MH-CLD Frequently Asked Questions

The Mental Health-Client Level Data (MH-CLD) is a compilation of several variables over a period of time. 

The variables are all related to clients served by the State Mental Health Agencies (SMHAs) and include:

• demographic information, 
• clinical attributes, and 
• National Outcomes Measures (NOMs) 

All of which must be within a 12-month reporting period. 

State Mental Health Agencies (SMHAs) submit information on: 

• all enrolled clients 
• who were served by the SMHA 
• within a 12-month reporting period. 

That is, for every reporting period, SMHAs submit data on new, continuing, and discharged clients during the reporting period. Only clients in the SMHA caseload who receive a service during the reporting period are reported. 

The 12-month reporting period corresponds 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

State Mental Health Agency’s (SMHAs) elect which reporting period to use. They use the same 12-month reporting period as their Uniform Reporting System (URS) data submission. 

State Mental Health Agencies (SMHAs) are responsible for mental health and support services. SMHAs are in charge of facilitating these publicly funded services. They are also in charge of providing these services to both children and adults with mental illnesses. They report the data according to the Behavioral Health Services Information System (BHSIS). 

SMHAs submit two data sets in a reporting period:

• Basic Client Information (BCI) data sets—due December 1st of each year.
• State Hospital Readmission (SHR) data sets—due about March 1st of the following year.

Both datasets provide the data that inform the mental health National Outcome Measures (NOMs). 

Mental Health Client Level Data (MH-CLD) is collected for, and reported to, SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ). This is done by the State Mental Health Agencies (SMHAs). SMHAs follow the reporting terms and conditions of the Behavioral Health Services Information System (BHSIS). These agreements are funded by SAMHSA.

The BHSIS Agreement requires that states and jurisdictions send client-level data by December 1st of each year. This keeps them in compliance with Mental Health Block Grant reporting requirements (42 U.S.C. §300x–6). 

The (MH-CLD) collection reflects SAMHSA’s interest in the behavioral health model within healthcare reform. 

Several factors were considered when deciding the reporting specifications. These include:

• adherence to the Treatment Episode Data Set (TEDS) system,
• appropriate reporting of outcomes for mental health consumers, and 
• the feasibility and burden of reporting specific data elements

SAMHSA received comments from states and territories on the burden this might present. Because of this feedback, the requirements are based on National Outcome Measures (NOMs). And only the essential information needed for NOM.

Clients included are those who received mental health and support services. 

Services may include: 

• screening, 
• assessment, 
• crisis services, and 
• telemedicine

These must be from programs operated or funded by the SMHAs during the 12-month reporting period.

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

States and territories have the option to participate in BHSIS: 

• conference calls, 
• webinars, 
• virtual discussion board group discussions, 

and other related activities, as needed, to prepare the data for submission. 

The Basic Client Information (BCI) dataset contains required and optional data elements on client: 

• demographics, 
• clinical attributes, and 
• outcomes. 

BCI is the master data file. It contains information on:

• all children and adults
• receiving mental health services
• that are provided by State Mental Health Agencies (SMHAs)
• during the reporting period. 

Clients reported on in this file are those who received services from:

• SMHA-funded or SMHA-operated community programs, 
• state hospitals, 
• other psychiatric inpatient facilities, 
• residential treatment centers, or
• institutions under the justice system, such as jails or prisons

The State Hospital Readmission (SHR) dataset contains: 

• all clients 
• who were discharged from a state hospital 
• during the reporting period, 

The exceptions to it are those discharges that constitute: 

• a transfer to a different unit or ward 
• a change of legal status within the same facility or 
• a transfer for short-term, acute, medical treatment 
  • where the client returns to continue their state hospital treatment during the reporting period. 

The SHR records the number of days elapsed following each discharge event and the succeeding readmission to the state hospital. 

• The readmission is measured for 30 and 180 days.  

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

No, Mental Health Client Level Data (MH-CLD) data is not optional for data reporting. Reporting this data is required. 

If you are a state or a State Mental Health Agency (SMHA) seeking assistance, please contact the Behavioral Health Services Information System (BHSIS) program office. You can call the BHSIS office toll-free at 1-833-888-1553 (Mon-Fri 8 a.m. - 6 p.m. ET) or email FindTreatment@samhsa.hhs.gov.

The Basic Client Information (BCI) and State Hospital Readmission (SHR) data files are prepared and submitted through the MH-CLD Data Submission System (DSS). SAMHSA and state representatives cooperatively developed the MH-CLD DSS. It is an intuitively designed system that allows states and territories to: 

• access MH-CLD reporting requirements,
• visualize their data through graphics, 
• review a simplified and informative edit report and 
• apply corrective actions, if needed, before submission. 

