Mental Health Care Critical for Battling the Opioid Crisis

Laura Schwab Reese, MA, PhD

A recent study examining the association between opioid abuse and depression turned a searing spotlight on the need for increased access to mental health in the United States.

The study is “highly suggestive” of an association between opioid abuse and depression, according to Laura Schwab Reese, MA, PhD, Assistant Professor in the Public Health Graduate Program at Department of Health & Kinesiology, College of Health & Human Sciences at Purdue University, who co-authored the study. Specifically, the study concluded that a 1% increase in state-level depression diagnoses was associated with a 26% increase in opioid analgesic-related deaths.

“In places where there are high levels of depression, there are also high levels of opioid related death,” Reese told MD Magazine®.

Opioids continue to pose a severe threat to Americans and were the leading cause of overdose death in the United States in 2016, accounting for approximately 43,000 of the 66,632 overdose deaths that year, according to the study. As the opioid crisis continues, it is estimated that more than 500,000 Americans could die in the next decade due to opioid-related causes.

Given the rampant frequency of opioid-related deaths, it is imperative that health care professionals understand the intricacies of this addiction. The study suggests that mental health is foundational to that understanding and, ultimately, the proper treatment for opioid abuse and addiction.

“[The study] really is suggestive to me that mental health is at the core of what is happening in our society. Suicide is increasing. Opioid-related deaths are increasing. I think it further supports the need for access to mental health care in the United States,” Reese said.

According to Reese, access to proper mental health care is severely inadequate due to a number of causal factors.

“From a broad perspective I think the number of folks who are able to provide mental health care is not sufficient in the United States,” she said, citing Indiana as an example.

“About half of Indiana counties are listed as mental health shortage areas. Folks in those counties who need a provider are probably going to have a hard time finding one. I think that’s further complicated by some other factors like insurance status. It’s easier for folks who have good insurance to find a mental health professional. Mental health care can be quite expensive for folks who don’t have insurance.”

However, Reese said the problem doesn’t simply lie in the number of available mental health care professionals, nor in the quality of care, nor availability of insurance. The ability to find an affordable mental health care provider that is equipped to suit the specific needs of the patient is yet another hurdle that individuals seeking help must overcome.

“[When you consider the] limited number of providers within a certain area and the inability of providers to respond to certain needs, it can be difficult for [patients] to find a provider who can treat the kinds of issues they have,” Reese said.

As health care professionals continue to combat the opioid crisis, Reese said she hopes that mental health becomes a central topic in that conversation.

“I would love for there to be more conversation about mental health care as we talk about opioids,” Reese said. “Increasing access to mental health care wouldn’t just positively impact the opioid crisis, I think it would have a lot of positive societal-level changes.”

The study, “Associations of state-level rates of depression and fatal opioid overdose in the United States, 2011—2015,” was published in Social Psychiatry and Psychiatric Epidemiology.