 11.8 statewide, according to the Colorado Health Access Survey.
But perhaps the most sobering mental health statistics in the county are the ones that are missing. Despite El Paso County having one of the highest youth suicide rates in the country, there’s no solid data on the mental health of its young people.
The public may not have noticed that those measures are missing, because while mental health data has long been collected statewide, it’s scattered, making comparisons and meaningful analysis difficult. Until now. The nonprofit Mental Health Colorado recently unveiled a website, or “data dashboard” as their leaders call it, which attempts to put all the state’s mental health metrics in a single, comprehensive, regularly updated page.
The interactive site lets users hover over particular topics to call up county-level data on all sorts of mental health indicators. The nonprofit’s president and CEO, Andrew Romanoff, who many will remember as the former speaker of the Colorado House, says the point of the dashboard is “to get a better handle on the nature of the problem so we can start talking about ways we can solve it.”
But the dashboard section for El Paso County’s teens and adolescents is listed as “unavailable.”
Three-quarters of American adults with a diagnosed mental health disorder (there’s over a million in Colorado alone) say their symptoms first appeared in adolescence, according to the National Institute of Mental Health. But it takes people nearly a decade, on average, to access treatment.
While that’s a good indicator that El Paso County youth could use more mental health care, there’s no way to know what, specifically, would help. That’s because nine of the 17 school districts in the county opt out of the Healthy Kids Colorado Survey — a voluntary, confidential and anonymous survey conducted at a random sampling of schools in participating districts. Three state agencies (CDPHE, Department of Education and Department of Human Services) collaborate on the survey, which is administered by researchers with the University of Colorado’s Anschutz Medical Campus in Denver.
It asks students about a host of issues under the mental health umbrella: bullying, mood, body weight, physical activity, substance use, sexuality and family life. The purpose, according to an overview on CDPHE’s website, is “to better understand youth health and what factors support youth to make healthy choices.” Without that data, advocates are, as Romanoff puts it, “flying blind.”
Public health planner Mina Liebert, who works for El Paso County Public Health and manages El Paso County’s Healthy Community Collaborative, says the county needs better information in order to help kids. “Asking our youth, ‘Do you have days when you’re sad and what do you do to cope?’ would help us be more proactive,” she says, “rather than [wait to] see a spike [in suicides] and start being like, ‘Oh we should do something.’”
Liebert says the effort to get non-participating school districts to administer the survey was especially robust this year, with representatives from El Paso County Public Health and the Anschutz Medical Campus doing outreach with school administrators, board members and superintendents. The purpose, she says, was to answer their questions and dispel myths about the survey, like that it infringes on students’ privacy or takes up too much time that could otherwise be spent learning. Another common concern is that asking kids about “risky behaviors” like drugs and sex serves to normalize those behaviors. Liebert says that’s naive — youth are inclined to experiment, so it’s better they be informed about the risks and be honest with the adults in their lives.
Without data on youth mental health, it’s obviously difficult to plan and program for kids’ needs. Less obvious is the impact that a lack of such data has on funding: It makes it impossible to win grants to fund such care.
“Funders see the value of data [because] if they don’t have anything to show the effect or impact, then they don’t know whether or not they’re doing right thing,” Liebert says, explaining that most grants for health and wellness in schools are only available if the recipient can offer measurables.
This past fall, Colorado Springs School District 11 opted into the survey, bringing the sample of participating districts in El Paso County up to a level that can actually yield statistically valid results for the first time. Those numbers will be available in spring 2018.
Local statistics missing from the Healthy Kids Colorado Survey isn’t the only deficiency in the data dashboard. Data collection on mental health, whether for adults or kids, is lacking statewide. That’s because most other data sources, including the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System and CDPHE’s Vital Statistics, only collect fresh data biennially, meaning there’s a years-long lag in statistics that inform policy decisions.
“We’re trying to do a better job collecting data across the board,” says Anderson Miller, Pikes Peak regional coordinator with Mental Health Colorado, suggesting his and other nonprofits could start filling the gaps public agencies leave by collecting their own data. But getting data can be tricky, because there are so many people who don’t want to talk about mental health.
“If we have more data and better access to it, then it starts to degrade that stigma,” he says. “But there’s this hesitation to open the doors [to data collection] in the first place.”
Indeed, Romanoff hopes the dashboard will hasten the paradigm shift toward treating mental illness like the legitimate medical condition and pressing public health problem it is. Once we better understand the problem, he envisions a number of ways to promote good mental health: universalizing mental health screenings in the primary care setting; stationing mental health professionals in schools; training law enforcement, hospital personnel and other people likely to come in contact with people in crisis to recognize the warning signs of suicide; and better enforcing laws already on the books requiring insurers to cover mental health care the same as physical health care.
“We’re in the business of trying to fight these problems, not just study them,” Romanoff says, “but it’s hard to make good decisions in the absence of good information.”