This system makes it easier for states and territories to follow reporting requirements.

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

• In 2011, there were 19 states and jurisdictions
• In 2022, there were 53 states and jurisdictions

To see detailed breakdowns of state and territory reporting methods and periods, please see Table C-1 in the most recent annual report. 

All states and territories must submit annual data on or about December 1 of each reporting year. This is required by Title XIX, Part B, Subpart III of the Public Health Service Act (42 U.S.C. §300x–52(a)). 

Under extenuating circumstances, special requests for extensions to submit the required data may be granted. Requests for extensions are not encouraged. Any granted extensions for data submissions are not guaranteed. 

Failure to comply with these requirements may lead to enforcement actions. This could result in suspension or reduction of block grant payments, as stipulated in 42 U.S.C. 300x-55. 

If you are a state or a State Mental Health Agency (SMHA) in need of help, please contact the Behavioral Health Services Information System (BHSIS) program office. You can call the BHSIS office toll-free at 1-833-888-1553 (Mon-Fri 8 a.m. - 6 p.m. ET) or email FindTreatment@samhsa.hhs.gov.

SAMHSA reports the most recent MH-CLD reporting period data on an annual basis. The preparation of data cannot begin until states 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 the annual report. It could also generate a lag in publication time. Because of this, CBHSQ does not encourage or guarantee deadline extensions to states and territories.

The Community Mental Health Services Block Grant (MHBG) program gives access to funding to all U.S. states and territories. These funds are intended to provide community mental health services for two main populations.

The targeted populations of the MHBG are:

• adults (ages 18 and older) with serious mental illness (SMI) and
• children (ages 0-17) with serious emotional disturbances (SED). 

Mental Health Client Level Data (MH-CLD) is part of the reporting requirements of the MHBG and is aligned with the Uniform Reporting System (URS). SAMHSA’s authority to collect data from MH-CLD and URS from states and territories comes from the MHBG statute. 

The block grant statutory provisions outline several requirements for states and territories, 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. 

Grantees are expected to report data on all clients served during the reporting period. 

SAMHSA uses the Mental Health Client Level Data (MH-CLD) to enhance our understanding of publicly funded mental health treatment service systems. 

The data are used to: 

• examine these service systems over time; 
• to inform decisions about SAMHSA’s use of its mental health block grant funds; 
• to assess outcomes of treatment for clients; and
• to better understand the technical assistance and support needs of mental health providers and the communities they serve. 

Center for Behavioral Health Statistics and Quality tracks 10 National Outcome Measures (NOMs). These serve as performance targets for states and federally funded programs for: 

• substance misuse prevention,
• mental health promotion, 
• early intervention, and 
• treatment services. 

Other clinical measures include: 

• mental health diagnosis, 
• Severe Mental Illness (SMI) status,
• Severe Emotional Disturbance (SED) status, 
• co-occurring mental and substance use disorders, and 
• mental health service setting. 

Mental Health Client Level Data (MH-CLD) has data for 5 of the 10 NOMs. Those NOMs are: 

1. increased access to services, 
2. increased stability in living conditions, 
3. reduced use of psychiatric inpatient beds,
4. increased employment for adults, or to stay in or return to school for children, and
5. decreased criminal justice involvement. 

The remaining 5 NOMs that CBHSQ collects are in the Uniform Reporting System (URS). 

No, data reported in Mental Health Client Level Data (MH-CLD) does not represent the total national demand for mental health treatment. It also does not describe the mental health status of the national population.

The data in MH-CLD only represents:

• clients served through State Mental Health Agencies (SMHAs)
• during the state-defined 12-month reporting period

No, it is not possible to identify a client through the Mental Health Client Level Data (MH-CLD). One of the important features of MH-CLD reporting is its use of non-protected health information (non-PHI). No personal identifying information is reported in the data files.

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. 

Mental Health Client Level Data (MH-CLD) collects data on these clinical measures: 

• mental health diagnosis, 
• Serious Mental Illness (SMI), 
• Serious Emotional Disturbance (SED), 
• co-occurring mental and substance use disorders, and
• mental health service settings. 

Yes, it is available to the public and researchers. Please visit the Mental Health Client-Level Data (MH-CLD) page to access the public use data files. 

Mental Health Client Level Data (MH-CLD) collects data on: 

• age, 
• sex, 
• race, 
• ethnicity, 
• marital status, and 
• veteran status. 

Data is collected only at the state level. There is no county-level data available in the MH-CLD. 

No, the Mental Health Client Level Data (MH-CLD) is not comparable. The number of states submitting client-level data varies between each reporting period. 

Because of this, many apparent differences across reporting periods may be more of a function of state reporting changes. Not from actual changes in client characteristics over time.