Quick Take
Public health data show that Santa Cruz County leads the Bay Area in rates of serious psychological distress and need for mental health or substance-use services. Mental health advocate Kevin Norton believes the real culprit isn’t our lifestyle — it’s our housing costs. Despite hundreds of millions spent on treatment each year, the county hasn’t addressed the root cause: unaffordable rent. Until it does, he writes, paradise will keep pushing people out — and breaking the rest of us down.
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Many people think we live in paradise — but the mental health data from Santa Cruz County tells a different story.
Over the past two years, Santa Cruz County has consistently recorded the highest rates of serious psychological distress in the Bay Area. Our numbers aren’t just bad; they’re well above California state averages, and would shock most developed countries. Behind the redwood trees and ocean views, many residents are quietly hurting. Thousands have already left, and many more are thinking about it.
When I lived in San Jose, I used to crawl over Highway 17 every weekend to surf in Santa Cruz. Every Saturday it was the same stop-and-go traffic, the same ambulances and car wrecks. I used to think: If people endure this kind of torture to get here, the locals must be the happiest people on earth.
I was wrong.
Yes, we have sunshine and surf, but we are also buckling under the strain of being the most unaffordable rental market in the nation for three years running. According to the latest California Health Interview Survey, more than 1 in 5 residents — over 20% — reported serious psychological distress in 2023 and 2024, the highest rate in the region for two consecutive years and about 47% above the state average.
The county also leads the Bay Area in the share of people who say they need mental health or substance-use services. About one-third of adults — 33.6% — reported needing such help over the past two years, again the highest in the region and 37% above the California average. In 2022, the most recent year of data from the Centers for Disease Control, we ranked highest in depression rates in the Bay Area. And our drug overdose death rate in 2023 — 45.9 per 100,000 residents — trailed only San Francisco.
The numbers tell a clear story: In many ways, Santa Cruz County residents are struggling more than our Bay Area neighbors, and more than most Californians.
Why are we different?
Our genes haven’t changed in the past few decades. What has changed is our rent, our workloads and our social lives.
In September, I wrote about how UC Santa Cruz students have reported the worst mental health of any UC campus for the past decade — In public health terms, this could be called an “observational study,” and I believe the main factor driving it is the high cost of housing.
The low wages and high housing costs in Santa Cruz County are crushing young people.
A recent academic analysis of 23 studies, published in the BMC Public Health journal, found that stress caused by rising housing costs leads to poor mental and physical health — increasing rates of alcohol use, poor nutrition, depression and anxiety — especially for renters and low-income residents.
Renters, in particular, carry the heaviest burden. In Santa Cruz County, renters were 63% more likely to report needing mental health or substance-use services than homeowners of single-family homes between 2023 and 2024.
Homeowners, by contrast, often benefit from what economists call the wealth effect. When your home increases in value, you feel more financially secure, even if your day-to-day life doesn’t change. For renters and low-income homeowners, it’s the opposite: Higher housing costs lead to more anxiety and depression.
Not exactly fair, is it?
Granted, education levels and demographics play a role in Santa Cruz County’s poor mental health rankings compared to the Bay Area, but those factors are small and largely beyond our control. Affordability — and affordable housing, especially, is something we can fix.
Younger adults are bearing the brunt
If there’s one age group most affected, it’s 18-to-45-year-olds — young and middle-aged adults who should be building our future, not struggling to survive.
Statewide, psychological distress for this group has nearly tripled since 2009. In Santa Cruz County, it’s even worse. High rents, long commutes and student debt are creating what looks like a midlife crisis before middle age even begins.
Renters in Santa Cruz County also report higher rates of high blood pressure and cholesterol than homeowners their age — physical signs of chronic stress. We often treat health and housing as separate issues, but in reality, they’re deeply intertwined.
Not surprisingly, there’s been an exodus of people leaving the county in recent years. Since 2019, around 13,700 residents — about 5.1% of the county’s population — have left. Workforce Santa Cruz County predicts another 10,000-plus will leave by 2029, driven mostly by the unaffordability of being a renter here.
Meanwhile, job growth has stalled in the county. The only sector adding positions is health care — up 1,600 jobs since 2021. People are leaving and the health care industry is growing — it’s an ominous sign, unless you’re in the funeral business.
The high cost of housing is draining the life from Santa Cruz County.
Why older generations often don’t see it
Perhaps the most troubling question is this: How have so many young and middle-aged adults been struggling so quietly, their pain barely noticed by older generations?
Culture plays a role. The U.S. prizes self-reliance, car-focused cities and new digital technology with little oversight. Smartphones, streaming and social media have distracted us and isolated us from people different from us, even from our neighbors. Meanwhile, the national news has turned into a bloody circus. Even in a small county like ours, it’s easy for older generations to overlook the struggles unfolding right next door.
Many retirees in Santa Cruz bought their homes decades ago, before prices exploded. They enjoy stability that younger generations can only dream of. But this gap has created a dangerous generation gap — an empathy divide. Many of those who are comfortable may not be able to see the suffering of those who aren’t.
On this unsustainable path we’re on, we need a correction. If you live in unincorporated Santa Cruz County, Capitola or Scotts Valley, know this: Your jurisdictions could be doing a lot more to create affordable housing. It’s time to tell them to catch up.
We have the power to act — but only if enough residents speak up and ask for change.
We’ve been watering the leaves instead of the roots. This year, Santa Cruz County will spend over $180 million — more than half of its entire health services budget — on mental health alone. And that’s only a fraction of what is spent here on mental health treatment every year.
For a place famous for its redwoods, beaches and laid-back lifestyle, that’s a shocking number — and a sign that something deeper is wrong.
It’s time for the entire county to recognize affordable housing as a fundamental part of the safety net — a basic necessity that should be accessible to all.
To make matters worse, both the State of California and the federal government are cutting homeless services and housing budgets this year. Unless we rapidly fix the housing crisis at the local level, we’ll continue to see more homelessness, more preventable health care bills and more families moving away.
Santa Cruz County is a natural paradise, yet our mental health tells a different story — a story shaped by American culture and the dysfunction it brings. One can imagine the Ohlone people shaking their heads at what is happening.
The evidence is clear: High housing costs in Santa Cruz County are driving some of the worst mental health outcomes in the Bay Area, which are also worse than state averages. County budgets and health services alone can’t fix this.
We must focus on the upstream factors — providing the basic need of affordable housing to every resident.
Feel free to reach out to your elected leaders in Scotts Valley, Capitola and Santa Cruz County; urge them to speed up the addition of affordable housing in your jurisdiction.
Kevin Norton has a master’s degree in public health from the University of Florida and lives on the Westside of Santa Cruz, where he volunteers as a community organizer for Pacific for People. He manages the stress of living in Santa Cruz with research-backed methods such as meditation, natural sleep, therapy, journaling, exercise, having a strong network of social support and limiting the amount of time he spends on social media. He voted yes on Measure C.