Chapter 1

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

Data Collection Procedures for the 2009 N-SSATS
Facility Selection for the 2009 N-SSATS Report
Survey Response Mode
Data Considerations and Limitations
Organization of the Report

This report presents tabular information and highlights from the 2009 National Survey of Substance Abuse Treatment Services (N-SSATS), conducted between March and October 2009, with a reference date of March 31, 2009. It is the 32nd in a series of national surveys begun in the 1970s. The surveys were designed to collect data on the location, characteristics, and utilization of alcohol and drug treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions.4 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 facilities5 in 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 A.)

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:

Data Collection Procedures for the 2009 N-SSATS

Field period and reference date

The survey reference date for the 2009 N-SSATS was March 31, 2009. The field period was from March 31, 2009, through October 17, 2009.

Survey universe

The 2009 N-SSATS facility universe included all 16,310 active treatment facilities on SAMHSA’s I-SATS at a point 6 weeks before the survey reference date. It also included 916 facilities that were added by State substance abuse agencies or through annual frame enhancement (see Appendix A), or discovered during the first 3 weeks of the survey. Thus, the total survey universe was 17,226 facilities.


The 2009 N-SSATS questionnaire was a 15-page document with 43 numbered questions (see
Appendix B). Topics included:

Data collection

Two primary data collection modes were employed—a paper questionnaire sent by mail and a secure web-based questionnaire. Respondents could select either method to complete the survey. Six weeks before the survey reference date (March 31, 2009), letters were mailed to all facilities to alert them to expect the survey. The letters also served to update records with new address information received from the U.S. Postal Service. On March 31, 2009, data collection packets (including the questionnaire, SAMHSA cover letter, State-specific letter of endorsement, information on completing the survey on the web, 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. Web-based support for facilities completing the questionnaire on the web was also available. Four to 5 weeks after the initial questionnaire mailing, thank you/reminder letters were sent to all facilities. Approximately 8 weeks after the initial questionnaire mailing, non-responding facilities were mailed a second questionnaire packet. About 4 to 5 weeks after the second questionnaire mailing, non-respondents received a reminder telephone call. Those facilities that had not responded within 2 to 3 weeks of the reminder call were telephoned and asked to complete the survey by computer-assisted telephone interview (CATI).

Facility status and response rate

Table 1.1 presents a summary of response rate information. Questionnaires were mailed to a total of 17,226 facilities believed to be actively providing substance abuse treatment services. Of these facilities, 12 percent were found to be ineligible for the survey because they had closed or did not provide substance abuse treatment or detoxification. Of the remaining 15,213 facilities, 14,209 facilities (93.4 percent) completed the survey and 13,513 (88.8 percent) were eligible for inclusionsion in this report.

Quality assurance

All mail questionnaires were reviewed manually for consistency and for missing data. Calls were made to facilities to clarify questionable responses and to obtain missing data. If facilities could not be reached during the edit callbacks, responses that were clearly in error were replaced by imputation. After data entry, automated quality assurance reviews were conducted. The reviews incorporated the rules used in manual editing, plus consistency checks and checks for data outliers not readily identified by manual review.

The web questionnaire was programmed to be self-editing; that is, respondents were prompted to complete missing responses and to confirm or correct inconsistent responses.

Item non-response was minimized through careful editing and extensive follow-up. The item response rate for the 2009 N-SSATS averaged 97.8 percent across 193 separate items. Appendix C details item response rates and imputation procedures.

Facility Selection for the 2008 N-SSATS Report

Table 1.1 The N-SSATS questionnaire serves several purposes, as noted earlier. Three hundred sixty-five of the 14,209 questionnaire respondents provided information but were deemed out of the scope of this report. They were excluded from the analyses presented here. The excluded facilities and reasons for exclusion fell into three categories:

An additional 331 facilities whose client counts were included in or “rolled into” other facilities’ counts and whose facility characteristics were not reported separately were excluded from facility counts in this report. However, their client counts are included.

After the exclusion of 365 out-of-scope facilities and 331 rolled-up facilities, 13,513 eligible respondent facilities were included in the 2009 N-SSATS report.

Number of respondents reporting facility and client data

There were 13,513 eligible respondents to the 2009 N-SSATS. The breakdown of facility data and client counts reported by these respondents is summarized below.

Survey Response Mode

Figure 1. The proportion of facilities using the web survey to respond to N-SSATS has increased steadily since introduction of the option in 2002. The percentage of facilities responding via the web increased from 33 percent in 2005 to 58 percent in 2009. Mail response declined from 45 percent in 2005 to 29 percent in 2009. Telephone response, which represents follow-up of facilities that have not responded by mail or web, also declined, from 22 percent in 2005 to 13 percent in 2009.

Figure 1
Survey Response Mode: 2005-2009

Stacked bar chart comparing Survey Response Mode: 2005-2009

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration,
National Survey of Substance Abuse Treatment Services (N-SSATS), 2005-2009.

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 2009 N-SSATS. Some general issues are listed below; other considerations are detailed in Appendix A. 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 the following chapters.


The majority of tables in the report are organized by facility operation and by primary focus of the facility. Therefore, it is important to define these terms.

4 The jurisdictions include the territory of Guam, the Federated States of Micronesia, the Republic of Palau, the Commonwealth of Puerto Rico, and the Virgin Islands of the United States.
5 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.

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