Lots of Prozac and Mental Illness in Utah: What Gives?

Last week a new national study reported that Utah, of all places, is home to the highest rate of mental illness in the nation – with nearly 22.4 percent of the state’s adult population purportedly experiencing some kind of mental disorder in the last year (5.14 percent severely). Twelve years ago, a study by a pharmacy company indicated that Utahans had ordered more Prozac than any other state per capita. In both cases, many have been happy (and quick) to proclaim these findings as definitive evidence of the “harmful mental health effects” of Mormonism.

Unfortunately, these same critics have disregarded other various studies showing active Mormons less depressed and less suicidal than the average population – and even living 5-10 years longer than most Americans. Even so, it’s still worth wondering why Utah would show itself anywhere near the top of any of these negative lists:  So what’s going on?

After finishing my own study on depression and anti-depressants several years ago, I was asked during my dissertation defense, “why is there such a high rate of Prozac in Utah?” After pointing out the studies confirming mental health benefits for active Mormons, I suggested that the answer may be more complex than it initially seems.  For instance, since Mormons don’t turn to alcohol and illegal drugs like most Americans do to “self-medicate,” there may be more of a natural impetus towards legal avenues.

Another contributor that doesn’t often get acknowledged is that Utahans are very conservative, by and large:  We trust authority.  When my liberal friends hear from their doctor they have a certain diagnosis and need to take this or that, they’re likely to respond, “Whatever…I’ll go get a second opinion from my naturopath.”

But that’s not what we say in Utah.  We listen.  And more than likely, we obey.  (Several people I interviewed told me how they went along with their doctor’s suggestions, even though they felt uncomfortable with them because…after all, “he’s the doctor”). While there are obviously many exceptions, I would argue that conservatives as a whole are more likely to accept a doctor’s prescribed counsel and more likely to become medical consumers as a result (Brent Sharman, a local psychologist, has argued for the same possibility).  This would explain why Utah also ranks seventh in overall prescription totals – including higher than normal rankings in use of penicillin, insulin, thyroid hormones, antirheumatics, and anticonvulsants.

So what’s responsible for high prescription rates?  Mormon culture?  Or doctor-following culture?

Perhaps a little of both.  Most important questions have a complexity that is unacknowledged.  And yet it’s clear in this case, that most of the inquiry on this particular issue focuses on the “easy target” – Mormon culture.  Mindfulness is about acknowledging and opening to anything arising – and not selectively focusing on our preferred answers (whether for or against the Church). If we balanced out the discussion more, perhaps we would notice how readily Utahans are also turning to national advocacy groups for information about mental health – groups with strong ties to the Pharmaceutical Industry.  Perhaps we could notice how different the messages of these groups are, when compared with the science itself.  And maybe we would notice what an impact some of these messages may be having on actual individuals and families.  For instance, once you come to accept the notion of a permanent chemical deficiency in the brain, you are clearly more likely to pursue certain treatments (and less likely to try others) (for an academic examination of this connection, see my in-press article here with colleagues at Florida State, Brown University and BYU).

So what’s the answer?  How about a more balanced, open dialogue – for starters? The problem isn’t trusting doctors – who can be a crucial support to our health.  The problem is when the terms of the health discussion are being set by large companies, rather than by individual patients and their doctors.  As my colleague Jeff Lacasse and I recently argued, “If the general public is to make treatment decisions that are fully informed of the entire scope of costs and benefits, they deserve a picture independent of those standing to profit from those treatments” (Hess & Lacasse, 2011).  In collaboration with a number of colleagues, we also just released our own online mental health curricula – without any ties to industry and with LOTS of ties to the actual scientific research:  Mindweather 101. Check it out!  And I’d love to hear your own thoughts on how to get a bigger dialogue going about mental health…and yes, that means bigger than glibly blaming it on “Mormon culture.”

One response

  1. Pingback: “Does God Want Me to Get on Prozac?” « Mindfully Mormon

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