National Mental Health Services Survey (N-MHSS), 2020

The 2019 N-MHSS survey universe included 14,936 facilities across the United States and other jurisdictions. Most facilities in the 2019 N-MHSS frame were identified from the updated database of the 2010 and 2014 N-MHSS; additional facilities were identified in the 2015, 2016, 2017, and 2018 mental health augmentation and from states’ requests for new facilities to be added to the Inventory of Behavioral Health Services (I-BHS).

Survey Coverage

The following types of mental health treatment facilities were included in the 2019 N-MHSS:

• Psychiatric hospitals are facilities licensed and operated as either state/public psychiatric hospitals or as state-licensed private psychiatric hospitals that primarily provide 24-hour inpatient care to persons with mental illness. They may also provide 24-hour residential care and/or less-than-24-hour care (i.e., outpatient, partial hospitalization/day treatment), but these additional service settings are not requirements.
• General hospitals with a separate inpatient psychiatric unit are licensed general hospitals (public or private) that provide inpatient mental health services in separate psychiatric units. These units must have specifically allocated staff and space for the treatment of persons with mental illness. The units may be located in the hospital itself or in a separate building that is owned by the hospital.
• Veterans Affairs (VA) medical centers are facilities operated by the U.S. Department of Veterans Affairs, including general hospitals with separate psychiatric inpatient units, residential treatment programs, and/or psychiatric outpatient clinics.
• Partial hospitalization/day treatment mental health facilities provide only partial-day mental health services to ambulatory clients, typically in sessions of three or more hours on a regular schedule. A psychiatrist generally assumes the medical responsibility for all clients and/or for the direction of their mental health treatment.
• Outpatient mental health facilities provide only outpatient mental health services to ambulatory clients, typically for less than three hours at a single visit. A psychiatrist generally assumes the medical responsibility for all clients and/or for the direction of their mental health treatment.
• Residential treatment centers (RTCs) for children are facilities not licensed as psychiatric hospitals that primarily provide individually planned programs of mental health treatment in a residential care setting for children under age 18 years. (Some RTCs for children may also treat young adults.) RTCs for children must have a clinical program that is directed by a psychiatrist, psychologist, social worker, or psychiatric nurse who has a master’s or doctoral degree.
• Residential treatment centers (RTCs) for adults are facilities not licensed as psychiatric hospitals that primarily provide individually planned programs of mental health treatment in a residential care setting for adults.
• Multi-setting mental health facilities provide mental health services in two or more service settings (non-hospital residential, plus either outpatient and/or day treatment/partial hospitalization), and are not classified as a psychiatric hospital, general hospital, medical center, or residential treatment center.
• Community mental health centers (CMHCs) provide either:
  • outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically mentally ill, and residents of its mental health service area who have been discharged from inpatient treatment at a mental health facility;
  • 24-hour emergency care services;
  • day treatment or other partial hospitalization services, or psychosocial rehabilitation services; or
  • screening for patients being considered for admission to state mental health facilities to determine the appropriateness of the admission. To be classified as a CMHC, a facility must meet applicable licensing or certification requirements for CMHCs in the state in which it is located.
• Other types of residential treatment facilities are facilities not licensed as psychiatric hospitals. The primary purpose of other types of residential treatment facilities is to provide individually planned programs of mental health treatment services in a residential care setting; such facilities are not specifically for children or adults only.
• Other refers to another type of hospital or mental health facility not defined in the categories above.

Exclusions

The survey universe for the 2019 N-MHSS excluded: (1) Department of Defense (DoD) military treatment facilities, (2) individual private practitioners or small group practices not licensed as a mental health clinic or center, and (3) jails or prisons. Facilities are not eligible for inclusion in the survey universe if they only provide one or more of the following services: crisis intervention services, psychosocial rehabilitation, cognitive rehabilitation, intake, referral, mental health evaluation, health promotion, psychoeducational services, transportation services, respite services, consumer-run/peer support services, housing services, or legal advocacy. Residential facilities whose primary function is not to provide specialty mental health treatment services are also not eligible for inclusion in the survey universe for the N-MHSS.

As with any data collection effort, limitations must be taken into account when interpreting data from N-MHSS.

• N-MHSS is a voluntary survey, and while it attempts to obtain responses from all known mental health treatment facilities within the scope of the survey, some facilities do not respond. The data are not adjusted for facility nonresponse.
• Multiple responses are allowed for certain questionnaire items (for example, services provided in languages other than English and types of payment or insurance accepted for mental health treatment services).

Considerations and limitations of specific data items are discussed where the data are presented.

For methodological information for a particular year or date range, please check the codebook for a specific data set above.