Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings

2014·2.4 MB·English

Results from the 2013
National Survey on Drug Use and Health:
Mental Health Findings
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Behavioral Health Statistics and Quality
Acknowledgments
This report was prepared by the Center for Behavioral Health Statistics and Quality (CBHSQ),
Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of
Health and Human Services (HHS), and by RTI International (a registered trademark and a trade
name of Research Triangle Institute), Research Triangle Park, North Carolina. Work by RTI was
performed under Contract No. HHSS283201000003C.
Public Domain Notice
All material appearing in this report is in the public domain and may be reproduced or copied
without permission from SAMHSA. However, this publication may not be reproduced or
distributed for a fee without the specific, written authorization of the Office of Communications,
SAMHSA, U.S. Department of Health and Human Services. When using estimates and
quotations from this report, citation of the source is appreciated.
Recommended Citation
Substance Abuse and Mental Health Services Administration, Results from the 2013 National
Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-49, HHS
Publication No. (SMA) 14-4887. Rockville, MD: Substance Abuse and Mental Health Services
Administration, 2014.
Electronic Access and Copies of Publication
This publication may be downloaded from http://store.samhsa.gov/home. Hard copies may be
obtained from SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español).
Originating Office
Substance Abuse and Mental Health Services Administration
Center for Behavioral Health Statistics and Quality
1 Choke Cherry Road, Room 2-1067
Rockville, MD 20857

November 2014
ii
Table of Contents
Chapter Page
List of Figures ..................................................................................................................... v 
List of Tables ..................................................................................................................... ix 
Highlights ........................................................................................................................................ 1 
1.  Introduction ......................................................................................................................... 3 
Summary of NSDUH .......................................................................................................... 3 
Limitations on Trend Measurement .................................................................................... 4 
Format of Report and Data Presentation ............................................................................. 6 
Other NSDUH Reports and Data ........................................................................................ 7 
2.  Mental Illness and Mental Health Service Utilization among Adults ................................ 9 
Any Mental Illness .............................................................................................................. 9 
Serious Mental Illness ....................................................................................................... 11 
Major Depressive Episode ................................................................................................ 13 
Mental Health Service Utilization .................................................................................... 18 
Perceived Unmet Need for Mental Health Services ......................................................... 24 
3.  Suicidal Thoughts and Behavior ....................................................................................... 29 
Suicidal Thoughts and Behavior among Adults ................................................................ 29 
College Students ................................................................................................... 31 
Criminal Justice Populations ................................................................................. 33 
Suicidal Thoughts and Behavior among Adults Who Used Substances ........................... 33 
Illicit Drug Use ..................................................................................................... 33 
Binge and Heavy Alcohol Use .............................................................................. 35 
Suicidal Thoughts and Behavior among Adults with Substance Use Disorder and
Adults with Major Depressive Episode ........................................................................ 35 
Suicidal Thoughts and Service Use among Adults ........................................................... 35 
4.  Major Depressive Episode and Mental Health Service Utilization among Youths .......... 37 
Major Depressive Episode (MDE), MDE with Severe Impairment, and Treatment
for Depression .............................................................................................................. 37 
Mental Health Service Utilization .................................................................................... 41 
5.  Co-Occurrence of Mental Illness and Substance Use ....................................................... 47 
Substance Use among Adults with Mental Illness ............................................................ 47 
Mental Illness and Substance Use Disorders among Adults ............................................ 49 
Co-Occurring Mental Illness and Substance Use Disorders among Adults, by
Sociodemographic Characteristics ............................................................................... 52 
Major Depressive Episode and Substance Use among Adults ......................................... 56 
Major Depressive Episode and Substance Use Disorders among Adults ......................... 57 
Mental Health Care and Specialty Substance Use Treatment among Adults with
Co-Occurring Mental Illness and Substance Use Disorders ........................................ 58 
Major Depressive Episode and Substance Use among Youths ........................................ 60 
Major Depressive Episode and Substance Use Disorders among Youths ........................ 61 
iii
Table of Contents (continued)
Appendix Page
A Description of the Survey ................................................................................................. 63 
A.1  Sample Design ...................................................................................................... 63 
A.2  Data Collection Methodology ............................................................................... 65 
A.3  Data Processing ..................................................................................................... 68 
B Statistical Methods and Measurement .............................................................................. 75 
B.1  Target Population .................................................................................................. 75 
B.2  Sampling Error and Statistical Significance ......................................................... 75 
B.3  Other Information on Data Accuracy ................................................................... 80 
B.4  Measurement Issues .............................................................................................. 85 
C Other Sources of Mental Health Data ............................................................................. 111 
C.1  Definition of Mental Illness ................................................................................ 111 
C.2  National Surveys Collecting Data on Mental Health in the Civilian,
Noninstitutionalized Population.......................................................................... 112 
C.3  Surveys of Populations Not Covered by NSDUH .............................................. 119 
D References ....................................................................................................................... 123 
E List of Contributors ......................................................................................................... 131 

