Idaho has among the highest suicide rates in the country — 1.5 times the national average over a 10-year period. In some parts of Idaho, the suicide rate is four times the U.S. average. Jails, hospitals and homeless shelters are crowded with people who can’t afford treatment. The entire state is a mental-health provider shortage area. Meanwhile, state lawmakers refuse to expand Medicaid to include many of the adults with mental illnesses, and mental health gets a progressively smaller share of the public-health budget each year. The state hired a managed-care company, Optum, to run its Medicaid behavioral-health services, which resulted in service cuts, payment delays and a federal investigation into potential privacy violations by Optum. We found effective programs that were underfunded and/or in silos that hindered their success. We also found that some of Idaho’s mental-health crisis is worsened by general characteristics of the state, such as rural and isolated communities, low income and a severe shortage of psychiatrists and psychologists.
