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Mental Health and Substance Abuse

Alabama’s #1 Health Indicator

The concern for mental health and substance abuse moved to number one from its previous second-highest rank in the 2015 survey. According to the World Health Organization (WHO), mental health is the “state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community” (WHO Mental Well-Being). Mental health affects an individual’s mood, emotional, psychological, and social well-being. Family history, biological factors, and life experiences influence mental health. The most common mental health illnesses are anxiety, depression, and post-traumatic stress disorders (WHO Mental Well-Being).

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 41 percent of AL adults sought medical treatment for a mental health issue between 2017-2019. Early signs of declining mental health can be an individual withdrawing from normal social support, displaying negative emotions, completing daily tasks, and abusing substances (SAMSHA Report). Substance misuse and abuse refer to the harmful use of alcohol and illicit drugs, including prescription drugs (CDC Mental Health). There can be physical, social, and psychological harm in addition to criminal penalties for substance possession. Often, practitioners see mental health and substance abuse co-occurring. Treatment solutions could include individual and group psychotherapies. Accountability and social support are an instrumental part of the recovery process. Discrimination, poverty, and segregation towards individuals with mental illness are all barriers to seeking treatment (CDC Mental Health). Raising awareness helps reduce stigma towards mental illness.

Disproportionately Affected Populations

Groups at a higher risk of having a persisting mental illness are veterans, individuals who have experienced traumatic events early in life, and individuals in abusive relationships or families. In the past 20 years, mental illness rates have been rising. While more services are available, rural and minority populations are still underrepresented due to access to care and social stigma (CDC Mental Health).

Geographic Variation

Health outcomes can vary over regions based on the populations and the opportunities to self-manage care. For mental health concerns, the Northeastern Public Health District had the highest suicide rate in 2019. This area also had the highest substance abuse diagnosis prevalence in Medicaid recipients in 2018.

Alabama Mental Health and Substance Abuse Highlights

The Centers for Medicaid and Medicare information only has limited claims data, not covering the total population. Data are also retrieved from the ADPH Center for Health Statistics, the ADPH Office of Primary Care and Rural Health, the ADPH Office of Emergency Medical Services (EMS), the Behavioral Risk Factor Surveillance System (BRFSS), and the National Center for Health Statistics: 

  • In 2019, suicide was the twelfth leading cause of death in AL.
  • In 2018, 38.8 percent of the adult Medicaid population initiated rehabilitation treatment within 14 days of being diagnosed with an alcohol or drug dependency.
  • The suicide mortality rate is almost more than four times greater for males compared to females (26.6 deaths compared to 6.9 deaths per 100,000 persons).

Health Indicators

The following indicators have been selected for use in developing a benchmark or starting point for measuring the current state of and monitoring future changes regarding mental health and substance abuse in the population of Alabama:


Page last updated: October 16, 2023