About the National Data
Baseline: 3.4 percent of adults aged 18 years and over with co-occurring substance use disorders and mental health disorders received both mental health care and specialty substance use treatment in 2018
Target: 8.2 percent
In the National Survey on Drug Use and Health (NSDUH), mental disorder was measured in the Mental Health Surveillance System (MHSS) clinical interviews using an adapted version of the Structured Clinical Interview for the DSM (SCID) and was differentiated by the level of functional impairment based on the Global Assessment of Functioning (GAF) scale. Past year disorders that were assessed through the SCID included mood disorders (e.g., major depressive episode, manic episode), anxiety disorders (e.g., panic disorder, generalized anxiety disorder, posttraumatic stress disorder), eating disorders (e.g., anorexia nervosa), intermittent explosive disorder, and adjustment disorder. In addition, the presence of psychotic symptoms was assessed. Substance Use Disorders (SUD) also were assessed, although these disorders were not used to produce estimates of mental illness.
- Respondents were defined as having any mental illness (AMI) if they were determined to have any of the mental disorders assessed in the SCID (not including SUDs), regardless of the level of functional impairment.
- Respondents were defined as having low (mild) mental illness if they had any of the mental disorders assessed in the SCID (not including SUDs), but these disorders resulted in no more than mild impairment, based on GAF scores of greater than 59.
- Respondents were defined as having moderate mental illness if they had any of the mental disorders assessed in the SCID (not including SUDs), and these disorders resulted in moderate impairment, based on GAF scores of 51 to 59.
- Respondents were defined as having serious mental illness (SMI) if they had any of the mental disorders assessed in the SCID (not including SUDs), and these disorders resulted in substantial impairment in carrying out major life activities, based on GAF scores of 50 or below. The SMI diagnosis was used as the response variable in both the 2008 and 2012 prediction models.
The SCID and the GAF in combination were considered to be the "gold standard" for measuring mental illness.
Serious mental illness (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.
Illicit drug use is defined as abusing any of the following substances: marijuana, hallucinogens, inhalants, tranquilizers, cocaine, heroin, pain relievers, stimulants, or sedatives.
Substance use disorders is defined as the use of alcohol, marijuana, cocaine, heroin, hallucinogen, inhalant, pain reliever, tranquilizer, stimulant, or sedatives accompanied by positive response to one or more of the following four abuse criteria; AND the respondent was determined not to be dependent upon the substance of interest:
- Serious problems due to substance use at home, work, or school.
- Reports of using substance regularly and then doing something where the substance use might have put the respondent in danger.
- Substance use causing actions that repeatedly got the respondent in trouble with the law.
- Problems with family or friends caused by substance use and continued use despite those problems.
Treatment for Illicit drug or alcohol use: A respondent was classified as receiving treatment in the past year if they reported receiving treatment for illicit drug or alcohol use and treatment was received at either a hospital (inpatient) or rehabilitation facility (in or outpatient), or a mental health center.
Treatment for mental disorders. 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.