Wisconsin Adult Prevalence Estimates of Serious Mental Illness (SMI) by County, 2004

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WISCONSIN STATISTICS In this section: Wisconsin Adult Prevalence Estimates of Serious Mental Illness (SMI) by County, 2004 Wisconsin Prevalence Estimates of Children with a Serious Emotional Disturbance (SED), 2004 Mental Health Information Wisconsin Suicide Fact Sheet WISCONSIN STATISTICS

Wisconsin Adult Prevalence Estimates of Serious Mental Illness (SMI) by County, 2004 COUNTY 2004 Estimated % of Non- Institutionalized Adults with SMI Estimated COUNTY # of Adults with SMI 2004 Population Estimate (Age 18+) Adams 16,396 4.30% 705 Ashland 12,649 4.70% 595 Barron 34,756 4.70% 1634 Bayfield 11,737 4.40% 516 Brown 175,641 5.60% 9836 Buffalo 10,511 4.70% 494 Burnett 12,774 4.10% 524 Calumet 31,613 6.70% 2118 Chippewa 43,757 4.90% 2144 Clark 24,057 4.60% 1107 Columbia 40,834 4.80% 1960 Crawford 12,920 4.60% 594 Dane 348,588 6.90% 24053 Dodge 66,437 5.10% 3388 Door 22,694 4.50% 1021 Douglas 33,404 6.20% 2071 Dunn 31,937 5.70% 1820 Eau Claire 73,680 5.70% 4200 Florence 4,022 4.50% 181 Fond du Lac 74,502 5.10% 3800 Forest 7,623 4.20% 320 Grant 38,545 5.10% 1966 Green 25,834 5.00% 1292 Green Lake 14,672 4.40% 646 Iowa 17,233 4.90% 844 Iron 5,599 3.70% 207 Jackson 14,935 4.70% 702 Jefferson 58,531 5.30% 3102 Juneau 19,004 4.60% 874 Kenosha 113,799 5.50% 6259 Kewaunee 15,455 4.80% 742 La Crosse 83,602 5.60% 4682 Lafayette 11,871 4.70% 558 Langlade 16,053 4.30% 690 Lincoln 22,588 4.70% 1062 Manitowoc 62,807 4.90% 3078 Population Estimate (Age 18+) Estimated % of Non- Institutionalized Adults with SMI Estimated # of Adults with SMI Marathon 95,124 5.20% 4,946 Marinette 33,805 4.85% 1,640 Marquette 11,728 4.00% 469 Menominee 2,819 5.40% 152 Milwaukee 691,828 6.70% 46,352 Monroe 30,643 4.90% 1,502 Oconto 27,951 4.60% 1,286 Oneida 29,324 4.30% 1,261 Outagamie 122,068 6.60% 8,056 Ozaukee 62,374 5.60% 3,493 Pepin 5,569 4.40% 245 Pierce 29,154 5.80% 1,691 Polk 32,331 4.70% 1,520 Portage 52,313 5.70% 2,982 Price 12,148 4.20% 510 Racine 140,159 5.40% 7,569 Richland 13,542 4.60% 623 Rock 114,287 5.30% 6,057 Rusk 11,659 4.50% 525 Sauk 52,291 4.80% 2,510 Sawyer 43,384 4.10% 1,779 Shawano 12,935 4.60% 595 Sheboygan 31,161 5.10% 1,589 St. Croix 85,928 5.50% 4,726 Taylor 14,480 4.90% 710 Trempeleau 20,720 4.60% 953 Vernon 20,969 4.40% 923 Vilas 17,431 3.80% 662 Walworth 73,269 5.40% 3,957 Washburn 12,771 4.20% 536 Washington 90,616 5.40% 4,893 Waukesha 275,072 5.50% 15,129 Waupaca 39,498 4.70% 1,856 Waushara 18,963 4.20% 796 Winnebago 123,281 6.60% 8,137 Wood 56,665 5.00% 2,833 State Total 4,119,320 5.66% 233,154 The estimates of percentage of non-institutionalized adults with SMI in this table is derived from "Estimation of the 12-month Prevalence of Serious Mental Illness (SMI)," Working Paper #8 (April, 1997, Kessler, Berglund, Walters, Leaf, Kouzia, Bruce, Friedman, et. al. FFY 2006-2007 Wisconsin State Mental Health Plan 21

