Increase the proportion of adults with serious mental illness who get treatment — MHMD‑04 Data Methodology and Measurement

In the National Survey on Drug Use and Health (NSDUH), serious mental illness (SMI) among adults is defined as persons aged 18 or older who currently or at any time in the past year have had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance abuse disorders) resulting in substantial impairment in carrying out major life activities. SMI was estimated based on a statistical model of a clinical diagnosis and responses to questions in the main NSDUH interview on distress (Kessler-6 scale), impairment (truncated version of the World Health Organization Disability Assessment Schedule), past year major depressive episode, past year suicidal thoughts, and age. To estimate SMI, NSDUH utilized short scales in its interview that separately measure psychological distress and functional impairment for use in a statistical model that predicts whether a respondent had mental illness. To accomplish this, SAMHSA's Center for Behavioral Health Statistics and Quality (CBHSQ) initiated a Mental Health Surveillance Study (MHSS) in 2007 as part of NSDUH to develop and implement methods to estimate SMI. Models using the short scales for psychological distress and impairment to predict mental illness status were developed from a subsample of adult respondents who had completed the NSDUH interview and were administered a clinical psychological diagnostic interview. For the clinical interview data, individuals were defined as having SMI if they had a diagnosable mental, behavioral, or emotional disorder in the past 12 months, other than a developmental disorder or substance use disorder that met DSM-IV criteria (APA, 1994) and resulted in substantial functional impairment. Mental health service utilization is defined as receiving, in the 12 months prior to the interview, treatment or counseling for any problem with emotions, nerves, or mental health in any inpatient or outpatient setting, or the use of prescription medication for treatment of any mental or emotional condition. Persons answering affirmatively to any of the battery of questions in the NSDUH mental health service utilization module were considered to have received treatment.