Depression & anxiety in the great recession: the prolonged economic downturn is taking a toll on mental health.

• Author: Taylor, Mike
• Position: [cover story] MENTAL HEALTH

The Jefferson Center for Mental Health is the proverbial safety net, a community nonprofit that caters mostly to the uninsured, the elderly, the homeless, the poor.

Lately, though, a different patient profile has emerged: "Middle-class people whose financial foundation has sort of collapsed in free fall," is how Dan Fishbein, the center's corporate business director, puts it. "To give you an example, I remember specifically a couple of Realtors who called in. No job. No income. 1 assume they had savings, but they're really dealing with free fall, and they might not have insurance. Three or four years ago you'd never see them."

The economic impact of the recession has been well documented: national unemployment hovering at 10 percent; one in four homeowners owing more on their houses than they're worth; foreclosures looming for many; family breadwinners working two part-time jobs that pay less than the job they lost, without benefits.

Less discussed has been the recession's impact on mental health since the toll on personal finances and jobs turned severe in late 2008.

"We normally serve about 5,000 to 6,000 people a year," says Jeanne Oliver, chief communications and development officer at Jefferson Center. "We surpassed that last year, and I believe our actual admissions per month are up about 40 percent."

Recognizing the stress the recession has put on people and their families, the Jefferson Center in April 2009 launched a program called Jefferson Center Partners, offering up to 10 counseling sessions for $5 per session for people dealing with mental-health issues related to the economy.

Similarly, the Mental Health Center of Denver has seen its role as a community safety net widen to include a more mainstream demographic. Last year, MHCD treated 13,500 people--2,000 more than the previous year.

"There are people who we typically wouldn't see who have wound up on our doorstep," says Dr. Carl Clark, CEO of MHCD, who still practices as a psychiatrist. "People who have lost their jobs, they've lost their homes, they've become homeless for the first time in their life, and the result of all that is people having mental health problems that they never expected to have."

The increased demand for behavioral-health services becomes understandable in the context of the national unemployment rate--9.7 percent nationally, 7.5 percent in Colorado--when you consider the view of Dr. Ted Wirecki, a Denver psychiatrist and former medical director of Anthem Behavioral Health.

"For people who don't have a job and who want to work ... next to major marital problems that's the biggest stressor there is," Wirecki says. "So if you have any kind of pre-existing depression/mental illness and you do lose that job ... it doesn't tend to cause mental illness, but it tends to exacerbate it for those patients who have a preexisting condition."

One positive development for those who still do have a job--and health insurance--is the federal Mental Health and Substance Abuse Parity Law, which went into...