After a person commits suicide, their loved ones often spend years asking themselves a simple question: Why? For decades, researchers have pointed to psychological, chemical, and genetic factors. But according to a recent study released by Mental Health America, a nonprofit research and advocacy organization based in Virginia, a person’s risk for depression and suicide may depend more on where that person lives than on their biology or brain chemistry.

The study, Ranking America’s Mental Health: An Analysis of Depression Across the States,” ranks depression and suicide rates in each of the 50 states and the District of Columbia, comparing these rates with the mental health resources available in each state. The rankings show that South Dakota is the least depressed state, followed by Hawaii, New Jersey, Iowa, and Maryland. Not surprisingly, states that are less depressed boast some of the highest numbers of psychiatrists, psychologists, and social workers per capita, and offer some of the easiest access to mental health care. They also report some of the highest numbers of antidepressant prescriptions per capita, and residents in these states have higher education levels and are more likely to have health insurance than are residents of other states, according to the study.

The study names Utah as the most depressed state. It’s joined at the bottom of the list by Nevada, Rhode Island, Kentucky and West Virginia, almost all of which reported having some of the highest suicide rates per capita between 2002 and 2006. Residents of many of the most depressed states also reported having a harder time obtaining access to mental health care.

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Additionally, states with the highest suicide rates, such as Alaska and New Mexico, have some of the lowest numbers of psychologists per capita, while the opposite is true for states with the lowest suicide rates, including New York and Massachusetts. Mental Health America president and CEO David Shern says the correlation between depression and suicide rates and public policy is telling.

“These rates can be driven lower by encouraging state policies designed to improve coverage and assure that qualified mental health professionals are available to serve everyone in need,” he says.

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