# Bibliography & Related Work — Phase B Outcome Correlation
**Companion to**: `mh_gap_youth_outcomes_v1_article.md`
**Inherits**: methodological provenance from `mh_gap_youth_v1_bibliography.md`
**Adds**: outcome surveillance sources, deaths-of-despair literature, multi-method correlation methodology
---
## I. New outcome data sources
1. **CDC YRBSS Mental Health Indicators — 2023 release.** data.cdc.gov dataset `nu3s-3dwd`. https://data.cdc.gov/resource/nu3s-3dwd.json. State-level self-reported high-school student responses on suicide-related questions (considered, planned, attempted).
2. **NCHS Leading Causes of Death — Suicide.** data.cdc.gov dataset `bi63-dtpu`. State-level age-adjusted death rates (AADR) for "Suicide" cause through 2017. https://data.cdc.gov/resource/bi63-dtpu.json.
3. **NCHS Vital Statistics Rapid Release — Provisional Drug Overdose Death Counts.** data.cdc.gov dataset `xkb8-kh2a`. State-level 12-month-ending drug overdose deaths by indicator. https://data.cdc.gov/resource/xkb8-kh2a.json.
4. **U.S. Census Bureau. American Community Survey 1-Year 2023.** B01001 total state population (for rate denominators).
5. **CDC WONDER. Detailed Mortality 1999-2020 (D77).** Underlying-cause-of-death state-level data for youth-specific (10-19) suicide. Pending v1.1 integration via XML POST API.
6. **FBI Crime Data Explorer.** api.usa.gov/crime/fbi/cde/*. Juvenile arrest data; pending api.data.gov key issuance for v1.1.
---
## II. Methodological provenance — correlation + outcome analysis
7. **Pearson, K.** (1895). *Note on regression and inheritance in the case of two parents.* Proceedings of the Royal Society of London 58: 240-242. The Pearson product-moment correlation coefficient.
8. **Mokdad, A. H., et al.** (2018). *The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States.* JAMA 319(14): 1444-1472. State-level burden-of-disease methodology with population-weighted age-adjusted rates; methodological precedent for our state-level rate comparisons.
9. **Curtin, S. C., Heron, M.** (2019). *Death rates due to suicide and homicide among persons aged 10-24: United States, 2000-2017.* NCHS Data Brief no. 352. The most-cited state-level youth-mortality reference; we cite it for the "national rate is rising for youth" baseline context (national rate roughly doubled 2007-2017).
10. **Case, A., Deaton, A.** (2015). *Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century.* PNAS 112(49): 15078-15083. The original "deaths of despair" framing. Critical for §5.4's argument that drug overdose is orthogonal to mental-health access.
11. **Case, A., Deaton, A.** (2020). *Deaths of Despair and the Future of Capitalism.* Princeton University Press. The book-length argument; relevant for understanding why drug-OD geography clusters in WV/OH/NM/DC + does not align with insurance coverage.
---
## III. State-level mental-health surveillance methodology
12. **Centers for Disease Control and Prevention.** *YRBS Methodology Overview.* https://www.cdc.gov/yrbs/about-yrbs/index.html. The biennial school-based survey instrument; state-level response rates documented per cycle.
13. **National Center for Health Statistics.** *Bridged-Race Vintage 2020 Postcensal Population Estimates.* https://www.cdc.gov/nchs/nvss/bridged_race.htm. The population denominator NCHS uses for published mortality rates; differs from ACS state estimates by 1-2% (our rate calculations use ACS for consistency with the gap-measure denominators).
14. **National Center for Health Statistics.** *Underlying Cause-of-Death by State Documentation.* https://wonder.cdc.gov/wonder/help/ucd.html. The full mortality file methodology behind bi63-dtpu and the WONDER POST API.
---
## IV. Provider supply measurement
15. **Centers for Medicare & Medicaid Services. National Plan and Provider Enumeration System (NPPES).** Federal registry of all licensed healthcare providers. Filtered for this analysis to 8 youth-serving mental-health taxonomies (4 narrow + 4 broad).
16. **McBain, R. K., et al.** (2019). *Growth and distribution of child psychiatrists in the United States: 2007-2016.* Pediatrics 144(6): e20191576. State-level provider supply analysis foundational to our supply layer.
