Highlights of the National Mental Health Services Survey, 2010

In Brief
  • In 2010, 10,374 eligible facilities responded to the National Mental Health Services Survey (N-MHSS) and reported a 1-day census of 3,186,636 clients enrolled in mental health treatment on April 30, 2010.
  • The majority of facilities surveyed (67.2 percent) were operated by private nonprofit entities, about 10 percent were operated by private for-profit entities, and the remainder were operated by the U.S. Department of Veterans Affairs, state, local, or regional governments or authorities.
  • Sixty-one percent of facilities were outpatient or day treatment or partial hospitalization facilities, 18 percent were psychiatric hospitals or psychiatric units within general hospitals, 16 percent were residential treatment centers, 3 percent were multisetting nonhospital facilities, and slightly more than 2 percent were facilities operated by the U.S. Department of Veterans Affairs.

This issue of The N-MHSS Report is designed to complement The N-MHSS Report: Introduction to the National Mental Health Services Survey, 2010 and presents tables of general results from the 2010 N-MHSS. Full findings are available on the SAMHSA Web site at http://www.samhsa.gov/data/DASIS.aspx#NMHSS.

The National Mental Health Services Survey (N-MHSS) is an annual1 survey of all known mental health treatment facilities in the United States, both public and private. The N-MHSS is conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) and is designed to collect data on the location, characteristics, and use of mental health treatment facilities throughout the 50 states, the District of Columbia, and other U.S. jurisdictions.2

There were 10,374 eligible mental health treatment facilities that responded to the 2010 N-MHSS, and they reported 3,186,636 clients in mental health treatment on the survey reference date of April 30, 2010. The overall survey response rate was 91 percent.

Data from the 2010 N-MHSS provide information about the basic characteristics of mental health treatment facilities. More than two-thirds of facilities surveyed in 2010 were operated by private nonprofit entities, about 10 percent were operated by private for-profit entities, and the remainder were operated by federal, state, local, or tribal governments. (Table 1). The majority (60.8 percent) of mental health facilities are outpatient or day treatment or partial hospitalization facilities (Table 2). More than three-fourths of facilities accepted Medicaid, client/patient fees, and private insurance (Table 3a). About 61 percent of facilities offered a sliding-fee scale (60.5 percent) or treatment at no charge (60.6 percent) (Table 3b).

Table 1. Facility operation: 2010
Facility operation Number of
facilities		 Percent of
facilities*
Private nonprofit organization   6,968   67.2%
Private for-profit organization      996     9.6%
Local, county, or municipal government      953     9.2%
State mental health agency      727     7.0%
Other state government      274     2.6%
U.S. Department of Veterans Affairs      252     2.4%
Regional or district authority      191     1.8%
Other        13     0.1%
Total 10,374 100.0%
* Percentages may not sum to totals due to rounding.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Mental Health Services Survey (N-MHSS), 2010.

Table 2. Facility type: 2010
Facility type* Number of
facilities		 Percent of
facilities**
Outpatient or day treatment or partial hospitalization mental health facility   6,305   60.8%
Public   1,519   14.6%
Private   4,786   46.1%
Separate inpatient psychiatric unit of a general hospital   1,170    11.3%
Public      155     1.5%
Private   1,015     9.8%
Residential treatment center for adults      875     8.4%
Public      116     1.1%
Private      759     7.3%
Residential treatment center for children      781     7.5%
Public        26     0.3%
Private      755     7.3%
Psychiatric hospital      648     6.2%
Public      272     2.6%
Private      376     3.6%
Multisetting (nonhospital) mental health facility      343     3.3%
Public        57     0.5%
Private      286     2.8%
U.S. Department of Veterans Affairs (VA)*      252     2.4%
Public      252     2.4%
Total 10,374 100.0%
* Facility types were identified based on responses to question A5 (facility type) on the survey questionnaire. VA facilities were identified based on responses to question A7 (facility operation) on the survey questionnaire, regardless of facility type response to question A5. Therefore, all categories are mutually exclusive.
** Percentages may not sum to totals due to rounding.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Mental Health Services Survey (N-MHSS), 2010.

