Mental Health Annual Report 2015-2020: Use of Mental Health Services: National Client-Level Data

2022·25 MB·English

Mental Health Annual Report
2015–2020
Use of Mental Health Services: National Client-Level Data
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
ii
Acknowledgments
This report was prepared for the Substance Abuse and Mental Health Services
Administration (SAMHSA), U.S. Department of Health and Human Services (HHS) under
Contract (cid:49)(cid:82)(cid:17)(cid:3) (cid:26)(cid:24)(cid:54)(cid:21)(cid:19)(cid:22)(cid:21)(cid:19)(cid:38)(cid:19)(cid:19)(cid:19)(cid:19)(cid:20)(cid:17)(cid:3) (cid:55)(cid:75)(cid:72)(cid:3) (cid:38)(cid:82)(cid:81)(cid:87)(cid:85)(cid:68)(cid:70)(cid:87)(cid:76)(cid:81)(cid:74)(cid:3) (cid:50)(cid:73)(cid:73)(cid:76)(cid:70)(cid:72)(cid:85)(cid:182)(cid:86)(cid:3) (cid:53)(cid:72)(cid:83)(cid:85)(cid:72)(cid:86)(cid:72)(cid:81)(cid:87)(cid:68)(cid:87)(cid:76)(cid:89)(cid:72)(cid:3) (cid:11)(cid:38)(cid:50)(cid:53)(cid:12)(cid:3) (cid:68)(cid:87)(cid:3)
(cid:54)(cid:36)(cid:48)(cid:43)(cid:54)(cid:36)'s Center for Behavioral Health Statistics and Quality ((cid:38)(cid:37)(cid:43)(cid:54)(cid:52))(cid:3)(cid:90)(cid:68)(cid:86)(cid:3)Heydy Juarez.
SAMHSA complies with applicable federal civil rights laws and does not discriminate on the basis
of race, color, national origin, age, disability, or sex. SAMHSA cumple con las leyes federales
de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad,
discapacidad o sexo.
Public Domain Notice
All material appearing in this report is in the public domain and may be reproduced or copied without
permission from SAMHSA. Citation of the source is appreciated. However, this publication may
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of Communications, SAMHSA, HHS.
Recommended Citation
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(cid:54)(cid:87)(cid:68)(cid:87)(cid:76)(cid:86)(cid:87)(cid:76)(cid:70)(cid:86)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)(cid:52)u(cid:68)(cid:79)(cid:76)(cid:87)(cid:92)(cid:17)(cid:3)(cid:48)(cid:72)(cid:81)(cid:87)(cid:68)(cid:79)(cid:3)(cid:43)(cid:72)(cid:68)(cid:79)(cid:87)(cid:75)(cid:3)(cid:36)nnual Report: 2015–2020. Use of Mental Health Services:
National Client-Level Data. Rockville, MD: Substance Abuse and Mental Health Services
Administration, 2022.
