Mental Health in Missouri: Limited Access, Increasing Demand and Tragic Consequences

July 1, 2016

Authors: Sarah Willson, Vice President of Clinical and Regulatory Affairs, and Mat Reidhead, Vice President of Research and Analytics

The June edition of HIDI HealthStats explores behavioral health in Missouri. Mental health disorders and suicide are a growing problem in the U.S. Missouri data suggest that Missouri is one of the leading contributors of that trend.

  • Access to mental health services are particularly limited in Missouri where 90 percent of counties are federally-designated mental health shortage areas, and 61 percent have no licensed psychiatrists.1
  • The growth rate of hospital utilization for mental health disorders in Missouri more than doubled the rate of hospital utilization for all other conditions combined during the previous 10 years.
  • Hospital visits by Missouri residents with diagnosed suicide ideation quadrupled between 2006 and 2015, and the death rate for suicide increased 34 percent between 2003 and 2014 (Figure 1).
  • Missouri has the 17th highest suicide rate in the country, and is second highest only to North Dakota in the Midwestern region.2

The state’s behavioral health system suffers from a massive supply and demand imbalance. Hospitals are acutely aware of the problem, having been the front line for the transition from institutional to community-based care. Although the hospital community supports robust, community-based care, the state has only half of the recommended number of psychiatric beds. In Missouri, funding for behavioral health is unidirectional — down. The state’s investment in public mental health services is well below the national average, reimbursement rates for community health providers haven’t kept up with inflation and some have pegged the state’s cuts to general revenue for mental health services at 35 percent since 2009. The costs of the mental health crisis are significant — financially, and in life quality and expectancy. Between 2006 and 2016, diagnoses of suicide ideation increased 433 percent for all Missouri residents, and nearly 900 percent among children and adolescents. In Missouri, suicide is the second leading cause of death in children.

There’s the adage that numbers talk. In Missouri, it’s time to change the conversation.

1 Health Resources and Services Administration. Data Warehouse. Missouri. Data as of May 19, 2016. Retrieved from
2 Drapeau, C. & McIntosh, J. (2015, December). U.S.A. suicide 2014: Official final data. Washington, DC: American Association of Suicidology. Retrieved from