Highlights

This report presents results from the 2002 National Survey of Substance Abuse Treatment Services (N-SSATS), an annual survey of facilities providing substance abuse treatment. Conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), N-SSATS is designed to collect data on the location, characteristics, and use of alcoholism and drug abuse treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions. Selected findings are given below.

 

Chapter 1
Description of the National Survey of Substance Abuse Treatment Services (N-SSATS)

Contents

Data Collection Procedures for the 2002 N-SSATS
      Field period and reference date
      Survey coverage
      Content
      Data collection
      Forms accounting and response rate
      Exclusions
      Number of respondents reporting facility and client data
      Quality assurance
      Item non-response

Methodology of Imputation of Missing Client Counts

Further Data Considerations and Limitations

Organization of the Report

Terminology

Back to Main TOC

This report presents tabular information and highlights from the 2002 National Survey of Substance Abuse Treatment Services (N-SSATS), conducted between March and October 2002, with a reference date of March 29, 2002. It is the 25th in a series of national surveys designed to collect data on the location, characteristics, and use of alcohol and drug abuse treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions.1 The Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, plans and directs N-SSATS.

N-SSATS is designed to collect information from all facilities2in the United States, both public and private, that provide substance abuse treatment. (Additional information on N-SSATS, its history, and changes in the survey and survey universe over time is provided in Appendix C.)

N-SSATS provides the mechanism for quantifying the dynamic character and composition of the U.S. substance abuse treatment delivery system. The objectives of N-SSATS are to collect multipurpose data that can be used to—
 

  • assist SAMHSA and State and local governments in assessing the nature and extent of services provided in State-supported and other treatment facilities and in forecasting treatment resource requirements;

  • update SAMHSA's Inventory of Substance Abuse Treatment Services (I-SATS), which includes all known drug and alcohol abuse treatment facilities;

  • analyze general treatment services trends and conduct comparative analyses for the nation, regions, and States;
     
  • generate the National Directory of Drug and Alcohol Abuse Treatment Programs, a compendium of facilities approved by State substance abuse agencies for the provision of substance abuse treatment; and

  • update the information in SAMHSA's Substance Abuse Treatment Facility Locator, a searchable database of facilities approved by State substance abuse agencies for the provision of substance abuse treatment. The Facility Locator is available on the Internet at:

    http://findtreatment.samhsa.gov

    Data Collection Procedures for the 2002 N-SSATS

    Field period and reference date

    The field period for the 2002 N-SSATS ran from March 2002 through October 2002, with a reference date of March 29, 2002.

    Survey coverage

    The 2002 survey was sent to all 18,204 active facilities that were on SAMHSA's Inventory of Substance Abuse Treatment Services (I-SATS; see Appendix C) as of about 6 weeks before the survey reference date. These facilities were contacted by mail. Facilities added by State substance abuse agencies or discovered during the survey prior to the second mailing were also included in the survey.

    Content

    The 2002 N-SSATS survey instrument was a 9-page document with 37 numbered questions (see Appendix A). Topics included:

    Data collection

    Six weeks before the survey, letters were mailed to all facilities to alert them to expect the survey. An additional benefit of the letters was to update records with new address information returned from the post office. Data collection packets, including the questionnaire, SAMHSA cover letter, State-specific letters of endorsement, information on completing the survey on the Internet, and a sheet of Frequently Asked Questions were mailed to each facility. During the data collection phase, contract personnel were available to answer facilities' questions concerning the survey. Support in responding to questions for those facilities completing the questionnaire over the Internet was also available. Four to five weeks after the initial mailing, thank you/reminder letters were sent to all facilities. Approximately 8 weeks after the initial mailing, non-responding facilities were sent a second mailing. About four to five weeks after the second mailing, non-respondents received a reminder telephone call. Those facilities that had not responded within two to three weeks of the reminder call were telephoned and asked to complete the survey by telephone. The overall response rate was 96 percent.

    Forms accounting and response rate

    Summary response rate information is presented in Table 1.1. Questionnaires were mailed to a total of 18,204 facilities believed to offer substance abuse treatment services. Of these facilities, 15 percent were found to be ineligible for the survey because they had closed or were not providing substance abuse treatment on March 29, 2002. Of the remaining 15,459 facilities, 96 percent completed the survey.
     

    Table 1.1
    Survey forms accounting and response rates:
    N-SSATS 2002
     

      Number Percent
    Total facilities in survey 18,204  100.0
    Closed/Ineligible 2,745 15.1
    Eligible 15,459 84.9
         
    Total eligible 15,459 100.0
    Non-respondents 703 4.5
    Respondents 14,756 95.5
       Excluded from Report 654 4.2
       Client data only1 382 2.5
       Included in Report 13,720 88.8
         
    Mode of response 13,720 100.0
    Mail 7,797 56.8
    Telephone 3,126 22.8
    Internet 2,797 20.4
    1Facilities for which client counts were reported by another facility, but no facility information was received from the facility itself.

    [BACK TO LIST OF TABLES]

    Exclusions

    Of the 14,756 survey respondents, 654 facilities provided information to I-SATS but were deemed out of the scope of this report and were excluded from the analyses presented here (see Appendix C).
     