Electronic Access and Copies of Publication
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Substance Abuse and Mental Health Services Administration
5600 Fishers Lane, Room 15SEH03
Rockville, Maryland 20857
(cid:50)(cid:70)(cid:87)(cid:82)(cid:69)(cid:72)(cid:85) 2022
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Table of Contents
List of Tables................................................................................................................................ ix
List of Figures ...........................................................................................................................xxxv
E(cid:91)ec(cid:88)ti(cid:89)e (cid:54)(cid:88)(cid:80)(cid:80)(cid:68)r(cid:92)........................................................................................................................1
Background ....................................................................................................................................5
Introduction ....................................................................................................................................9
Chapter 1. Summary of Annual Data in State Client-Level Data Reporting: 2015–2020 ...13
Individuals Served ...................................................................................................................13
Regional Distributions .............................................................................................................16
(cid:36)(cid:81)(cid:92)(cid:16)(cid:48)(cid:72)(cid:81)(cid:87)(cid:76)(cid:82)(cid:81)(cid:3)(cid:48)(cid:72)(cid:81)(cid:87)(cid:68)(cid:79)(cid:3)(cid:43)(cid:72)(cid:68)(cid:79)(cid:87)(cid:75)(cid:3)(cid:39)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:72)(cid:86) ...................................................................................17
Chapter 2. Characteristics of Children and Adolescents Aged 17 Years and
Younger Receiving Mental Health Services ...............................................................................19
Individuals Served ...................................................................................................................19
Gender ......................................................................................................................................19
Race .........................................................................................................................................19
Ethnicity ...................................................................................................................................20
Living Arrangements ...............................................................................................................20
SED Status ...............................................................................................................................20
Client Treatment Status at the Start of the Reporting Period ...................................................20
SED Status, by Service Setting ................................................................................................20
Chapter 3. Characteristics of Young Adults Aged 18 to 24 Years Receiving
Mental Health Services ................................................................................................................21
Individuals Served ...................................................................................................................21
Gender ......................................................................................................................................21
Race and Ethnicity ...................................................................................................................21
Education .................................................................................................................................22
Marital Status ...........................................................................................................................22
Living Arrangements ...............................................................................................................22
SMI Status ................................................................................................................................22
Veteran Status ..........................................................................................................................22
Employment Status ..................................................................................................................22
Client Treatment Status at the Start of the Reporting Period ...................................................22
Service Setting .........................................................................................................................23
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SMI Status, by Service Setting ................................................................................................23
Chapter 4. Characteristics of Adults Aged 25 to 54 Years Receiving Mental
