MH-CLD Frequently Asked Questions

MH-CLD is a compilation of the demographic, clinical, and socioeconomic characteristics and National Outcomes Measures (NOMs) of persons who are receiving mental health and support services from programs provided or funded by a State Mental Health Agency (SMHA) within a 12-month window. 

Clients included in the MH-CLD are those who received mental health and support services from programs operated or funded by SMHAs during the 12-month reporting period. Clients who receive screening, assessment, crisis services, and telemedicine services should also be reported. Data should be reported for all clients in the reporting facilities, regardless of individual client funding source—federal block grants, Medicaid, Medicare, private insurance, self-pay, or no charge. In other words, all clients who received mental health and support services should be reported if the provider is part of the SMHA system. However, clients with only a diagnosis of, or receiving only specialty services for, substance use, intellectual disabilities, or developmental disabilities should be excluded from MH-CLD reporting.

Information on clients who received mental health and support services is collected through state administrative systems and then is reported to the Substance Abuse and Mental Health Services Administration (SAMHSA) by the SMHAs

The number of states and territories reporting mental health client data to SAMHSA using MH-CLD/MH-TEDS has increased over the years:

• In 2011, 19 states and territories reported MH-CLD.
• In 2023, 53 states and territories reported MH-CLD (including 19 states reporting MH-TEDS data subsequently processed to MH-CLD data).

To see detailed breakdowns of states and territories’ reporting methods and periods over the past five years, please see Table C-1 in the most recent Annual Report. Comprehensive historical data can be found in the Annual Detail Tables, Appendix B, Table B1.

MH-CLD are collected by State Mental Health Agencies (SMHAs) and submitted to SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ), following the reporting terms and conditions of the Behavioral Health Services Information System (BHSIS) State Agreement. The BHSIS State Agreement requires that states and territories send client data annually. This keeps them compliant with the Community Mental Health Block Grant (MHBG) reporting requirements (42 U.S.C. §300x–6). 

SMHAs are responsible for facilitating and/or providing publicly funded mental health and support services to children and adults with mental illnesses. They are also responsible for submitting two datasets: Basic Client Information (BCI) and State Hospital Readmission (SHR) per reporting period in accordance with the BHSIS State Agreement. 

SAMHSA uses the MH-CLD to enhance our understanding of publicly funded mental health and support service systems.

Specifically, the data are used to:

• Examine the characteristics of clients served and their changes over time;
• Assess outcomes of services received by clients;
• Inform decisions about SAMHSA’s use of its Mental Health Block Grant funds; and
• Better understand the technical assistance and support needs of mental health providers and the communities they serve. 

The BCI dataset is one of the datasets that constitute MH-CLD. It is a client-level dataset that includes demographics (age, sex, race, ethnicity, and marital status), clinical status (SMI/SED status, mental health and substance use diagnoses, substance use problem, GAF/CGAS score), and outcomes (employment, living situation, criminal justice involvement, and education). All children and adults who received mental health and support services provided by State Mental Health Agencies (SMHAs) during the reporting period are included in the dataset.

The clients reported in BCI dataset are those who received services from:

• SMHA-funded or SMHA-operated community programs
• State hospitals
• Other psychiatric inpatient facilities
• Residential treatment centers
• Institutions under the justice system (such as jails or prisons)

It is one of the datasets that constitute MH-CLD. It is a dataset that contains all discharge events from state hospitals during the reporting period, except discharges that constitute a transfer within the same facility or for short-term acute medical treatment after which the clients return to continue their state hospital treatment. It records the number of days elapsed following each discharge event and the succeeding readmission to the state hospital. The readmission is observed and measured for 30 and 180 days, following the end of a reporting year.

Clients included in the SHR dataset must also be reported in the Basic Client Information (BCI) dataset. These two datasets are linkable using the Client IDs. 

States can use a 12-month reporting period corresponding to either the state fiscal year (July 1 – June 30, October 1 – September 30, September 1 – August 31, or April 1 – March 31) or the calendar year (January 1 – December 31), depending on the SMHA’s election. However, SMHAs must use the same 12-month reporting period as their Uniform Reporting System (URS) data submission when submitting MH-CLD. 