    An additional 382 facilities did not provide data on facility characteristics, although another facility provided their client counts. These were excluded from the facility counts in this report.

    Number of respondents reporting facility and client data

    Table 1.2. There were a total of 13,720 eligible respondents to the 2002 N-SSATS. The breakdown of these respondents with respect to their reporting of facility data and client counts is summarized below.

    There were 11,969 facilities that reported both facility data and client counts for their own organization.

    An additional 678 facilities reported on characteristics of their own facility and provided client counts for their own facility as well as other facilities. These 678 facilities reported client counts for a total of 2,732 facilities.

    There were 1,039 facilities that reported facility characteristics only. Their client counts were reported by another facility.

    There were 34 facilities that reported facility characteristics and client counts for their facility, but the number of other facilities for which they reported for was unknown.

     

    Table 1.2
    Number of facilities reporting client and/or facility data:
    N-SSATS 2002

    Type of data reported Number of facilities for which facility characteristics reported1 Number of facilities for which client counts
    reported
         
    Facility characteristics and client counts for responding facility only 11,969 11,969
    Facility characteristics for responding facility only; client counts for responding facility and other facilities as well 678 2,732
    Facility characteristics only (client counts reported by another facility) 1,039 0
    Facility characteristics and client counts for responding facility, but number of other facilities reported for is unknown  34  34
    1Excludes 354 facilities treating incarcerated clients only, 206 non-State-approved solo practitioners, and 94 non-treatment halfway houses.

    [BACK TO LIST OF TABLES]

    Quality assurance

    All mail questionnaires were reviewed for inconsistencies and missing data. Calls were made to facilities to obtain missing data and to clarify questionable responses. After data entry, automated quality assurance reviews were conducted. These incorporated the rules used in manual editing, plus consistency checks not readily implemented by manual review.

    If facilities could not be reached during the edit callbacks, responses that were clearly in error were deleted and imputed.

    Item non-response

    Careful editing and extensive follow-up have minimized item non-response (Appendix B). There are instances of non-response in most data items, however, and some variables have an explicit Unknown response option. Missing data for client count variables (e.g., the number of clients in hospital inpatient, non-hospital residential, and outpatient treatment) were imputed.

    For the remaining unimputed variables, facilities with missing values for a given variable were excluded from the tabulations using that variable. As a result, the number of treatment facilities on which tables are based may vary somewhat from table to table. The number of facilities actually reporting data is generally included on each table.

    Methodology of Imputation of Missing Client Counts

    A total of 232 facilities were missing client count values for one or more types of service (i.e., hospital inpatient detoxification, hospital inpatient rehabilitation, residential detoxification, etc.). A facility was given imputed values for a type of service if it reported that it provided the service but had not provided client counts for that service type. For example, if a facility reported that it provided hospital inpatient services and outpatient services, but not residential services, client values were imputed for the hospital inpatient and outpatient variables only. Missing values for the number of clients under age 18 and the number of hospital and/or residential beds were not imputed.

    When available, client values from the 2000 NSSATS were used to impute the missing client counts on the 2002 N-SSATS. In all other cases, the average client value stratified by State and type of ownership was used to impute the missing client counts. If a facility were unique in its ownership category and State, values were imputed using average values for the State only. Client counts were imputed for each type of service (i.e., hospital inpatient detoxification, hospital inpatient rehabilitation, residential detoxification, etc.) and summed to the larger totals (total hospital inpatient, residential, and outpatient clients, and total clients).

    Further Data Considerations and Limitations

    As with any data collection effort, certain procedural considerations and data limitations must be taken into account when interpreting data from the 2002 N-SSATS. Some of these are outlined above. Other general issues are listed below. Considerations and limitations of specific data items are discussed where the data are presented.
     

    Organization of the Report

    The balance of this report is organized into four analytic sections. Chapter 2 presents broad trends in facility characteristics for 1996 to 2002. Chapter 3 describes key characteristics of facilities and the programs and services they provide. Chapter 4 describes key characteristics of clients in substance abuse treatment on March 29, 2002. Finally, Chapter 5 presents State-level detail for most of the tables presented in Chapters 3 and 4.

    Terminology

    The majority of tables in the report are organized according to facility ownership/operation and the primary focus of the facility, and present data on the characteristics of facilities and clients in treatment at these facilities. Therefore, it is important to define these terms.

    Ownership/operation indicates the type of entity owning or responsible for the operation of the facility: private for-profit, private non-profit, or government (Federal, State, local, or tribal).

    Primary focus indicates the services the facility primarily provides: substance abuse treatment services, mental health services, general health care, a mix of mental health and substance abuse treatment services, and other.

    Clients in treatment are defined as: 1) hospital inpatient and residential clients receiving treatment (and not discharged) on the reference date, and 2) outpatient clients who received treatment during the prior 30 days and were still enrolled on the reference date.

    1 The jurisdictions include the territories of American Samoa and Guam, the Federated States of Micronesia, the Republic of Palau, the Commonwealth of Puerto Rico, and the Virgin Islands of the United States.
    2 In this report, entities responding to N-SSATS are referred to as "facilities." As discussed later in the report, a "facility" may be a program-level, clinic-level, or multi-site respondent.