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Health Behaviors • 11%felt that mental health was an issue. Health behaviors are not always determined by a choice • 52%said they would refer a family member/friend to to be healthy or unhealthy but rather the influence from a private counselor/therapist if they needed counsel- one's community, systemic racism, exposure to trauma, ing. physical activity, food accessibility, substance use, sexu- . 14% did not know who to refer a family member or al health and one's social and economic status. friend to for counseling. Mental Health Suicide Mental health is defined as an individual's emotional, The rate of suicide (2014- psychological and social well-being22. Mental health 2018) in Orange County is 9.8 J the 70 suicideess w were shapes and helps to determine how individuals relate per 100,000, accounting for to themselves and others, how to deal with stress and 70 deaths, compared to 66 how to make choices, and handle everyday life activities. SUICIDE Mental health problems are common, and it is estimated deaths from 66 of P R E V E N T 10 N that 21% of adults in Orange County and 19% of adults in were a among NC live with depression23. White, non-Hispanic individ- LIFELINE uals and 55 of the 70 deaths 1-800-273-TALK(8255) Although rates of depression are lower among African were completed by men. •_• _ • • Americans and Hispanic/Latinx than in Whites, depres- Suicide is the 9tn leading cause sion among African Americans and Hispanic/Latinx are of death for all ages in Orange likely to occur more often. LGBTQ+ individuals are 2.5 County, the 711 leading cause of death among those 0 times more likely to experience depression, anxiety and - 19 years of age, the 2nd leading cause of death among substance misuse compared to heterosexual individu- those 20-39 years of age, and the 511 leading cause of als. Twice as many women will experience depression, death among those 40 - 64 years of age. While sui- generalized anxiety disorder or PTSD (post-traumatic cide in Orange County is higher among White males, stress disorder) in their lifetime, versus men 24. About 1 the data also shows that the suicide rate is significantly in 5 American adults have a mental health condition, yet lower among African Americans, American Indians and about 56% of mentally ill adults lack treatment. Barri- Hispanic/Latinx to the point where the numbers are ers to care include a chronically underfunded mental too low (or non-existent)to produce a rate. Racial and healthcare system, the social stigma of mental health ethnic differences in suicide and suicidal behaviors are conditions, high costs of care, lack of mental health pro- often related to underreporting and limitations among fessionals, and a scarce number of community-based data collection systems. resourceS25. Suicide is preventable and there are a number of signs Among survey responders: and symptoms to be aware of that can ultimately save a life. Warning signs of suicide ideation include26: • Mental health concerns were one of the most com- mon issues, being more prevalent than high blood • Talking about wanting to kill oneself pressure, diabetes, or high cholesterol. • Sleeping more or less than usual Figure 3: Where Survey Responders Would Refer Someone for Counseling Don't Know/Not Sure 13.7�W Minister/religious official School Staff Support Group(i.e.AA,NA,etc.) Doctor Private Counselor/Therapist 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 2019 COMMUNITY HEALTH ASSESSMENT 11