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December 22, 2008

Serious Psychological Distress and Receipt of Mental Health Services

In Brief
  • In 2007, 10.9 percent of adults aged 18 or older (an estimated 24.3 million persons) experienced serious psychological distress (SPD) in the past year, and about two fifths of these (44.6 percent) received mental health services in the past year
  • Young adults aged 18 to 25 with SPD were less likely than their older counterparts to have received mental health services (29.4 vs. 47.2 percent among those aged 26 to 49 and 53.8 percent among those aged 50 or older)
  • Of those receiving mental health services, an estimated 6.9 percent received all three types of services (inpatient, outpatient, and prescription medication), 43.3 percent received only outpatient services and prescription medication, and 34.6 percent received only prescription medication

Mental health disorders affect persons in all age, racial, ethnic, educational, and socioeconomic groups, as well as persons of both genders. Monitoring the prevalence of mental health problems and receipt of treatment is vital to ensuring that the health needs of all Americans are met.

Serious psychological distress (SPD) is a nonspecific indicator of past year mental health problems, such as anxiety or mood disorders.1 This report provides information on the prevalence of past year SPD, the receipt of mental health services, and the types of mental health services received by adults aged 18 or older. All findings are based on 2007 National Survey on Drug Use and Health (NSDUH) data.


Prevalence of SPD

In 2007, an estimated 24.3 million adults aged 18 or older experienced SPD in the past year, representing 10.9 percent of the adult population. Past year SPD was higher among young adults aged 18 to 25 (17.9 percent) than among those aged 26 to 49 (12.2 percent) and those aged 50 or older (7.0 percent) (Figure 1). Females were more likely than males to have past year SPD (13.4 vs. 8.2 percent). Rates of past year SPD ranged from 14.0 percent among persons of two or more races to 6.4 percent among Asians (Figure 2).

Figure 1. Percentages of Adults with Past Year Serious Psychological Distress, by Age Group: 2007
This figure is a vertical bar graph comparing percentages of adults with past year serious psychological distress, by age group: 2007. Accessible table located below this figure.

Figure 1 Table. Percentages of Adults with Past Year Serious Psychological Distress, by Age Group: 2007
Age Group Percent
18 to 25 17.9%
26 to 49 12.2%
50 or Older   7.0%
Source: SAMHSA, 2007 NSDUH.

Figure 2. Percentages of Adults with Past Year Serious Psychological Distress, by Race/Ethnicity: 2007
This figure is a horizontal bar graph comparing percentages of adults with past year serious psychological distress, by race/ethnicity: 2007. Accessible table located below this figure.

Figure 2 Table. Percentages of Adults with Past Year Serious Psychological Distress, by Race/Ethnicity: 2007
Race/Ethnicity Percent
Two or More Races 14.0%
American Indian or Alaska Native 13.7%
Native Hawaiian or Pacific Islander 11.9%
White 11.3%
Black or African American 10.5%
Hispanic or Latino 10.2%
Asian   6.4%
Source: SAMHSA, 2007 NSDUH.


Receipt of Mental Health Services

About two fifths (44.6 percent) of adults with past year SPD received mental health services in the past year. Young adults aged 18 to 25 with SPD were less likely than their older counterparts to have received mental health services (29.4 vs. 47.2 percent among those aged 26 to 49 and 53.8 percent among those aged 50 or older) (Figure 3). Among those with SPD, females were more likely to have received services than males (49.2 vs. 36.7 percent), and whites were more likely than Hispanics and blacks to have received mental health services (50.9 vs. 29.6 and 26.0 percent, respectively) (Figure 4).

Figure 3. Percentages of Adults Who Received Mental Health Services in the Past Year among Those with Past Year Serious Psychological Distress, by Age Group: 2007
This figure is a vertical bar graph comparing percentages of adults who received mental health services in the past year among those with past year serious psychological distress, by age group: 2007. Accessible table located below this figure.

Figure 3 Table. Percentages of Adults Who Received Mental Health Services in the Past Year among Those with Past Year Serious Psychological Distress, by Age Group: 2007
Age Group Percent
18 to 25 29.4%
26 to 49 47.2%
50 or Older 53.8%
Source: SAMHSA, 2007 NSDUH.