iv
List of Figures
Figure Page
2.1  Any Mental Illness in the Past Year among Adults Aged 18 or Older, by Age and
Gender: 2013 ......................................................................................................................10 
2.2  Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age
and Gender: 2013 ...............................................................................................................12 
2.3  Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by
Age and Gender: 2013 .......................................................................................................15 
2.4  Receipt of Treatment for Major Depressive Episode in the Past Year among
Adults Aged 18 or Older Who Had a Major Depressive Episode in the Past Year,
by Age and Gender: 2013 ..................................................................................................16 
2.5  Type of Professional Seen among Adults Aged 18 or Older with a Major
Depressive Episode Who Received Treatment in the Past Year: 2013 .............................17 
2.6  Past Year Mental Health Service Use among Adults Aged 18 or Older, by Type of
Care: 2002-2013.................................................................................................................19 
2.7  Receipt of Mental Health Services among Adults Aged 18 or Older, by Level of
Mental Illness: 2013 ...........................................................................................................21 
2.8  Number of Types of Mental Health Services Received among Adults Aged 18 or
Older with Past Year Any Mental Illness Who Received Mental Health Services
in the Past Year: 2013 ........................................................................................................22 
2.9  Number of Types of Mental Health Services Received among Adults Aged 18 or
Older with Past Year Serious Mental Illness Who Received Mental Health
Services in the Past Year: 2013 .........................................................................................23 
2.10  Reasons for Not Receiving Mental Health Services in the Past Year among Adults
Aged 18 or Older with a Perceived Unmet Need for Mental Health Care Who Did
Not Receive Mental Health Services: 2013 .......................................................................25 
2.11  Reasons for Not Receiving Mental Health Services in the Past Year among Adults
Aged 18 or Older with Past Year Any Mental Illness and a Perceived Unmet Need
for Mental Health Care Who Did Not Receive Mental Health Services: 2013 .................26 
2.12  Reasons for Not Receiving Mental Health Services in the Past Year among Adults
Aged 18 or Older with Past Year Serious Mental Illness and a Perceived Unmet
Need for Mental Health Care Who Did Not Receive Mental Health Services: 2013 ........27 
3.1 Suicidal Thoughts in the Past Year among Adults Aged 18 or Older, by Age and
Gender: 2013 ......................................................................................................................30 
v
List of Figures (continued)
Figure Page
3.2 Suicidal Thoughts and Behavior in the Past Year among Adults Aged 18 or Older:
2013 ...................................................................................................................................30 
3.3 Suicidal Thoughts in the Past Year among Full-Time College Students Aged 18 to
22 and Other Adults Aged 18 to 22, by Gender: 2013 ......................................................32 
3.4 Suicidal Thoughts in the Past Year among Adults Aged 18 or Older, by Past Year
Use of Selected Illicit Drugs: 2013 ....................................................................................34 
3.5 Suicidal Thoughts and Behavior in the Past Year among Adults Aged 18 or Older,
by Substance Dependence or Abuse: 2013 ........................................................................36 
4.1  Major Depressive Episode in the Past Year among Youths Aged 12 to 17, by
Severe Impairment, Age, and Gender: 2013 ......................................................................38 
4.2  Major Depressive Episode in the Past Year among Youths Aged 12 to 17, by
Gender: 2004-2013 ............................................................................................................39 
4.3  Major Depressive Episode with Severe Impairment in the Past Year among
Youths Aged 12 to 17, by Gender: 2006-2013 ..................................................................39 
4.4  Type of Treatment Received for Major Depressive Episode in the Past Year
among Youths Aged 12 to 17, by Gender: 2013 ...............................................................40 
4.5  Reasons for Receiving Specialty Mental Health Services among Youths Aged 12
to 17 Who Received Mental Health Services in the Past Year: 2013 ................................43 
4.6  Past Year Mental Health Service Use among Youths Aged 12 to 17, by Gender:
2012 and 2013 ....................................................................................................................44 
