Substance Abuse & Mental Health Services Administration

CMHS Consumer Affairs E-News
July 30, 2004, Vol. 04-80

New SAMHSA Report on Mental Health and Co-Occurring Issues

The following provides highlights of a recently released report on the prevalence and treatment of serious mental illness (SMI) and their association with substance use and co-occurring substance use disorders based on the 2002 National Survey on Drug Use and Health (NSDUH). The survey, formerly known as the National Household Survey on Drug Abuse (NHSDA), is a project of the Substance Abuse and Mental Health Services Administration (SAMHSA). To view the entire report, please see:
http://oas.samhsa.gov/CoD/CoD.htm

Serious Mental Illness

+ In 2002, there were 17.5 million adults aged 18 or older with SMI during the 12 months prior to being interviewed. This represents 8.3 percent of all adults in the United States. On average, adults with SMI were younger, less educated, and more likely to be female than adults without SMI

+ Adults with SMI were more likely to be either unemployed or not in the labor force (36.4 percent) than were persons without SMI (31.2 percent).

+ Of the three age groups considered in this report, adults aged 18 to 25 had the highest rate of SMI (13.2 percent), followed by adults aged 26 to 49 (9.5 percent) and adults aged 50 or older (4.9 percent).

+ Overall, the rate of SMI was almost twice as high among females (10.5 percent) as it was among males (6.0 percent).

+ The two racial/ethnic groups with the highest prevalence of SMI were those reporting more than one race (13.6 percent) and American Indians and Alaska Natives (12.5 percent).

+ In 2002, there were 5 million adults aged 18 or older who had SMI and used an illicit drug in the past year. This represented 28.9 percent of all persons with SMI).

+ The prevalence of SMI was more than twice as high among those who used an illicit drug during the past year than it was among those who did not (17.1 vs. 6.9 percent).

+Although the rate of SMI did not vary by past year alcohol use (8.5 percent for users vs. 8.0 percent for nonusers), adults who were heavy alcohol users in the past month were more likely to have SMI than those without heavy alcohol use in the past month (11.1 vs. 8.1 percent)

Co-Occurrence of Serious Mental Illness and Substance Use Disorder

+ In 2002, there were 33.2 million adults aged 18 or older with SMI or a substance use disorder. Of these adults, 13.4 million (40.4 percent) had only SMI, 15.7 million (47.4 percent) had only a substance use disorder, and 4.0 million (12.2 percent) had SMI and a substance use disorder.

+ The 4.0 million adults with SMI and a substance use disorder represented 23.2 percent of all adults with SMI and 20.4 percent of all adults with a substance use disorder in 2002.

+ Rates of SMI were relatively low among adults who did not have a substance use disorder. The rate of SMI was 7.0 percent among adults with no substance use disorder. The rate was much higher among those with alcohol dependence or abuse (19.0 percent) and was even higher among those with illicit drug dependence or abuse (29.1 percent). The rate of SMI was highest among adults who met the criteria for both drug and alcohol dependence or abuse (30.1 percent).

+ Adults with nicotine (cigarette) dependence in the past year had higher odds of having SMI than those without nicotine (cigarette) dependence.

Treatment for Mental Health and Substance Use Problems

+ In 2002, an estimated 8.4 million, or 48 percent, of the 17.5 million adults with SMI received treatment in the 12 months prior to the interview. When compared with adults with SMI who did not receive treatment, these adults were more likely to belong to the following sociodemographic groups: aged 26 or older, female, non-Hispanic whites, or college graduates.

+ Among adults with SMI but no substance use disorder, almost half (48.4 percent) received treatment for their mental health problem in the past year.

+ The rate of treatment for a mental health problem among adults with SMI but no substance use disorder was roughly 9 times higher than the rate of specialty substance use treatment among adults with a substance use disorder but no SMI (48.4 vs. 5.4 percent). Although 48.0 percent of the adults with both a mental health and substance use disorder received some type of treatment, only 11.8 percent of these adults received both types of services.

+ Among adults with SMI, adults aged 26 to 49 were more likely to receive treatment for their mental health problem than those aged 50 or older.

+ Females with SMI were more likely to receive treatment for their mental health problem than men with SMI, and non-Hispanic whites were more likely to receive treatment for their mental health problem than any other racial/ethnic group.

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The Center for Mental Health Services is a component of the Substance Abuse and Mental Health Services Administration, United States Department of Health and Human Services.