Figure 4. Percentages of Adults Who Received Past Year Mental Health Services among Those with Past Year Serious Psychological Distress, by Race/Ethnicity*: 2007
This figure is a vertical bar graph comparing percentages of adults who received past year mental health services among those with past year serious psychological distress, by race/ethnicity*: 2007. Accessible table located below this figure.

Figure 4 Table. Percentages of Adults Who Received Past Year Mental Health Services among Those with Past Year Serious Psychological Distress, by Race/Ethnicity*: 2007
Race/Ethnicity Percent
White 50.9%
Hispanic or Latino 29.6%
Black or African American 26.0%
Source: SAMHSA, 2007 NSDUH.


Types of Mental Health Services

Of those adults who had past year SPD and received mental health services, 87.0 percent received prescription medication, 61.3 percent received outpatient services, and 11.4 percent received inpatient services (Table 1). There were some differences by demographic characteristics. For example, 16.8 percent of males who had SPD and received mental health services in the past year received inpatient services compared with 9.1 percent of females.

Table 1. Specific Types of Mental Health Services Received in the Past Year among Persons Aged 18 or Older with Past Year Serious Psychological Distress Who Received Mental Health Services in the Past Year, by Demographic Characteristics: Percentages, 2007
Demographic Characteristic Inpatient Outpatient Prescription Medication
Total 11.4% 61.3% 87.0%
Age in Years      
18 to 25 13.2% 59.5% 79.2%
26 to 49 10.8% 65.0% 87.7%
50 or Older 11.7% 55.9% 89.7%
Gender      
Male 16.8% 56.6% 87.5%
Female    9.1% 63.4% 86.8%
Race/Ethnicity*      
White    9.4% 61.5% 88.6%
Black or African American * 60.9% 86.3%
Hispanic or Latino * * *
Source: SAMHSA, 2007 NSDUH.

Individuals may have received more than one type of service in the past year. Of those experiencing SPD and receiving services, 47.2 percent received only one type of service; 46.0 percent received two types; and 6.9 percent received all three types. The service-type configurations most frequently mentioned were outpatient services and prescription medication (43.3 percent) and prescription medication only (34.6 percent) (Figure 5).

Figure 5. Percentages of Types of Mental Health Services Received in the Past Year among Adults with Past Year Serious Psychological Distress Who Received Mental Health Services in the Past Year: 2007
This figure is a horizontal bar graph comparing percentages of types of mental health services received in the past year among adults with past year serious psychological distress who received mental health services in the past year: 2007. Accessible table located below this figure.

Figure 5 Table. Percentages of Types of Mental Health Services Received in the Past Year among Adults with Past Year Serious Psychological Distress Who Received Mental Health Services in the Past Year: 2007
Mental Health Services Percent
Inpatient Only   1.9%
Outpatient Only 10.7%
Prescription Medication Only 34.6%
Inpatient and Outpatient   0.5%
Inpatient and Prescription Medication   2.2%
Outpatient and Prescription Medication 43.3%
Inpatient, Outpatient, and Prescription Medication   6.9%
Source: SAMHSA, 2007 NSDUH.


Discussion

About 1 in 10 American adults aged 18 or older experienced SPD in the past year, with particular subgroups—such as young adults aged 18 to 25—having rates as high as almost 2 in 10.

Despite the effectiveness of mental health services and the variety of service options available, fewer than half of the adults with SPD reported having received mental health services. Rates of service utilization were particularly low among young adults (the subgroup that exhibited the highest rates of SPD), blacks, and Hispanics, with less than 30 percent of adults with SPD in each of these groups receiving mental health services.

These findings point to the need to find innovative strategies to identify, engage, and treat individuals with mental health problems, as well as the need to develop additional approaches to address disparities in service utilization.


End Note
1 SPD is defined as having a score of 13 or higher on the K6 scale, which measures symptoms of psychological distress during the 1 month in the past 12 months when respondents were at their worst emotionally.


Table/Figure Note
* Data for additional racial/ethnic groups were suppressed because of low precision.


Suggested Citation
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (December 22, 2008). The NSDUH Report: Serious Psychological Distress and Receipt of Mental Health Services. Rockville, MD.

The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The data used in this report are based on information from 2007. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information on the most recent NSDUH is available in the following publication:

Office of Applied Studies. (2008). Results from the 2007 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 08-4343, NSDUH Series H-34). Rockville, MD: Substance Abuse and Mental Health Services Administration. Also available online: http://oas.samhsa.gov.

The NSDUH Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.

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