Table 3A. Funding or payments accepted: 2010
Type of payment/funding accepted by
facility*		 Number of
facilities**		 Percent of
facilities
Medicaid 8,062 88.2%
Client/patient fees 7,689 84.1%
Private insurance 7,166 78.4%
State mental health agency funds 6,466 70.8%
Medicare 6,324 69.2%
Local government funds 4,493 49.2%
State welfare or child/family services agency funds 4,092 44.8%
Community mental health block grants 3,375 36.9%
State corrections/juvenile justice agency funds 2,932 32.1%
Community service block grants 2,214 24.2%
U.S. Department of Veterans Affairs (VA) funds 2,177 23.8%
State education agency funds 1,922 21.0%
Other private funds    687   7.5%
Other public funds    527    5.8%
* Facilities may accept payment/funding from more than one source; therefore, they may be included in more than one category.
** Of the 10,374 facilities in the N-MHSS, basic facility information, service characteristics, and client counts were reported for 9,139 facilities. This table excludes the 1,235 facilities that did not report service characteristics.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Mental Health Services Survey (N-MHSS), 2010.

Table 3B. Availability of treatment at no charge/sliding-fee scale: 2010
Type of payment/funding accepted by
facility*		 Number of
facilities**		 Percent of
facilities
Offers treatment at no charge 5,537 60.6%
Uses sliding-fee scale 5,527 60.5%
* Facilities may provide treatment at no charge to the client or use a sliding-fee scale; therefore, facilities may be included in more than one category.
** Of the 10,374 facilities in the N-MHSS, basic facility information, service characteristics, and client counts were reported for 9,139 facilities. This table excludes the 1,235 facilities that did not report service characteristics.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Mental Health Services Survey (N-MHSS), 2010.

On April 30, 2010, there were 60,764 clients in residential mental health care and 99,493 in inpatient mental health care. There were 3,026,379 clients who received outpatient mental health care at least once in April 2010 and were still enrolled in treatment as of April 30, 2010 (Table 4). More than half of facilities offered special treatment programs for adults with serious mental illness (SMI) (62.8 percent) or individuals with co-occurring mental health and substance use disorders (58.4 percent) (Table 5). The most common treatment approaches offered in mental health facilities were cognitive/behavioral therapy (88.2 percent), individual psychotherapy (85.8 percent), and group therapy (84.7 percent) (Table 6). Case management (73.8 percent) and family psychoeducation (60.1 percent) were among the most common supportive services provided (Table 7).


Table 4. Facility capacity and client counts (April 30, 2010): 2010
Facility setting Number of
clients
Residential treatment*
Number of residential facilities        2,274
Number of residential clients      60,764
Number of designated residential treatment beds      68,053
Hospital inpatient treatment**
Number of hospital inpatient facilities        1,975
Number of hospital inpatient clients      99,493
Number of designated hospital inpatient beds     113,569
Outpatient (including day treatment/partial hospitalization)***
Number of outpatient or day treatment or partial hospitalization facilities        7,931
Number of outpatient or day treatment or partial hospitalization clients 3,026,379
* Residential treatment is defined as those facilities that reported in question A3 that their facility offered treatment in a 24-hour residential service setting at that location.
** Hospital inpatient treatment is defined as those facilities that reported in question A3 that their facility offered treatment in a 24-hour hospital inpatient service setting at that location.
*** Outpatient (including partial day treatment/hospitalization treatment) is defined as those facilities that reported in question A3 that their facility offered treatment in an outpatient or day treatment or partial hospitalization service setting at that location.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Mental Health Services Survey (N-MHSS), 2010.

Table 5. Facilities offering treatment programs for specific client groups: 2010
Exclusively designed treatment
programs for specific client groups*		 Number of
facilities**		 Percent of
facilities
Adults with serious mental illness 5,738 62.8%
Individuals with co-occurring mental health and substance use disorders 5,333 58.4%
Individuals with post-traumatic-stress disorder 4,569 50.0%
Individuals with co-occurring mental health and nonsubstance use disorders 4,299 47.0%
Youth with serious emotional disturbance 3,944 43.2%
Forensic clients (referred from the court/judicial system) 2,986 32.7%
Transition-aged young adults aged 18-25 2,747 30.1%
Gay, lesbian, bisexual, or transgendered clients 2,405 26.3%
Veterans 2,086 22.8%
Individuals with Alzheimer's or dementia 1,165 12.7%
Individuals with traumatic brain injury 1,057 11.6%
Other specific client groups    568   6.2%
* Facilities may offer more than one exclusively designed treatment program/group for specific client groups; therefore, they may be included in more than one category.
** Of the 10,374 facilities in the N-MHSS, basic facility information, service characteristics, and client counts were reported for 9,139 facilities. This table excludes the 1,235 facilities that did not report service characteristics.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Mental Health Services Survey (N-MHSS), 2010.

