Receipt of Services for Substance Use and Mental Health Issues among Adults:
Results from the 2015 National Survey on Drug Use and Health

Authors

SAMHSA: Eunice Park-Lee, Rachel N. Lipari, and Sarra L. Hedden; RTI International: Elizabeth A. P. Copello and Larry A. Kroutil

Abstract

Background. Mental disorders and substance use disorders (SUDs) affect people of all age groups and from different socioeconomic statuses. These disorders are common and recurrent, but people experiencing these disorders may benefit from treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports information from the National Survey on Drug Use and Health (NSDUH) on substance use treatment (i.e., treatment for problems related to the use of alcohol or illicit drugs) and mental health service use in the United States to help evaluate access to and use of substance use treatment and mental health services.

Methods. This report presents data from the 2015 NSDUH for substance use treatment and data from the 2002 through 2015 NSDUHs for mental health service use among adults aged 18 or older. Estimates for the receipt of substance use treatment are presented for young adults aged 18 to 25 and for adults aged 26 or older. Estimates for mental health service use are shown for young adults aged 18 to 25, adults aged 26 to 49, and those aged 50 or older. Where trends for mental health service use are presented, the report focuses on long-term trends by comparing estimates from the 2015 NSDUH with comparable estimates from 2002 to 2014 (or from 2008 to 2014 for selected estimates). Statistically significant differences are noted between estimates in 2015 and those in prior years. Trends for substance use treatment and other related estimates are not reported because of methodological changes in 2015.

Results. An estimated 1.4 percent of adults aged 18 or older in 2015 (3.5 million adults) received any substance use treatment in the past year, and 0.9 percent (2.3 million adults) received treatment at a specialty facility. In 2015, about 20.4 million adults needed substance use treatment in the past year, representing 8.4 percent of adults. Of the 18.1 million adults who needed substance use treatment but did not receive specialty treatment, only 4.8 percent (863,000) felt that they needed treatment for their use of alcohol or illicit drugs. Included in the 863,000 adults with a perceived need for substance use treatment who did not receive treatment are 309,000 adults who made an effort to get treatment and 554,000 adults who did not report making an effort to get treatment.

In 2015, about 34.2 million adults aged 18 or older (14.2 percent) received mental health services in the past year. The estimate of 14.2 percent of adults in 2015 who received mental health services in the past year was similar to the estimates in most years from 2010 to 2014, but it was higher than the estimates in most years between 2002 and 2009. Among the 43.4 million adults with any mental illness (AMI) in the past year, about 18.6 million (43.1 percent) received mental health services in the past year. The percentage of adults with AMI who received mental health care in 2015 was similar to the percentages in most years from 2008 to 2014. Included in the 43.4 million adults with past year AMI were 9.8 million with severe mental illness (SMI). Of the 9.8 million adults with past year SMI, 65.3 percent received mental health services in the past year. The 2015 estimate of adults with past year SMI who received mental health services in the past year was similar to the estimates in all years between 2008 and 2014. Among the 8.1 million adults in 2015 with co-occurring AMI and an SUD in the past year, less than half (48.0 percent) received either mental health services or substance use treatment at a specialty facility in the past year. Close to two thirds (62.6 percent) of the 2.3 million adults with co-occurring SMI and an SUD received either mental health services or specialty substance use treatment in the past year.

The two most common reasons for not receiving substance use treatment among adults aged 18 or older who needed but did not receive treatment at a specialty facility, despite perceiving a need for treatment, were that they were not ready to stop using alcohol or illicit drugs (40.7 percent) or that they had no health care coverage and could not afford the cost of treatment (30.6 percent). Similarly, among all adults and among adults with AMI or among those with SMI who perceived a need for mental health services but did not receive services in the past year, inability to afford the cost of care was the most commonly reported reason for not receiving services.

Conclusions. This report provides the most current findings from NSDUH on the receipt of substance use treatment and trends in mental health service use among adults aged 18 or older in the United States. Findings presented in the report can be useful for monitoring the use of substance use treatment and mental health services and assessing whether adults are receiving the services they need.

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Introduction

Mental disorders and substance use disorders (SUDs) are common and recurrent. These disorders affect people of every age and socioeconomic status. They also are costly to society because they are often associated with negative outcomes, such as involvement with the justice system,1,2 occurrence of chronic health conditions,3 and poorer health outcomes.4 Nevertheless, people with these disorders often benefit from treatment.