No. All states and territories must submit their data to fulfil reporting requirements under the terms and conditions of the SAMHSA funded Behavioral Health Services Information System (BHSIS) Agreement and the Community Mental Health Services Block Grant (MHBG) data reporting requirements as mandated by Title XIX, Part B, Subpart III of the Public Health Service Act (42 U.S.C. §300x–52(a)). 

The Basic Client Information (BCI) dataset is due December 1^st of each year and the State Hospital Readmission (SHR) dataset is due March 1^st of the following year. 

All states/territories must submit data as required by 42 U.S.C. §300x–52(a) by the due date specified in Title XIX, Part B, Subpart III of the Public Health Service Act (42. USC §300x-6).

Under extenuating circumstances, extensions for submitting the required data may be requested. However, requests for extensions are not encouraged and granting such requests is not guaranteed. Failure to comply with these requirements may lead to enforcement actions, potentially resulting in suspension or reduction of block grant payments, as stipulated in 42 U.S.C. 300x-55.

SAMHSA publishes Annual Reports, public-use files (PUFs), and other ad hoc reports, using the most recent MH-CLD reporting period data on an annual basis. The preparation of these dissemination materials cannot begin until all states and territories have completed their data submission for that year. CBHSQ must balance the timeliness of reporting and the completeness of the dataset. If a state or territory does not submit complete data on time, they risk not being included in these dissemination materials. It could also generate a lag in publication time. Because of this, CBHSQ does not encourage or guarantee deadline extensions to states and territories.

In addition, the Uniform Reporting System (URS) tables, required as part of the states’ application package for the Community Mental Health Services Block Grant (MHBG), cannot be populated using MH-CLD in a timely manner if the BHSIS Project Office does not receive the data on time.

States and territories use a web-based data preparation and submission system, called the MH-CLD Data Submission System (MH-CLD DSS). The MH-CLD DSS is designed to provide a secure, interactive, and transparent data submission process and to facilitate states’ and territories’ adherence to reporting requirements. The MH-CLD DSS allows states and territories to:

• Easily and securely upload state data.
• Identify data errors and quality issues through a simplified and informative edit report with table and graphics.
• Apply corrective actions, if needed, before submission. 

The Behavioral Health Services Information System (BHSIS) Project Office provides technical assistance to help states and territories to prepare the data for submission through conference calls, webinars, virtual discussion board group discussions, and other related activities as needed.

States are highly encouraged to reach out to the BHSIS Project Office for any technical assistance they need for data reporting. They can call the BHSIS Project Office toll-free number at 1-833-888-1553 (Mon-Fri 8 a.m. - 6 p.m. ET) or email BHSIS@samhsa.hhs.gov.

The MHBG is the principal federal block grant program supporting community-based mental health services for adults with SMI and children with SED. The program makes funds available to all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and six Pacific Jurisdictions. The MHBG program is authorized by sections 1911-1920 of Title XIX, Part B, Subpart I and III of the Public Health Service (PHS) Act (42 U.S.C. §300x - §300x-9).  Provisions in Section 1941 – 1958 of the Public Health Service Act (42 U.S.C. §300x-51 – §300x-68 (except Section 1955, §300x-65) also apply to the MHBG.  

MH-CLD is part of the reporting requirements of the MHBG and is aligned with the Uniform Reporting System (URS). The authority for SAMHSA to collect MH-CLD from states is derived from the MHBG statute. While the targeted populations of the MHBG are adults with serious mental illness and children with serious emotional disturbances, grantees are expected to report data on all clients served by SMHAs during the reporting period. Some of the URS tables can be populated using MH-CLD submitted by states, which are submitted as part of the MHBG application. The block grant statutory provisions outline several requirements for states, including the need for the application to contain each funding agreement, assurances of compliance, submission of required reports, and adherence to the form and manner specified by the Secretary.

States that are requesting population of URS tables from MH-CLD data must submit a population request by February 28. States need to adhere to the data submission due date of March 1 and ensure all data covering the URS reporting period are received by the BHSIS Project Office. They should also ensure that the state data are successfully accepted and processed by the BHSIS Project Office by March 14, by addressing any data issues identified by the BHSIS Project Office. This will allow the BHSIS Project Office to populate the URS tables in a timely manner. States that are unable to complete updates by this date must populate the affected URS tables themselves.

