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The two faces of Utah: Healthy but mentally ill
Health » One theory says mental illness and suicide can be linked to altitude, a pattern seen in Mountain states.
First Published Mar 16 2014 01:01 am • Last Updated Mar 17 2014 11:27 am

Utah often ranks among the healthiest states, a place where residents have a strong sense of well-being.

And yet Utah also has the nation’s highest rate of mental illness.

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What’s going on?

"It’s an interesting juxtaposition," says Doug Thomas, director of the Utah Division of Substance Abuse and Mental Health. "If I knew the answer, I’d be a wealthy man."

While both trends have been apparent for years, there’s still no definitive research into why Utahns suffer the highest rate of mental illness while also enjoying relatively good health and well-being.

There are plenty of theories, though, many having to do with cultural influences of the predominant faith, a dearth of psychiatrists and inadequate health insurance even while healthy living is prized, and the fact that statistics can be interpreted in differing ways.

But one idea continues to gain ground in mental health circles: Mental illness might sometimes be linked to altitude.

The theory places Utah in the wider context of Rocky Mountain states, which generally see the same pattern: high mental illness and suicide but otherwise healthy residents. The region is sometimes called the suicide belt.

The elevated brain » Research at the University of Utah and elsewhere so far supports the hypothesis that there’s a link between high altitude and increased incidence of mood disorders and suicide.


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The theory is that diminished oxygen at high altitudes may affect the brain chemistry in a detrimental way for those prone to depression, bi-polar disorder or schizophrenia. There’s also indication that some medicines don’t work as well high up.

There are hundreds of studies showing the benefits of athletic training at a higher elevation, and even many showing that people are healthier living at higher altitudes, says Douglas Kondo, a child psychiatrist and researcher at the U.’s Brain Institute.

But there’s been little research on altitude’s effect on the brain — which may change, thanks to a team led by U. psychiatrist Perry Renshaw that is doing research on individual patients, mice and population studies using data from the Centers for Disease Control.

Everyone knows that mountain climbers’ thinking can go haywire at high altitudes, and yet skeptics question a mental illness link, says Kondo.

"It’s so basic and fundamental," he says, "it strains credulity that someone wouldn’t have thought of it before."

And the surveys say ... » In a February report by the Substance Abuse and Mental Health Services Administration, Utah had the highest rate of all mental illnesses in the years 2011 and 2012.

Of adults surveyed in Utah, 22.35 percent reported having mental illness of any kind, including depression, in the prior year.

For serious mental illnesses, the Beehive State had the third highest rate, at 5.14 percent.

The national averages were 18.19 percent for any mental illness and 3.97 percent for serious mental illness.

Other Rocky Mountain states also were above the national average, with Idaho and New Mexico not far behind Utah.

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