An analysis of emergency department visits throughout New Jersey shows the mental health and substance abuse crisis is more widespread than many would expect.

Taking a deep dive into 2017 data from 70 of the state's 71 acute care hospitals, the Center for Health Analytics, Research and Transformation (CHART) at the New Jersey Hospital Association found that areas hit hardest by mental health disorders and substance misuse extend beyond traditional hot spots.

When adjusted for population density and examined for growth over five years, the numbers reveal a number of counties that may have fallen under the radar when it comes to delivering services where they're needed most.

By raw volume, the total number of ER visits with mental health diagnoses, which includes substance abuse and self-harm, was greatest in Essex, Camden, Ocean, Monmouth and Middlesex — all among the most populated in the state.

But, when looking at the rate of these diagnoses per 1,000 population, only Camden County remains in the top 5. Salem County had the highest use rate, followed by Cumberland, Atlantic, and Warren.

At 146.2 visits per 1,000 population, Salem County's use rate was 49 percent greater than Essex County.

From 2013 to 2017, the CHART report shows, emergency visits related to mental health and substance use issues spiked the most in Gloucester County (132.57 percent). Warren (98.82 percent), Camden (98.47 percent), Salem (92.79 percent), and Sussex (80.50 percent) counties rounded out the top 5 for growth rate.

As a point of reference, during the same five-year period, Essex County saw its raw volume increase by less than 4 percent.

"No community has really gone untouched by this mental health and substance use disorder crisis," said NJHA's Sean Hopkins, senior vice president of CHART. "The northwestern and southwestern parts of the state are experiencing significant penetration and growth of this problematic area, and may have been flying under the radar for quite some time."

Hopkins said the data can be used to broaden the discussion on these issues, and light a spark for finding creative solutions.

"We're really hopeful that this will spur dialogue on where to strategically place services, including preventative services," Hopkins said.

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