Health Services .............................................................................................................................25
(cid:44)ndividuals Served ...................................................................................................................25
Gender ......................................................................................................................................25
Race .........................................................................................................................................25
Ethnicity ...................................................................................................................................26
Education .................................................................................................................................26
Marital Status ...........................................................................................................................26
Living Arrangements ...............................................................................................................26
SMI Status ................................................................................................................................26
Veteran Status ..........................................................................................................................26
Employment Status ..................................................................................................................27
Client Treatment Status at the Start of the Reporting Period ...................................................27
Service Setting .........................................................................................................................27
SMI Status, by Service Setting ................................................................................................27
Chapter 5. Characteristics of Older Adults Aged 55 Years and Older
Receiving Mental Health Services ..............................................................................................29
Individuals Served ...................................................................................................................29
Gender ......................................................................................................................................29
Race .........................................................................................................................................29
Ethnicity ...................................................................................................................................30
Education .................................................................................................................................30
Marital Status ...........................................................................................................................30
Living Arrangements ...............................................................................................................30
SMI Status ................................................................................................................................30
Veteran Status ..........................................................................................................................30
Employment Status ..................................................................................................................31
Client Treatment Status at the Start of the Reporting Period ...................................................31
Service Setting .........................................................................................................................31
SMI Status, by Service Setting ................................................................................................31
Chapter 6. Characteristics of Individuals With Co-occurring Mental Health
and Substance Use Disorders Receiving Mental Health Services ...........................................33
Individuals Served ...................................................................................................................33
Gender ......................................................................................................................................33
Age ...........................................................................................................................................33
Race .........................................................................................................................................34
Ethnicity ...................................................................................................................................34
Substance Use Diagnosis .........................................................................................................34
Living Arrangements ...............................................................................................................34