States must conform to the state’s URS reporting period when submitting the data. The URS reporting period can be either the calendar year or the state fiscal year, with or without a lag time. For example, if the state’s URS reporting period covers the period from July 1, 2024, through June 30, 2025, then the state should ensure that all client data corresponding to this period should be submitted by the December 1, 2025 due date.

To calculate the State Hospital 30-day and 180-day Readmission Rates NOMs, states must submit records for all state hospital discharges that occurred during the reporting period plus the records for admissions that occurred in the 6 months following the end of the reporting period. This means that records for all state hospital admissions that occurred between July 1, 2024, and December 31, 2024, must be submitted by March 1 of the following year (March 1, 2025).

The following URS tables can be populated using MH-CLD:

• URS Tables 2A and 2B (MHBG Tables 8A and 8B): Profile of Persons Served—All Programs by Age, Sex, Race, and Ethnicity.
• URS Tables 2C and 2D (MHBG Tables 8C and 8D): Profile of Persons Served—All Programs by Sexual Orientation, Race, and Ethnicity
• URS Table 3 (MHBG Table 9): Profile of Persons Served in Community Mental Health Setting, State Psychiatric Hospitals, and Other Settings.
• URS Tables 4 and 4A (MHBG Tables 15A and 15B): Profile of Adult Clients by Employment Status and Primary Diagnosis.
• URS Tables 5A and 5B (MHBG Tables 10A and 10B): Profile of Persons Served by Type of Funding Support in All Programs by Sex, Race, and Ethnicity
• URS Tables 14A and 14B (MHBG Tables 13A and 13B): Profile of Persons with SMI/SED served by Age, Sex, Race, and Ethnicity.
• URS Table 14C (MHBG Table 14): Profile of Persons Served in Community Mental Health Setting, State Psychiatric Hospitals, and Other Settings for Adults with SMI and Children with SED.
• URS Table 15 (MHBG Table 18): Living Situation Profile.
• URS Tables 20A and 20B (MHBG Tables 23A and 23B): Profile of Non-Forensic/Forensic (Voluntary and Civil Involuntary) Patients Readmission to any State Psychiatric Inpatient Hospital within 30/180 Days of Discharge.

Prior to generating the URS tables, the BHSIS Project Office will consult with each state regarding the summary statistics derived from the compiled MH-CLD data files that will be used to populate the tables. The populated URS tables will then be combined with the rest of the URS tables to comprise a complete state URS data set for the reporting period.

The five NOMs that are captured by MH-CLD and their relevant fields are summarized as followed:

Public-use files (PUFs) are available to the general public in SAS, SPSS, Stata, R, and ASCII comma-delimited formats. To access the public-use data files, please visit https://www.samhsa.gov/data/data-we-collect/mh-cld-mental-health-client-level-data. 

MH-CLD collects demographic data including age, sex, race, and ethnicity as required data fields and marital status and veteran status as optional data fields. 

MH-CLD collects data on these clinical measures:

• Mental health diagnosis
• Serious Mental Illness (SMI) and Serious Emotional Disturbance (SED)
• Co-occurring mental and substance use disorders

No, data reported in MH-CLD do not represent the mental health status of the national population or the total national demand for mental health and support services. The data in MH-CLD only represent clients served through SMHAs during the state-defined 12-month reporting period. 

No, MH-CLD are not comparable across years or across states. The number of states submitting client-level data varies between each reporting period. The type of providers and facilities operated and funded by SMHAs also varies across states and territories.

Because of this, many apparent differences across reporting periods or across states and territories may be a result of changes in reporting practices and not from actual changes or differences in client characteristics. 

No, it is not possible to identify a client through the MH-CLD. One of the important features of MH-CLD reporting is its use of non-protected health information (non-PHI). No personally identifying information is reported in the data files. The MH-CLD files use a unique client ID, which is used for reporting any information on a particular client within and across reporting periods. However, this client ID does not contain any PHI.

Furthermore, additional measures (such as recoding location and other demographic variables for records with a unique combination of variables) are taken to ensure confidentiality protection.