Table 6. Facilities offering various treatment approaches: 2010
Treatment approach* Number of
facilities**		 Percent of
facilities
Cognitive/behavioral therapy 8,061 88.2%
Individual psychotherapy 7,844 85.8%
Group therapy 7,742 84.7%
Psychotropic medication therapy 7,601 83.2%
Couples/family therapy 6,129 67.1%
Behavior modification 5,950 65.1%
Integrated dual disorders treatment 4,967 54.3%
Activity therapy 4,676 51.2%
Telemedicine therapy 1,409 15.4%
Electroconvulsive therapy    573  6.3%
Other treatment approach    763  8.3%
* Facilities may offer more than one treatment approach; therefore, they may be included in more than one category.
** Of the 10,374 facilities in the N-MHSS, basic facility information, service characteristics, and client counts were reported for 9,139 facilities. This table excludes the 1,235 facilities that did not report service characteristics.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Mental Health Services Survey (N-MHSS), 2010.

Table 7. Facilities offering supportive services: 2010
Supportive services offered by facility* Number of
facilities**		 Percent of
facilities
Case management 6,741 73.8%
Family psychoeducation 5,490 60.1%
Suicide prevention services 5,230 57.2%
Psychosocial rehabilitation services 4,347 47.6 %
Education services 4,066 44.5%
Psychiatric emergency walk-in services 3,392 37.1%
Illness management and recovery 3,027 33.1%
Smoking cessation services 2,190 24.0%
Housing services 2,171 23.8%
Supported employment 1,884 20.6%
Chronic disease/illness management 1,849 20.2%
Supported housing 1,699 18.6%
Consumer-run services 1,695 18.5%
Assertive community treatment 1,621 17.7%
Vocational rehabilitation services 1,459 16.0%
Legal advocacy    766  8.4%
Therapeutic foster care    650  7.1%
Other supportive services    528  5.8%
* Facilities may offer more than one supportive service; therefore, they may be included in more than one category.
** Of the 10,374 facilities in the N-MHSS, basic facility information, service characteristics, and client counts were reported for 9,139 facilities. This table excludes the 1,235 facilities that did not report service characteristics.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Mental Health Services Survey (N-MHSS), 2010.

End Notes
1 Previously, the N-MHSS was a biennial survey. Beginning in 2014, the N-MHSS will be conducted annually, alternating years between a full-scale questionnaire and an abbreviated locator questionnaire. In 2012, the abbreviated locator questionnaire was administered. In 2014, the full-scale N-MHSS will be conducted, and the abbreviated N-MHSS-Locator Survey will be conducted in 2015. The abbreviated N-MHSS-Locator Survey includes only basic facility information needed to update SAMHSA's online Behavioral Health Treatment Services Locator (http://findtreatment.samhsa.gov/).
2 The other U.S. jurisdictions include the territory of Guam, the Federated States of Micronesia, the Republic of Palau, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands.

Suggested Citation
Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (August 7, 2014). The N-MHSS Report: Highlights of the National Mental Health Services Survey, 2010. Rockville, MD

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.

The National Mental Health Services Survey (N-MHSS) is one component of the Behavioral Health Services Information System (BHSIS), maintained by the Center for Behavioral Health Statistics and Quality (CBHSQ), SAMHSA. The N-MHSS is an annual1 survey designed to collect information from all mental health treatment facilities in the United States, both public and private. N-MHSS provides the mechanism for quantifying the dynamic character and composition of the U.S. mental health treatment delivery system. The objectives of N-MHSS are to collect multipurpose data that can be used to assist SAMHSA and state and local governments understand the nature and extent of services provided, help forecast treatment resource requirements, update SAMHSA's Inventory of Behavioral Health Services (I-BHS), analyze general treatment services trends, and provide information for the Behavioral Health Treatment Services Locator (http://findtreatment.samhsa.gov/).

The N-MHSS collects three types of information from facilities: (1) characteristics of individual facilities such as services offered, types of treatment provided, primary focus of the facility, and payment options; (2) client count information such as counts of clients served by service type and number of beds designated for treatment; and (3) general information such as licensure, certification, or accreditation, and facility Web site availability. In 2010, N-MHSS collected information from 10,374 facilities from all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands.

The N-MHSS Report is prepared by the Center for Behavioral Health Statistics and Quality, SAMHSA; and RTI International, Research Triangle Park, NC. RTI International is a trade name of Research Triangle Institute. Information and data for this report are based on data reported to N-MHSS for the survey reference date April 30, 2010.

Latest N-MHSS public use files and variable definitions:
http://www.icpsr.umich.edu/icpsrweb/SAMHDA/

Other mental health reports:
http://www.samhsa.gov/data

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