(cid:54)(cid:48)(cid:44)(cid:18)(cid:54)(cid:40)(cid:39)(cid:3)(cid:54)(cid:87)(cid:68)(cid:87)u(cid:86) .......................................................................................................................34
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Veteran Status ..........................................................................................................................35
Employment Status ..................................................................................................................35
Service Setting .........................................................................................................................35
Client Treatment Status at the Start of the Reporting Period ...................................................35
Chapter 7. Client Outcomes Among Individuals Receiving Mental Health
Services: 2015–2020 .....................................................................................................................37
Employment Status ..................................................................................................................37
Transitions in Living Arrangements ........................................................................................38
Transitions in Employment Status ...........................................................................................41
Chapter 8. Geographic and Clinical Trends: 2015–2020 ........................................................45
Chapter 9. Client Characteristics by State or Jurisdiction: 2015–2020 ................................47
Chapter 10. Client Characteristics by State or Jurisdiction: 2020 ........................................49
Tables .............................................................................................................................................51
Appendix A. MH-TEDS/MH-CLD Crosswalk Tables ............................................................789
Appendix B. MH-TEDS and MH-CLD 2011–2020 reporting methods and
2020 reporting period, by state or jurisdiction ........................................................................799
Appendix C. MH-TEDS and MH-CLD Data Dictionary of Included Variables .................801
Appendix D. SMI/SED Federal De(cid:73)initions .............................................................................813
Serious Mental Illness (SMI) .................................................................................................813
Serious Emotional Disturbance (SED) ...................................................................................813
Appendix E. Mental Health and Substance Use Diagnosis Codes.........................................815
(cid:48)(cid:72)(cid:81)(cid:87)(cid:68)(cid:79)(cid:3)(cid:43)(cid:72)(cid:68)(cid:79)(cid:87)(cid:75)(cid:3)(cid:39)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:87)(cid:76)(cid:70)(cid:3)(cid:42)(cid:85)(cid:82)u(cid:83)(cid:86)(cid:3)(cid:58)(cid:76)(cid:87)(cid:75)(cid:3)(cid:38)(cid:82)(cid:85)(cid:85)(cid:72)(cid:86)(cid:83)(cid:82)(cid:81)(cid:71)(cid:76)(cid:81)(cid:74)(cid:3)(cid:44)(cid:38)(cid:39)(cid:16)(cid:28)(cid:3)(cid:39)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:87)(cid:76)(cid:70)(cid:3)(cid:38)(cid:82)(cid:71)(cid:72)(cid:86) .........(cid:3)...(cid:3).(cid:17)(cid:27)(cid:20)(cid:24)
(cid:48)(cid:72)(cid:81)(cid:87)(cid:68)(cid:79)(cid:3)(cid:43)(cid:72)(cid:68)(cid:79)(cid:87)(cid:75)(cid:3)(cid:39)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:87)(cid:76)(cid:70)(cid:3)(cid:42)(cid:85)(cid:82)u(cid:83)(cid:86)(cid:3)(cid:90)(cid:76)(cid:87)(cid:75)(cid:3)(cid:38)(cid:82)(cid:85)(cid:85)(cid:72)(cid:86)(cid:83)(cid:82)(cid:81)(cid:71)(cid:76)(cid:81)(cid:74)(cid:3)(cid:44)(cid:38)(cid:39)(cid:16)(cid:20)(cid:19)(cid:3)(cid:39)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:87)(cid:76)(cid:70)(cid:3)(cid:38)(cid:82)(cid:71)(cid:72)(cid:86) ...........(cid:3)(cid:3)(cid:3)..(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3).(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)820
TEDS Substance Use Diagnosis Codes ................................................................................(cid:3)827
Appendix F. Terms and Acronyms .......................................................................................(cid:3)...829
Appendix G. List of Contributors .......................................................................................(cid:3)....831
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List f Tables
O
Summary of Annual Data in State Client-Level Data Reporting: 2015–2020
1.1a Individuals, by mental health diagnosis: Number, 2015–2020 .......................................52
1.1b Individuals, by mental health diagnosis: Column percent distribution, 2015–2020 ......53
1.2a Individuals, by gender and age: Number, 2015–2020 .....................................................54
1.2b Individuals, by gender and age: Column percent distribution, 2015–2020 .....................55