This report contains some of the first findings from the 2015 National Survey on Drug Use and Health (NSDUH) on the receipt of substance use treatment (i.e., treatment for problems related to the use of alcohol or illicit drugs) and mental health service use among adults aged 18 years or older in the United States. Comprehensive 2015 NSDUH detailed tables that show additional substance use and mental health-related outcomes, including data for various subpopulations covered in NSDUH, are available separately at http://www.samhsa.gov/data/.5

Survey Background

NSDUH is an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years old or older.6 The survey is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS). The survey covers residents of households and individuals in noninstitutional group quarters (e.g., shelters, boarding houses, college dormitories, migratory workers' camps, halfway houses). The survey excludes people with no fixed address (e.g., homeless people not in shelters), military personnel on active duty, and residents of institutional group quarters, such as jails, nursing homes, mental institutions, and long-term care hospitals.

NSDUH employs a stratified multistage area probability sample that is designed to be representative of both the nation as a whole and for each of the 50 states and the District of Columbia. The 2015 NSDUH annual target sample size of 67,500 interviews was distributed across three age groups, with 25 percent allocated to adolescents aged 12 to 17, 25 percent allocated to young adults aged 18 to 25, and 50 percent allocated to adults aged 26 or older. Although the sample design changed in 2014, NSDUH had the same total target sample size per year of 67,500 interviews in 2002 to 2015.7

NSDUH is a face-to-face household interview survey that is conducted in two phases: the screening phase and the interview phase. The interviewer conducts a screening of the eligible household with an adult resident (aged 18 or older) in order to determine whether zero, one, or two residents aged 12 or older should be selected for the interview.8 NSDUH collects data using audio computer-assisted self-interviewing (ACASI) in which respondents read or listen to the questions on headphones, then enter their answers directly into a NSDUH laptop computer. ACASI is designed for accurate reporting of information by providing respondents with a highly private and confidential mode for responding to questions about illicit drug use, mental health, and other sensitive behaviors. NSDUH also uses computer-assisted personal interviewing (CAPI) in which interviewers read less sensitive questions to respondents and enter the respondents' answers into a NSDUH laptop computer.

In 2015, screening was completed at 132,210 addresses, and 68,073 completed interviews were obtained, including 51,118 interviews from adults aged 18 or older. Weighted response rates for household screening and for interviewing were 79.7 and 69.3 percent, respectively, for an overall response rate of 55.2 percent for people aged 12 or older. The weighted interview response rate was 68.4 percent for adults.9 Further details about the 2015 NSDUH design and methods can be found on the web at http://www.samhsa.gov/data/.10

Notable 2015 NSDUH Questionnaire Changes

The NSDUH questionnaire underwent a partial redesign in 2015 to improve the quality of the NSDUH data and to address the changing needs of policymakers and researchers with regard to substance use and mental health issues. The prescription drug questions were redesigned to shift the focus from lifetime misuse to past year misuse. Additionally, questions were added about any past year prescription drug use rather than just misuse. New methamphetamine questions were added, replacing the methamphetamine questions that were previously asked within the context of prescription stimulants. Substantial changes were also made to questions about smokeless tobacco, binge alcohol use, inhalants, and hallucinogens. These changes led to potential breaks in the comparability of 2015 estimates with estimates from prior years. Consequently, these changes potentially affected overall summary measures, such as illicit drug use, and other measures, such as initiation, SUDs, and substance use treatment. Additionally, certain demographic items were changed as part of the partial redesign. Education questions were updated, and new questions were added on disability, English-language proficiency, sexual orientation of adults, and military families.

Due to these changes, only 2015 data are presented for certain estimates until comparability with prior years can be established. Trends will continue to be presented for items that are assumed to have remained comparable with earlier years. Due to the patterns in the 2015 estimates of risk and protective factor data, only 2015 estimates are presented. Details on the 2015 NSDUH questionnaire changes, reasons for the changes, and implications of the changes for NSDUH data users are included in a brief report on these questionnaire changes, in a report on the design changes for the 2014 and 2015 NSDUHs, and in the methodological summary and definitions report for 2015.11,12,13

Data Presentation and Interpretation

This report presents estimates of the receipt of substance use treatment and mental health service use for adults aged 18 or older. Although NSDUH collects data on the receipt of substance use treatment and mental health service use for adolescents aged 12 to 17, this report focuses on adults. Estimates for the receipt of substance use treatment and mental health service use among adolescents are presented in a report of key substance use and mental health indicators for the United States in 2015.14

In this report, estimates are presented by adult age subgroups. Substance use treatment estimates are shown for young adults aged 18 to 25 and adults aged 26 or older. Mental health service use estimates are shown for young adults aged 18 to 25, adults aged 26 to 49, and those aged 50 or older. The comparability of the substance use treatment estimates may have been affected by changes to the substance use questions as part of the partial redesign of NSDUH in 2015. Therefore, substance use treatment estimates are presented only for 2015. The mental health service use questions in 2015 continue to allow comparisons with prior years.

