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PAGE 56 DEPRESSION PREVALENCE POOR MENTAL HEALTH PREVALENCE Dublin 16.8 13.3 Livermore 19.6 14.8 Pleasanton 17.3 12.6 Tri-Valley 17.8 13.4 Alameda County 15.9 13.5 California 17.5 15.9 Mental Health Mental health was also a significant concern and opportunity area for the Tri-Valley across various stakeholders including community members, non- profit employees, and first responders. Additionally, triangulation with other needs assessments validates the finding that mental and behavioral health service is a significant need.11 Within mental health, challeng- es related to accessibility (similar to those categorized under health care), including distance to services, service availability and costs, and insurance; factors exacerbating conditions; populations with distinct needs; and workforce arose. Table 22. Adult Mental Health Indicators Source: CDC BRFSS PLACES, 2021 As seen in Table 22, rates of depression and poor mental health in the Tri-Valley are highest in Livermore. Just under one-in-every five Livermore adults is diagnosed with depression. Depression rates are higher than in Alameda County for every municipality in the Tri-Valley, though only Livermore’s rate (20%) exceeds the state’s (18%). Rates of poor mental health across the region are more in line with the county rate, though Livermore also stands out with nearly 15% of its adult population reporting that their mental health is poor. Further, the suicide rate in Livermore (9.8 per 100,000) is higher than in Alameda County (7.7), with the rate being highest among the white population.9 In the Alameda County needs assessment, Livermore identified behavioral health as a key priority.14 A number of factors hinder access to mental health services. Community members cited the limited number of mental health providers and services in the region, and relatedly, long wait lists to receive care. One individual said that “it can take up to two months to get an appointment.” These issues were interwoven with transportation challenges, particularly when referrals sent those seeking mental health services to parts of the county outside the Tri- Valley. The long wait lists and provider shortage in the Tri-Valley echoed the Livermore focus group findings from the Alameda County Needs Assessment.14 Insurance impedes access to mental health care through service coverage (or lack thereof), the result- ing effect on service costs, availability of providers who take a particular type of insurance, and need for individuals to be able to navigate the complex system. Participants noted difficulty navigating insurance, which often resulted in decreased access to care. This was a problem for public and private insurance (par- ticularly Kaiser), demonstrating that mental health service access is a barrier regardless of an individual’s socioeconomic status. One participant expressed the relationship between insurance type and the need for service navigation: “Another issue or challenge is that a lot of the coun- ty resources that are available require you to have MediCal insurance. The Tri-Valley in and of itself is socioeconomically more affluent, and we have a population of people who are experiencing mental health challenges. They can’t get help in the inter- im because they have a level of insurance, but they can’t navigate that insurance to get mental health resources. Because they have privatized insurance, they’re not eligible for programs.” This issue was also captured by one participant’s experience trying to ensure her children had mental health services and her challenges navigating insur- ance and transportation. “I am a widow and when my husband died, we went on medical and Social Security. At the time, my kids were under 18 so they were on Medicare. We chose Kaiser, and Kaiser doesn’t do regular counseling so basically I paid out of pocket for grief counseling for three years for both my kids. Then when the kids both developed anxiety and depression we needed to get regular psychology and psychiatry appointments. So first we were shunted up to [name redacted] in Oakland. That’s a long way to go to get a psychiatry or psychology appointment. And we were supposed to be going every week. And now that my kids are both over EASTERN ALAMEDA COUNTY HUMAN SERVICES NEEDS ASSESSMENTSS Page 114 of 554