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6. Mental Disorders

This chapter presents findings from the National Survey on Drug Use and Health (NSDUH) on past year serious mental illness, any mental illness, serious thoughts of suicide, and major depressive episode (i.e., depression) for adults aged 18 or older. Estimates of depression among youths aged 12 to 17 also are included. In addition to the findings, a brief description of each measure is provided. For more details on these measures, see Section A.11 in Appendix A.

6.1  Serious Mental Illness among Adults

Public Law No. 102-321, the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) Reorganization Act of 1992, established a block grant for States within the United States to fund community mental health services for adults with serious mental illness. The law required States to include prevalence estimates in their annual applications for block grant funds. This legislation also required the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop an operational definition of serious mental illness.

SAMHSA defined serious mental illness among adults as persons aged 18 or older who currently or at any time in the past year have had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association [APA], 1994) that has resulted in serious functional impairment, which substantially interferes with or limits one or more major life activities.

Nationally in 2009-2010, 4.9 percent of adults aged 18 or older (an increase from 4.6 percent in 2008-2009) had serious mental illness in the past year (Table C.23). Arkansas had the highest rate (6.3 percent), while Maryland and New Jersey had the lowest rate (4.3 percent) among adults 18 or older. Across age groups, the highest rates of past year serious mental illness occurred among 18 to 25 year olds (7.6 percent nationally), ranging from 6.0 percent in Georgia to 9.5 percent in Idaho and Utah (Table B.23).

At the census region level, increases in past year serious mental illness rates from 2008-2009 to 2009-2010 were seen in the Northeast and South for persons aged 18 or older and in the South for persons aged 26 or older. Among the 18 or older group, nine States had an increase. There were increases in five States for the 26 or older age group, and only Idaho's rate increased among the 18 to 25 year olds. No decreases occurred in any State or age group.

6.2  Any Mental Illness among Adults

Any mental illness among adults aged 18 or older is defined as currently or at any time in the past year having had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) of sufficient duration at any time during the past year to meet diagnostic criteria specified within the DSM-IV (APA, 1994). Adults who had a diagnosable mental, behavioral, or emotional disorder in the past year, regardless of their level of functional impairment, were defined as having any mental illness.

In 2009-2010, the national rate of past year any mental illness among adults aged 18 or older was 20.0 percent (Table B.24). The highest rate for any mental illness among persons aged 18 or older occurred in Utah (25.4 percent); the lowest rate occurred in Georgia (17.9 percent). Among persons aged 18 or older, Alabama, Idaho, Montana, Rhode Island, Tennessee, Utah, and West Virginia ranked in the highest fifth for both serious mental illness and any mental illness (Figures 6.1 and 6.4).

Among young adults aged 18 to 25, a decrease in the rate of any mental illness between 2008-2009 and 2009-2010 was seen the Midwest region (from 32.3 to 31.1 percent) (Table C.24). Among adults aged 18 or older, two States had increases (Alabama and Idaho), while three States had decreases among young adults aged 18 to 25 (Michigan, New York, and Wisconsin). No other changes occurred in any State and age group for this measure.

6.3  Serious Thoughts of Suicide among Adults

Responding to a need for national and State-level data on the prevalence of suicidal thoughts and behavior, a set of questions was added beginning with the 2008 NSDUH questionnaire. These questions include asking all adult respondents aged 18 or older if at any time during the past 12 months they had serious thoughts of suicide.

In 2009-2010, 3.8 percent of adults aged 18 or older had serious thoughts of suicide in the past year in the United States, which was similar to the rate from 2008-2009 (3.7 percent) (Table C.25). State-level estimates ranged from 3.1 percent in Georgia and Texas to 5.0 percent in Utah. Having serious thoughts of suicide in the past year was highest among young adults aged 18 to 25 (6.4 percent nationwide) in 2009-2010 (Table B.25).

Between 2008-2009 and 2009-2010, an increase in the percentage of adults having had serious thoughts of suicide was seen in Delaware (from 3.0 to 3.9 percent among all adults 18 or older). No other changes in any State or age group were observed.

6.4  Youth and Adult Depression

Whether a person has a major depressive episode is determined from the criteria specified in the DSM-IV (APA, 1994). The NSDUH questionnaire allows for the production of various estimates related to major depressive episode, including lifetime and past year prevalence, treatment, and role impairment. For this report, estimates were produced only for past year major depressive episode (i.e., depression). Some questions in the adult module differ slightly from questions in the adolescent depression module. Therefore, data on major depressive episode for adults aged 18 or older should not be compared or combined with data on major depressive episode for youths aged 12 to 17.

Nationwide in 2009-2010, 6.7 percent of adults aged 18 or older had a major depressive episode in the past year, which was similar to the rate from 2008-2009 (6.5 percent) (Table C.26). Estimates at the State level ranged from 5.9 percent in New Mexico to 8.2 percent in Utah (Table B.26). Between 2008-2009 and 2009-2010, rates of depression among adults aged 18 or older increased in Iowa and Ohio (Table C.26).

In 2009-2010, 8.1 percent of youths aged 12 to 17 experienced depression nationwide during the past year (Table B.26), which was similar to the rate in 2008-2009 (8.2 percent) (Table C.26). In 2009-2010, rates of depression among youths ranged from 6.9 percent in the District of Columbia and Louisiana to 9.6 percent in Missouri. At the State level, there were no significant changes in the rates of depression among youths between 2008-2009 and 2009-2010.

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Figure 6.1 Serious Mental Illness in Past Year among Persons Aged 18 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.1

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.2 Serious Mental Illness in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.2

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.3 Serious Mental Illness in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.3

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.4 Any Mental Illness in Past Year among Persons Aged 18 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.4

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.5 Any Mental Illness in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.5

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.6 Any Mental Illness in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.6

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.7 Had Serious Thoughts of Suicide in Past Year among Persons Aged 18 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.7

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.8 Had Serious Thoughts of Suicide in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.8

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.9 Had Serious Thoughts of Suicide in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.9

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.10 Had at Least One Major Depressive Episode in Past Year among Persons Aged 18 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.10

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.11 Had at Least One Major Depressive Episode in Past Year among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.11

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.12 Had at Least One Major Depressive Episode in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.12

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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Figure 6.13 Had at Least One Major Depressive Episode in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2009 and 2010 NSDUHs

Figure 6.13

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2009 and 2010 (Revised March 2012).

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