All estimates (e.g., percentages and numbers) presented in the report are derived from NSDUH survey data that are subject to sampling errors. The estimates have met the criteria for statistical precision. Estimates that do not meet these criteria for reliability have been suppressed and are not shown.15 For estimates of mental health service utilization, long-term trends are presented by comparing estimates in 2015 with estimates in each of the years from 2002 to 2014 (or from 2008 to 2014 for selected measures). Statistical tests also have been conducted for comparisons that appear in the text of the report. Statistically significant differences are described using terms such as "higher," "lower," "increased," or "decreased." Statements use terms such as "similar," "remained steady," or "stable" when a difference is not statistically significant. Analyses of long-term trends in this report summarize whether the 2015 estimates are different from or similar to estimates in most or all previous years16 while minimizing discussion of anomalous differences between any 2 years that can occur due to these estimates being based on samples.17 Graphics contain estimates that support the statements in this report, and supplemental tables of estimates (including standard errors) are included in Appendix A.

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Receipt of Any Substance Use Treatment

NSDUH respondents who used alcohol or illicit drugs in their lifetime are asked whether they ever received substance use treatment. Those who received substance use treatment in their lifetime are asked whether they received treatment in the 12 months prior to the survey interview (i.e., the past year). NSDUH estimates of "illicit drug use" include the data from 10 drug categories: the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine or the misuse of prescription pain relievers, tranquilizers, stimulants, or sedatives.18 Substance use treatment refers to treatment or counseling that was received for illicit drug or alcohol use or for medical problems associated with the use of illicit drugs or alcohol. In this report, receipt of any substance use treatment refers to treatment that was received in the past year at any location, such as a hospital (inpatient), rehabilitation facility (outpatient or inpatient), mental health center, emergency room, private doctor's office, prison or jail, or a self-help group (e.g., Alcoholics Anonymous, Narcotics Anonymous). People could report receiving treatment at more than one location.

NSDUH also includes a series of questions about past year SUDs among respondents who used alcohol or illicit drugs in the past 12 months. These questions are used to classify people as having an SUD in the past 12 months based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).19 The criteria include symptoms such as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference with major obligations at work, school, or home during the past 12 months.

In 2015, about 19.6 million adults aged 18 or older met the criteria for an SUD in the past year, representing 8.1 percent of the population aged 18 or older (Figure 1). Of the 19.6 million adults with a past year SUD, 2.1 million adults received any substance use treatment in the past year (i.e., treatment for problems related to the use of alcohol or illicit drugs). Thus, in 2015, about 1 in 10 adults with an SUD received any substance use treatment in the past year.

Figure 1. Past Year Substance Use Disorder (SUD) and Receipt of Any Substance Use Treatment in the Past Year among Adults Aged 18 or Older: 2015
Figure 1     D

People who did not meet the criteria for having an SUD but received any substance use treatment in the past year may include those in recovery or those with subthreshold characteristics. Because recovery from SUDs is a long-term process that can entail multiple interventions and involve regular monitoring, people in recovery may be participating in treatment to maintain abstinence from alcohol or illicit drugs despite not meeting the criteria for an SUD in the past year or not using alcohol or illicit drugs.

By Age Group

In 2015, there were about 3.5 million adults aged 18 or older who received any substance use treatment in the past year, representing 1.4 percent of adults (Figure 2). This number included about 669,000 young adults aged 18 to 25 (1.9 percent of young adults) and about 2.8 million adults aged 26 or older (1.4 percent of adults in this age group) who received any substance use treatment within the past year. The percentage of young adults in 2015 who received any substance use treatment in the past year (1.9 percent) was higher than that for adults aged 26 or older (1.4 percent).

Figure 2. Received Any Substance Use Treatment in the Past Year among Adults Aged 18 or Older, by Age Group: 2015
Figure 2     D

Any Substance Use Treatment for Specific Substances

Respondents who reported receiving any substance use treatment in the past year were asked to indicate the specific substances for which they received treatment during their most recent substance use treatment episode in the past year (i.e., their last or current episode).20 As shown in Figure 3, the following numbers of adults aged 18 or older in 2015 received treatment for specific substances21 during their most recent treatment in the past year:

Figure 3. Substances for Which Last or Current Treatment Was Received in the Past Year among Adults Aged 18 or Older (in Thousands): 2015
Figure 3     D

Among adults aged 18 or older who received treatment in the past year, these numbers correspond to 55.2 percent of adults whose last or current treatment was for alcohol use, 26.6 percent whose last or current treatment was for marijuana use, 22.9 percent whose last or current treatment was for prescription pain reliever misuse, 18.2 percent whose last or current treatment was for heroin use, 17.2 percent whose last or current treatment was for cocaine use, and 12.5 percent whose last or current treatment was for methamphetamine use.