17. **Bishop, T. F., Press, M. J., Keyhani, S., Pincus, H. A.** (2014). *Acceptance of insurance by psychiatrists and the implications for access to mental health care.* JAMA Psychiatry 71(2): 176-181. The classic paper documenting that NPI count overstates accessible supply because not all enrolled providers accept insurance. Critical for §5 Discussion's "supply count ≠ capacity" argument.
18. **Cunningham, P. J.** (2009). *Beyond parity: primary care physicians' perspectives on access to mental health care.* Health Affairs 28(3): w490-w501. Documents the PCP-referral-side capacity constraint that NPPES counts cannot capture.
---
## V. Cross-state confounding literature
19. **Stone, D. M., et al.** (2018). *Vital Signs: Trends in State Suicide Rates — United States, 1999-2016.* MMWR 67(22): 617-624. Documents the rural-state suicide cluster (MT, AK, WY, NM, ID) that confounds our cross-state analysis.
20. **Hempstead, K., Phillips, J.** (2015). *Rising suicide among adults aged 40-64 years: the role of job and financial circumstances.* American Journal of Preventive Medicine 48(5): 491-500. Economic-distress driver of state-level suicide patterns; relevant to interpreting the cross-state mortality correlation.
21. **Knopov, A., et al.** (2019). *Household gun ownership and youth suicide rates at the state level, 2005-2015.* American Journal of Preventive Medicine 56(3): 335-342. State-level household gun ownership is a major confounding variable for state suicide rates; our analysis does not adjust for this. Cited as v1.2 motivation.
22. **Olfson, M., et al.** (2024). *Treatment of common mental disorders in the United States.* Health Affairs. State-level treatment-receiving rates are not currently observable from public surveillance; the gap between observed supply (NPPES) and observed delivery (treatment-receiving) is a major source of the framework's mortality non-prediction.
---
## VI. Policy lever literature (referenced in §5.5)
23. **Behavioral Health Workforce Education and Training (BHWET) Program.** HRSA. https://www.hrsa.gov/grants/find-funding/HRSA-22-064.
24. **Certified Community Behavioral Health Clinic (CCBHC) Program.** SAMHSA. https://www.samhsa.gov/programs/certified-community-behavioral-health-clinics.
25. **Title V Maternal and Child Health Block Grant.** HRSA MCHB. https://mchb.hrsa.gov/programs-impact/programs/title-v-maternal-child-health-services-block-grant-program.
26. **National Suicide Prevention Lifeline / 988 Suicide and Crisis Lifeline.** SAMHSA. https://988lifeline.org.
---
## VII. Companion papers in the Trellison Need-vs-Access series
27. **Trellison Institute.** (2026, May). *The Mental Health Access Gap in the United States Divides into Two Distinct Problems.* Working paper v1.0. https://trellison.com/research/mental-health-supply-demand-gap. The adult tract-level companion paper; first published application of the framework.
28. **Trellison Institute.** (2026, May). *The Youth Mental Health Access Gap is Structurally More Severe Than the Adult Gap and Wider Across States.* Working paper v1.0. https://trellison.com/research/youth-mental-health-supply-demand-gap. The Phase A youth state-level paper; this Phase B paper is its outcomes-correlation follow-up.
---
## VIII. Phase B specific contribution
The Phase B paper's specific methodological contributions:
- Documents the within-YRBSS suicide-indicator coupling at state level (r > +0.75 across 4 measures), establishing that the sad/hopeless prevalence is a strong proxy for state-level suicide ideation/attempts.
- Documents the cross-instrument signal degradation (within-YRBSS r > +0.75 vs across-instrument r ≈ +0.34) as a quantitative bound on the predictive value of state-level surveillance for state-level mortality.
- Documents the non-protective state-level provider supply signal, with the framework's residual measure essentially orthogonal to mortality outcomes.
- Pre-specifies the policy interpretation: the framework's outputs are the *workforce-build-out priority list*, not the *suicide-prevention triage list*.
This is the foundational result for the framework's interpretive boundaries. v1.1 will extend with FBI crime + multivariate confounding adjustment; v2.0 will add HCUP ER visit licensed data.