1.3a Individuals, by race and ethnicity: Number, 2015–2020 .................................................56
1.3b Individuals, by race and ethnicity: Column percent distribution, 2015–2020 .................57
1.4a Individuals aged 17 years and younger, by mental health diagnosis:
Number, 2015–2020 ........................................................................................................58
1.4b Individuals aged 17 years and younger, by mental health diagnosis:
Column percent distribution, 2015–2020 ........................................................................59
1.5a Individuals aged 18 to 24 years, by mental health diagnosis: Number, 2015–2020 .......60
1.5b Individuals aged 18 to 24 years, by mental health diagnosis: Column
percent distribution, 2015–2020 ......................................................................................61
1.6a Individuals aged 25 to 54 years, by mental health diagnosis: Number, 2015–2020 .......62
1.6b Individuals aged 25 to 54 years, by mental health diagnosis: Column
percent distribution, 2015–2020 ......................................................................................63
1.7a Individuals aged 55 years and older, by mental health diagnosis: Number, 2015–2020 .64
1.7b Individuals aged 55 years and older, by mental health diagnosis: Column
percent distribution, 2015–2020 ......................................................................................65
1.8a Individuals, by marital status and living arrangement: Number, 2015–2020 ..................66
1.8b Individuals, by marital status and living arrangement: Column percent
distribution, 2015–2020 ...................................................................................................67
(cid:3)(cid:20)(cid:17)(cid:28)(cid:68)(cid:3) (cid:44)(cid:81)(cid:71)(cid:76)(cid:89)(cid:76)(cid:71)u(cid:68)(cid:79)(cid:86)(cid:15)(cid:3)(cid:69)(cid:92)(cid:3)(cid:54)(cid:48)(cid:44)(cid:18)(cid:54)(cid:40)(cid:39)(cid:3)(cid:86)(cid:87)(cid:68)(cid:87)u(cid:86)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)(cid:70)(cid:82)(cid:16)(cid:82)(cid:70)(cid:70)u(cid:85)(cid:85)(cid:76)(cid:81)(cid:74)(cid:3)(cid:80)(cid:72)(cid:81)(cid:87)(cid:68)(cid:79)(cid:3)(cid:75)(cid:72)(cid:68)(cid:79)(cid:87)(cid:75)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)
substance use disorder status: Number, 2015–2020 ........................................................68
(cid:3)(cid:20)(cid:17)(cid:28)(cid:69)(cid:3) (cid:44)(cid:81)(cid:71)(cid:76)(cid:89)(cid:76)(cid:71)u(cid:68)(cid:79)(cid:86)(cid:15)(cid:3)(cid:69)(cid:92)(cid:3)(cid:54)(cid:48)(cid:44)(cid:18)(cid:54)(cid:40)(cid:39)(cid:3)(cid:86)(cid:87)(cid:68)(cid:87)u(cid:86)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)(cid:70)(cid:82)(cid:16)(cid:82)(cid:70)(cid:70)u(cid:85)(cid:85)(cid:76)(cid:81)(cid:74)(cid:3)(cid:80)(cid:72)(cid:81)(cid:87)(cid:68)(cid:79)(cid:3)(cid:75)(cid:72)(cid:68)(cid:79)(cid:87)(cid:75)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)
substance use disorder status: Column percent distribution, 2015–2020 ........................69
1.10a Individuals aged 18 years and older, by employment status, ‘detailed not
(cid:76)(cid:81)(cid:3)(cid:79)(cid:68)(cid:69)(cid:82)(cid:85)(cid:3)(cid:73)(cid:82)(cid:85)(cid:70)(cid:72)(cid:15)(cid:182)(cid:3)(cid:72)(cid:71)u(cid:70)(cid:68)(cid:87)(cid:76)(cid:82)(cid:81)(cid:15)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)(cid:89)(cid:72)(cid:87)(cid:72)(cid:85)(cid:68)(cid:81)(cid:3)(cid:86)(cid:87)(cid:68)(cid:87)u(cid:86)(cid:29)(cid:3)(cid:49)u(cid:80)(cid:69)(cid:72)(cid:85)(cid:15)(cid:3)(cid:21)(cid:19)(cid:20)(cid:24)(cid:177)(cid:21)(cid:19)(cid:21)(cid:19)(cid:3) ...............................70
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List f Tables (Continued)
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1.10b Individuals aged 18 years and older, by employment status, ‘detailed not
(cid:76)(cid:81)(cid:3)(cid:79)(cid:68)(cid:69)(cid:82)(cid:85)(cid:3)(cid:73)(cid:82)(cid:85)(cid:70)(cid:72)(cid:15)(cid:182)(cid:3)(cid:72)(cid:71)u(cid:70)(cid:68)(cid:87)(cid:76)(cid:82)(cid:81)(cid:15)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)(cid:89)(cid:72)(cid:87)(cid:72)(cid:85)(cid:68)(cid:81)(cid:3)(cid:86)(cid:87)(cid:68)(cid:87)u(cid:86)(cid:29)(cid:3)(cid:38)(cid:82)(cid:79)u(cid:80)(cid:81)(cid:3)(cid:83)(cid:72)(cid:85)(cid:70)(cid:72)(cid:81)(cid:87)(cid:3)(cid:71)(cid:76)(cid:86)(cid:87)(cid:85)(cid:76)(cid:69)u(cid:87)(cid:76)(cid:82)(cid:81)(cid:15)(cid:3)
2015–2020 ...................................................................................................................(cid:17)....71
1.11a Individuals, by timing of admission and mental health service setting:
Number, 2015–2020 .................................................................................................(cid:17).......72
1.11b Individuals, by timing of admission and mental health service setting:
Column percent(cid:3)(cid:71)(cid:76)(cid:86)(cid:87)(cid:85)(cid:76)(cid:69)u(cid:87)(cid:76)(cid:82)(cid:81), 2015–2020 ..(cid:3)(cid:17)(cid:17).....................................................................73