PREVALENCE OF SERIOUS EMOTIONAL DISTURBANCE FOR CHILDREN IN WISCONSIN, 2004 999,680: The child population in Wisconsin defined as 5-17 years of age or older 209,932 (21 percent): Estimated number of children in Wisconsin with some level of mental need (Methodology for Epidemiology of Mental Disorders in Children and Adolescents [MECA] study) 89,971 (9 percent): Estimated number of Wisconsin children with a serious emotional disturbance (SED) 10.9 percent: Wisconsin s estimated poverty rate for children 17 and under in 2002 (US Census Bureau) Methodology Wisconsin bases its estimation methodology on that of the federal Center for Mental Health Services (CMHS). The poverty rate is factored into the prevalence rate. Because Wisconsin is more than 5 percent below the national poverty level, the lower end of the 9-11 percent range is used for our prevalence estimates as recommended by CMHS. Information compiled from the Description of Wisconsin s Mental Health Service System: Federal Fiscal Years 2006-2007. For definition of Serious Emotional Disorders for Children, see Glossary. MENTAL HEALTH INFORMATION IN THE WISCONSIN FAMILY HEALTH SURVEY, 2004 Wisconsin Family Health Survey, 2004 22 STORY IDEA FACT: According to the National Institute of Mental Health, women and children account for 75 percent of people in the United States living in poverty. Poverty contributes to negative health outcomes and in many cases the onset of stress that leads to depression. Overall, rates of depression are higher among single women with children and women of color (Fazel et al.). STORY: Run a feature on the implications of being a woman of color and dealing with depression as well as the caliber of services provided by the state. Highlights: 128,000 adults (3 percent of all adults) in Wisconsin were limited by a mental health condition. About half the adults limited by a mental health condition were also reported to be limited in working, housework, or going to school (68,000 adults). 301,000 adults (7 percent of all adults) in Wisconsin reported receiving mental health counseling in the past year, 2004. 70,000 children (5 percent of all children) in Wisconsin reported receiving mental health counseling in the past year, 2004. 371,000 Wisconsin adults (9 percent of the adult household population) have been diagnosed with depression at some point in their lives. Less than half received mental health counseling in the past year. 211,000 Wisconsin adults (5 percent of the adult household population) have ever been diagnosed with anxiety disorder or post-traumatic stress disorder at some point in their lives. Over half received mental health counseling in the past year.

WISCONSIN SUICIDE STATISTICS, 2004 Statewide Suicide was 10th ranking cause of death, 11th ranking cause of death nationally 656 Wisconsin residents died by suicide, compared to 149 Wisconsin residents who died by homicide Suicides outnumber homicides 4:1 Suicide rate: 11.7 per 100,000. The national suicide rate was 10.8 Suicide accounted for 74 percent of violent deaths, approximately 2 suicides each day Age Adults Adult working men and women ages 25-64 account for more than two-thirds of the total suicides in Wisconsin Elderly males ages 75 and older are three times more likely to complete suicide than the general Wisconsin population In the month prior to their suicide, 75 percent of elderly persons had visited a physician STORY IDEA FACT: The rate of youth suicide in Wisconsin is higher than the national rate. On average, one Wisconsin youth will complete suicide each week (DPI). STORY: You could investigate the underlying causes of these numbers, particularly among American Indian youth. Youth More teenagers and young adults died from suicide in 2004 than heart disease, cancer, birth defects, AIDS, pneumonia, stroke, influenza and chronic lung disease, combined Suicide was the second leading cause of death among ages 15 to 34 in 2003. The first leading cause of death for youth is car accidents. Nationally for this age group, suicide is the third ranking cause of death The cause of death for about 20 percent of people under age 25 in Wisconsin was suicide (State of Wisconsin Department of Public Instruction) Gender Males: approximately 76 percent of suicides; 8th ranking cause of death Females: approximately 24 percent of suicides; 18th ranking cause of death Males died from suicide at rate 3.2 times the rate of female death by suicide Women are less likely to complete suicide, but are 1.6 times more likely to make suicide attempts Diverse populations White Non-Hispanic (NH): 82 percent of firearm suicides and 79 percent of non-firearm suicides Hispanic: 1.7 percent firearm suicides and 5.2 percent non-firearm suicides * Hispanic ethnicity may be any race. African Americans: 2.8 percent firearm suicides and 5.2 percent non-firearm suicides American Indian: 1 percent firearm suicides and 1.4 percent non-firearm suicides Location The Southern Region* had the highest suicide rate, 13.3 per 100,000 * Statistic represents Adams, Columbia, Crawford, Dane, Dodge, Grant, Green, Iowa, Juneau, Lafayette, Richland, Vernon, Rock and Sauk counties. 23