4.7  Number of Outpatient Visits in the Past Year among Youths Aged 12 to 17 Who
Received Outpatient Specialty Mental Health Services: 2013 ..........................................45 
5.1  Past Year Substance Use among Adults Aged 18 or Older, by Any Mental Illness:
2013....................................................................................................................................48 
5.2  Past Year Substance Use Disorders and Mental Illness among Adults Aged 18 or
Older: 2013 ........................................................................................................................49 
5.3  Past Year Substance Use Disorders and Serious Mental Illness among Adults
Aged 18 or Older: 2013 .....................................................................................................50 
5.4  Past Year Substance Use Disorders among Adults Aged 18 or Older, by Level of
Mental Illness: 2013 ...........................................................................................................51 
vi
List of Figures (continued)
Figure Page
5.5  Past Year Illicit Drug Use Disorders among Adults Aged 18 or Older, by Level of
Mental Illness: 2013 ...........................................................................................................51 
5.6  Past Year Alcohol Use Disorders among Adults Aged 18 or Older, by Level of
Mental Illness: 2013 ...........................................................................................................52 
5.7  Co-Occurring Mental Illness and Substance Use Disorders in the Past Year
among Adults Aged 18 or Older, by Age and Gender: 2013 .............................................53 
5.8  Co-Occurring Mental Illness and Substance Use Disorders in the Past Year
among Adults Aged 18 or Older, by Employment Status: 2013 .......................................54 
5.9  Past Year Substance Use among Adults Aged 18 or Older, by Major Depressive
Episode in the Past Year: 2013 ..........................................................................................56 
5.10  Past Year Substance Dependence or Abuse among Adults Aged 18 or Older, by
Major Depressive Episode in the Past Year: 2013 .............................................................57 
5.11  Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past
Year among Adults Aged 18 or Older Who Had Past Year Mental Illness and
Substance Use Disorders: 2013 .........................................................................................58 
5.12  Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past
Year among Adults Aged 18 or Older Who Had Past Year Serious Mental Illness
and Substance Use Disorders: 2013 ...................................................................................59 
5.13  Past Year Substance Use among Youths Aged 12 to 17, by Past Year Major
Depressive Episode: 2013 ..................................................................................................60 
5.14  Past Year Substance Use Disorders and Past Year Major Depressive Episode
among Youths Aged 12 to 17: 2013 ..................................................................................61 
5.15  Past Year Substance Dependence or Abuse among Youths Aged 12 to 17, by Past
Year Major Depressive Episode: 2013 ..............................................................................62 
B.1  Required Effective Sample in the 2013 NSDUH as a Function of the Proportion
Estimated..........................................................................................................................106 

vii
viii
List of Tables
Table Page
A.1  Weighted Statistical Imputation Rates (Percentages) for the 2013 NSDUH,
by Interview Section ..........................................................................................................74 
B.1  Demographic and Geographic Domains Forced to Match Their Respective
U.S. Census Bureau Population Estimates through the Weight Calibration
Process, 2013 ...................................................................................................................105 
B.2  Summary of 2013 NSDUH Suppression Rules ...............................................................106 
B.3  Weighted Percentages and Sample Sizes for 2012 and 2013 NSDUHs, by Final
Screening Result Code .....................................................................................................107 
B.4  Weighted Percentages and Sample Sizes for 2012 and 2013 NSDUHs, by Final
Interview Code .................................................................................................................108 
B.5  Response Rates and Sample Sizes for 2012 and 2013 NSDUHs, by Demographic
Characteristics ..................................................................................................................109 
B.6  Final SMI Prediction Models in the 2008-2012 MHSSs .................................................110 

ix
x