1.12a Individuals, by number of mental health (cid:71)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:76)(cid:86) and any mention of
mental health diagnosis: Number, 2015–2020 ................................................................74
1.12b Individuals, by number of mental health (cid:71)(cid:76)(cid:86)(cid:74)(cid:81)(cid:82)(cid:86)(cid:76)(cid:86) and any mention of
mental health diagnosis: (cid:38)(cid:82)(cid:79)u(cid:80)(cid:81)(cid:3)(cid:83)ercent distribution, 2015–2020 ................................75
1.13a Individuals, by Census region and division: Number, 2015–2020 ..................................76
1.13b Individuals, by Census region and division: Column percent distribution, 2015–2020 ..77
(cid:3)(cid:20)(cid:17)(cid:20)(cid:23)(cid:68)(cid:3) (cid:44)(cid:81)(cid:71)(cid:76)(cid:89)(cid:76)(cid:71)u(cid:68)(cid:79)(cid:86)(cid:3)(cid:90)(cid:76)(cid:87)(cid:75)(cid:3)(cid:71)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:76)(cid:86)(cid:3)(cid:82)(cid:73)(cid:3)(cid:87)(cid:85)(cid:68)u(cid:80)(cid:68)(cid:16)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)(cid:86)(cid:87)(cid:85)(cid:72)(cid:86)(cid:86)(cid:82)(cid:85)(cid:16)(cid:85)(cid:72)(cid:79)(cid:68)(cid:87)(cid:72)(cid:71)(cid:3)(cid:71)(cid:76)(cid:86)(cid:82)(cid:85)(cid:71)(cid:72)(cid:85)(cid:86)(cid:15)(cid:3)(cid:69)(cid:92)(cid:3)
gender, age, race, and ethnicity: Number, 2015–2020 ....................................................78
(cid:3)(cid:20)(cid:17)(cid:20)(cid:23)(cid:69)(cid:3) (cid:44)(cid:81)(cid:71)(cid:76)(cid:89)(cid:76)(cid:71)u(cid:68)(cid:79)(cid:86)(cid:3)(cid:90)(cid:76)(cid:87)(cid:75)(cid:3)(cid:71)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:76)(cid:86)(cid:3)(cid:82)(cid:73)(cid:3)(cid:87)(cid:85)(cid:68)u(cid:80)(cid:68)(cid:16)(cid:3)(cid:68)(cid:81)(cid:71)(cid:3)(cid:86)(cid:87)(cid:85)(cid:72)(cid:86)(cid:86)(cid:82)(cid:85)(cid:16)(cid:85)(cid:72)(cid:79)(cid:68)(cid:87)(cid:72)(cid:71)(cid:3)(cid:71)(cid:76)(cid:86)(cid:82)(cid:85)(cid:71)(cid:72)(cid:85)(cid:86)(cid:15)(cid:3)(cid:69)(cid:92)(cid:3)
gender, age, race, and ethnicity: Column percent distribution, 2015–2020 ....................80
1.15a Individuals with diagnosis of anxiety disorders, by gender, age, race, and
ethnicity: Number, 2015–2020 ........................................................................................82
1.15b Individuals with diagnosis of anxiety disorders, by gender, age, race, and
ethnicity: Column percent distribution, 2015–2020 ........................................................84
(cid:3)(cid:20)(cid:17)(cid:20)(cid:25)(cid:68)(cid:3) (cid:44)(cid:81)(cid:71)(cid:76)(cid:89)(cid:76)(cid:71)u(cid:68)(cid:79)(cid:86)(cid:3)(cid:90)(cid:76)(cid:87)(cid:75)(cid:3)(cid:71)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:76)(cid:86)(cid:3)(cid:82)(cid:73)(cid:3)(cid:68)(cid:87)(cid:87)(cid:72)(cid:81)(cid:87)(cid:76)(cid:82)(cid:81)(cid:3)(cid:71)(cid:72)(cid:191)(cid:70)(cid:76)(cid:87)(cid:18)(cid:75)(cid:92)(cid:83)(cid:72)(cid:85)(cid:68)(cid:70)(cid:87)(cid:76)(cid:89)(cid:76)(cid:87)(cid:92)(cid:3)(cid:71)(cid:76)(cid:86)(cid:82)(cid:85)(cid:71)(cid:72)(cid:85)(cid:15)(cid:3)(cid:69)(cid:92)(cid:3)
gender, age, race, and ethnicity: Number, 2015–2020 ....................................................86
(cid:3)(cid:20)(cid:17)(cid:20)(cid:25)(cid:69)(cid:3) (cid:44)(cid:81)(cid:71)(cid:76)(cid:89)(cid:76)(cid:71)u(cid:68)(cid:79)(cid:86)(cid:3)(cid:90)(cid:76)(cid:87)(cid:75)(cid:3)(cid:71)(cid:76)(cid:68)(cid:74)(cid:81)(cid:82)(cid:86)(cid:76)(cid:86)(cid:3)(cid:82)(cid:73)(cid:3)(cid:68)(cid:87)(cid:87)(cid:72)(cid:81)(cid:87)(cid:76)(cid:82)(cid:81)(cid:3)(cid:71)(cid:72)(cid:191)(cid:70)(cid:76)(cid:87)(cid:18)(cid:75)(cid:92)(cid:83)(cid:72)(cid:85)(cid:68)(cid:70)(cid:87)(cid:76)(cid:89)(cid:76)(cid:87)(cid:92)(cid:3)(cid:71)(cid:76)(cid:86)(cid:82)(cid:85)(cid:71)(cid:72)(cid:85)(cid:15)(cid:3)(cid:69)(cid:92)(cid:3)
gender, age, race, and ethnicity: Column percent distribution, 2015–2020 ....................88
1.17a Individuals with diagnosis of bipolar disorders, by gender, age, race, and
ethnicity: Number, 2015–2020 ........................................................................................90
1.17b Individuals with diagnosis of bipolar disorders, by gender, age, race, and
ethnicity: Column percent distribution, 2015–2020 ........................................................92
1.18a Individuals with diagnosis of depressive disorders, by gender, age, race,
and ethnicity: Number, 2015–2020 .................................................................................94
1.18b Individuals with diagnosis of depressive disorders, by gender, age, race,
and ethnicity: Column percent distribution, 2015–2020 .................................................96
1.19a Individuals with diagnosis of schizophrenia and other psychotic disorders,
by gender, age, race, and ethnicity: Number, 2015–2020 ...............................................98
x