Method Firearms: 1st leading method Suffocation: 2nd leading method Poisoning: 3rd leading method Males vs. Females Firearms: 1st leading method for males; males completed approximately 88 percent of suicides by firearm Poisoning: most frequent method of injury used in female suicides, approximately 43 percent Firearms: Men completed suicide by firearm at rates 7 times that of females Cost Average medical cost for Self-Inflicted Violent Injury Hospitalization: $9,242 Average medical cost for Self-Inflicted Violent Injury Emergency Department Visits: $1,464 STORY IDEA STORY: Increasing coverage of mental health issues in any way can help normalize discussions, support and treatment of mental illnesses. This could prevent drastic consequences like suicide. Circumstances 90 percent of those who completed suicide had either a mental illness or a substance abuse disorder Facts from specific studies According to the 2005 Youth Risk Behavior Survey, 18 percent of Wisconsin high school students reported to have seriously considered attempting suicide Data from 1999 to 2005 shows Wisconsin has the 8th highest rate of youth suicide among all states (State of Wisconsin Department of Public Instruction) Data from 1995 to 2002 show American Indian youth have the highest rates of suicide and hospitalization of all ethnic groups in Wisconsin (Eisenberg, et al., 2005) Prevention Trigger locks most effective prevention Recognize depression (screening) Treat depression QPR training (Questions, Persuade, Refer). Question the person, save a life. Contact HOPES for more information on available QPR training. National Depression Screening Day in October Fact sheet compiled from the Annual Report 2004 Wisconsin Violent Injuries and Deaths produced by the Wisconsin Department of Health and Family Services, Division of Public Health, Injury Prevention Program, and the State of Wisconsin Department of Public Instruction (DPI) Youth Suicide in Wisconsin fact sheets, and the Centers for Disease Control and Prevention. 24 W I S C O N S I N U N I T E D F O R M E N T A L H E A L T H

O P E N M I N D S O P E N D O O R S 25

TIPS FOR INTERVIEWING A PERSON WHO HAS MENTAL ILLNESS OR A FAMILY AFFECTED BY MENTAL ILLNESS STORY IDEA FACT: Some people with chronic and acute diseases have been associated with higher rates of depression, including: People with coronary heart disease and history of heart attack, whose rate of depression may be as high as 65 percent Adults with diabetes, who may be twice as likely to develop depression People with cancer, of which 15 to 25 percent experience depression beyond the normal grieving period People with Down syndrome People with autism and Asperger syndrome People with sickle cell anemia STORY: It would be interesting to investigate what factors of these chronic and acute conditions play into developing depression, and what can be done to help. Setting Up an Interview: When setting up an interview with someone with a mental illness, always ask the interviewee for any special accommodations to put him or her at ease, including: Meeting at a specific place or time Being accompanied by another person during the interview Be frank and direct about the purpose of the interview. Clarity helps prepare the person for the interview. To help the interviewee feel more prepared and comfortable, send some of the questions you wish to ask ahead of time. Allow ample time for the interview. A person s experiences might be painful and he or she may need extra time to discuss difficult subject matter. During the Interview: Treat interviewees with mental illness as you would any others. A large part of the stigma associated with mental illness is that people with mental illness are different from the average person. This is not true. If you do not know something, ask. People with mental illness appreciate that you are taking the time to become informed and will answer your questions. Actively listen. As many journalists already know, while it is important to contribute to the conversation and establish rapport, be careful not to make assumptions. 123456789 LOOK AT THESE NUMBERS - Six- layer Ripple Effect: Each suicide death is estimated to affect at least six other people including family, friends, classmates, coworkers and others in the community. This would mean over 3900 people were affected by a suicide death in Wisconsin in 2004 (Wisconsin Department of Health and Family Services- Division of Public Health). Interviewing Others Impacted by Suicide The accounts of grieving family and friends shortly after a completed suicide can be vague and incomplete. Research shows that grieving family and friends have difficulty understanding what has happened during the period immediately after a death by suicide. Answers may be extreme, problems may be minimized and motives complicated (Centers for Disease Control and Prevention), et al., (Ness & Pfeffer 147, 279-285). Surviving family and friends are at increased risk of developing other disorders, including post-traumatic stress disorder. This tip does not concern the current interview, but is a consideration for developing stories. Ask questions about mental illness and substance abuse. In the case of a suicide, it is acceptable to ask if the person had any known history of documented mental illness or substance abuse. Co-occurring disorders are an important issue to address when covering mental health issues. 8 W I S C O N S I N U N I T E D F O R M E N T A L H E A L T H