The client-level data files use a unique, non-PHI client ID. This ID is used for reporting any information on a particular client, within and across reporting periods. 

More information on PHI can be found on this Summary of the HIPPA Privacy Rule page. 

MH-TEDS is an alternative to MH-CLD reporting. States may choose to report MH-TEDS or MH-CLD; however, all states and territories must submit data on clients who receive mental health and support services from programs operated or funded by the SMHAs to fulfill reporting requirements under the terms and conditions of the SAMHSA funded Behavioral Health Services Information System (BHSIS) Agreement and the Community Mental Health Services Block Grant (MHBG) client-level data reporting requirements and as required by Title XIX, Part B, Subpart III of the Public Health Service Act (42 U.S.C. §300x–52(a)).

MH-TEDS data collected by SMHAs are rolled up to produce two data sets: Basic Client Information (BCI) and State Hospital Readmission (SHR) data. BCI data is due on December 1 and the SHR data is due on March 1 of the following year. To facilitate the production of these data sets, the BHSIS Project Office requires that SMHAs submit all relevant admission, update, and discharge records covering the reporting period by December 1 and the records for admissions that occurred in the 6 months following the end of the reporting period by March 1 of the following year.

Monthly or quarterly reporting at minimum is strongly recommended. Routine submission of records facilitates data processing at the BHSIS Project Office and to help states ease the burden of reporting very large data files and allow for more timely detection and resolution of data errors or quality issues. It is not necessary to wait until the statutory MH-CLD’s due date of December 1 or March 1 each year to submit MH-TEDS files.

If the state is in possession of additional MH-TEDS records pertaining to the previous year’s reporting and with an admission date of January 1, 1920, or later, the records may be submitted at any time. The MH-TEDS database will be updated accordingly.

SMHAs submit MH-TEDS admissions and discharges data through the TEDS Data Submission System (TEDS DSS). The TEDS DSS is a web-based data preparation and submission system designed to provide an interactive and transparent data submission process. These functionalities, along with the overall intuitive design of the TEDS DSS, provide states and territories with easier access to and the means to comply with MH-TEDS reporting requirements.

A provider may generate a separate “admission” record for every billable service for the same client (e.g., group therapy, individual therapy, etc.). If these services were delivered within a single service setting (e.g., outpatient), report only the first record to MH-TEDS as the admission record and the last as the discharge record to MH-TEDS for the service setting and the provider.

MH-TEDS does not collect data on the individual services delivered, but only on the general service setting.

The same record should be submitted to both MH-TEDS and SU-TEDS to avoid undercounting clients in either of the systems.

States that are requesting population of URS tables from MH-TEDS data must submit a population request by February 28. States need to adhere to the data submission due date of March 1 and ensure all data covering the URS reporting period are received by the BHSIS Project Office. They should also ensure that the state data are successfully accepted and processed by the BHSIS Project Office by March 14, by addressing any data issues identified by the BHSIS Project Office. This will allow the BHSIS Project Office to pre-populate the URS tables in a timely manner. States that are unable to complete updates by this date must populate the affected URS tables themselves.

States must conform to the state’s URS reporting period when submitting the data. The URS reporting period can be either the calendar year or the state fiscal year, with or without a lag time. For example, if the state’s URS reporting period covers the period from July 1, 2024, through June 30, 2025, then the state should ensure that all MH-TEDS admission and discharge data corresponding to this period should be submitted by the December 1, 2025, due date.

In order to calculate the State Hospital 30-day and 180-day Readmission Rates NOMs, states must submit records for all state hospital discharges that occurred during the reporting period plus the records for admissions that occurred in the 6 months following the end of the reporting period. This means that records for all state hospital admissions that occurred between July 1, 2024, and December 31, 2024, must be submitted by March 1 of the following year (March 1, 2025).

MH-TEDS data are converted and rolled up to MH-CLD. MH-CLD public-use files (PUFs) are available to the general public in SAS, SPSS, Stata, R, and ASCII comma-delimited formats. To access the PUFs, please visit here: https://www.samhsa.gov/data/data-we-collect/mh-cld-mental-health-client-level-data.