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Arizona ranks close to last in the nation when it comes to available mental health care providers—a problem that’s been underscored during a pandemic that is increasing anxiety and depression.

Heather Ross, a clinical assistant professor at Arizona State University who advises Phoenix Mayor Kate Gallego on health policy issues, said the state also lacks sufficient beds and inpatient facilities to treat patients with mental health challenges.

Still, she added: “You can build a building, you can stick a bed in a room, but unless you have the professionals to deliver the care, those beds almost don’t matter.”

Arizona ranks 47th among all 50 states and the District of Columbia in the rate of available mental health care providers, according to the latest report by the nonprofit group Mental Health America. The state’s ratio of 790 people for every 1 provider compares with Massachusetts’ leading rate of 180 to 1.

Providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, and advanced practice nurses specializing in mental health care.

All 15 counties in Arizona include places considered Health Professional Shortage Areas specifically for mental health, according to data from the U.S. Department of Health and Human Services.

The Navajo Nation is ranked as one of the highest areas of need. A 2017 study by Northern Arizona University’s Center for Health Equity Research found that the ratio of people to mental health providers in Navajo County, which includes a section of the Navajo reservation, was a whopping 1,504:1.

These provider shortages are especially concerning given the job losses, isolation and grief people are experiencing during the COVID-19 pandemic, Ross said. The Navajo Nation has been hit hard by the deadly disease, with more than 10,000 cases and 550 deaths, while statewide cases have surpassed 200,000, with more than 5,600 deaths.

Ross said it’s vital the dearth of behavioral health providers is addressed, because a mental health problem can affect every aspect of one’s life.

“It’s not like when you sprain your elbow and you can wear a sling,” she said. “You can’t put a Band-Aid on it and put it aside. It’s always with you.

“In a perfect world, every person who was experiencing mental illness, behavioral disorders or crisis would reach out … and would have a mental health professional immediately available.”

A June survey by the Centers for Disease Control and Prevention documented how COVID-19 has increased mental health problems, particularly in younger adults, people of color, essential workers and unpaid adult caregivers. These groups have reported experiencing worse mental health, increased substance use and elevated suicidal ideation.

A bill to provide financial aid to students who commit to enter the mental health care workforce was introduced during the 2020 Arizona legislative session but didn’t make it out of committee.

The bill would have expanded the Arizona Teachers Academy program to provide scholarships ranging from $3,000 to $10,000 a year for students who agree to become social workers or counselors in Arizona public schools.

The measure’s sponsor, Sen. Sean Bowie, D-Phoenix, told Cronkite News he plans to reintroduce the proposal when the new legislative session begins in January.

Mental health conditions have worsened since the pandemic was declared in March, but even before then, reports of anxiety and depression had been on a “scary but steady increase,” said Mark Carroll, chief medical officer of Health Choice Arizona in Flagstaff.

Now, with some of the financial impacts of COVID-19, people may be putting their mental health on the back burner.

“If I don’t have stable housing or I don’t have money for reliable and consistent food on my table, other things are just not going to be a priority for me and it’s going to impact my health in general,” Carroll said. “And it’s going to have a significant impact on my mental health and well-being.”