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Receipt of Specialty and Nonspecialty Substance Use Treatment

Questions in NSDUH about the receipt of substance use treatment (i.e., treatment for problems related to illicit drug or alcohol use) in the past year include whether respondents received substance use treatment at a specialty facility. Specialty treatment refers to substance use treatment at a hospital (only as an inpatient), a drug or alcohol rehabilitation facility (as an inpatient or outpatient), or a mental health center. This NSDUH definition historically has not considered emergency rooms, private doctors' offices, prisons or jails, and self-help groups to be specialty substance use treatment facilities;23 in this report, these other locations are referred to as nonspecialty treatment facilities.

In 2015, about 2.3 million adults aged 18 or older received substance use treatment at a specialty facility in the past year. This number represents 0.9 percent of adults and nearly two thirds of the 3.5 million adults in 2015 who received any substance use treatment in the past year (Figure 4 and Table A.1A in Appendix A).

Figure 4. Type of Substance Use Treatment Received in the Past Year among Adults Aged 18 or Older Who Received Any Substance Use Treatment in the Past Year, by Treatment Facility Type: Percentages, 2015
Figure 4     D
Note: The percentages do not add to 100 percent due to rounding.
1 Unknown Facility Type includes all respondents with insufficient information to definitively classify in which facility type(s) they received treatment regardless of whether they received treatment for alcohol, illicit drugs, or both.

About 535,000 adults aged 18 or older in 2015 received substance use treatment only at a specialty facility, 924,000 received treatment only at a nonspecialty facility, and 1.7 million received treatment at both specialty and nonspecialty facilities (Table A.4A in Appendix A).24 Stated another way, among the 3.5 million adults who received any substance use treatment in the past year, 15.4 percent received only specialty treatment, 26.6 percent received only nonspecialty treatment, and 49.6 percent received both specialty and nonspecialty treatment.

By Age Group

In 2015, about 417,000 young adults aged 18 to 25 and 1.8 million adults aged 26 or older received substance use treatment at a specialty facility in the past year (Figure 5). These numbers represent 1.2 percent of young adults and 0.9 percent of adults aged 26 or older in 2015 (Table A.1A in Appendix A).

Figure 5. Received Substance Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older, by Age Group: 2015
Figure 5     D

About 112,000 young adults aged 18 to 25 in 2015 received substance use treatment in the past year only at a specialty facility, 189,000 received treatment only at a nonspecialty facility, and 304,000 received treatment at both specialty and nonspecialty facilities (Table A.4A in Appendix A). Among young adults who received any substance use treatment in the past year, these numbers correspond to 16.8 percent who received treatment only at a specialty facility, 28.2 percent who received treatment only at a nonspecialty facility, and 45.5 percent who received treatment at both types of facilities.24

In 2015, approximately 423,000 adults aged 26 or older received substance use treatment in the past year only at a specialty facility, 736,000 received treatment only at a nonspecialty facility, and 1.4 million received treatment at both specialty and nonspecialty facilities. Among the 2.8 million adults aged 26 or older who received any substance use treatment in the past year, these numbers correspond to 15.0 percent who received only specialty treatment, 26.2 percent who received only nonspecialty treatment, and 50.6 percent who received both specialty and nonspecialty treatment.24

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Need for Substance Use Treatment

As noted previously, NSDUH includes questions about past year SUDs and the receipt of substance use treatment at a specialty facility in the past year. These data are used to identify people who needed substance use treatment in the past year (i.e., treatment for problems related to the use of alcohol or illicit drugs). For NSDUH, people are defined as needing substance use treatment if they had an SUD in the past year or they received substance use treatment at a specialty facility in the past year.25

In 2015, an estimated 20.4 million adults aged 18 or older needed substance use treatment in the past year (Figure 6). Included in the 20.4 million adults who were classified as needing treatment in the past year were 19.6 million with an SUD in the past year (Figure 1). Thus, about 96.0 percent of the adults in 2015 who needed treatment for a substance use problem were defined as such because they had an SUD in the past year, regardless of whether they received substance use treatment at a specialty facility.

Figure 6. Need for Substance Use Treatment in the Past Year among Adults Aged 18 or Older, by Substance (in Millions): 2015
Figure 6     D
Note: Numbers of adults who needed treatment specifically for illicit drug use or for alcohol use are not mutually exclusive.

The 20.4 million adults aged 18 or older in 2015 who needed substance use treatment represent 8.4 percent of all adults (Figure 7). The 7.5 million adults who needed treatment for an illicit drug use problem and the 15.8 million adults who needed treatment for an alcohol use problem represent 3.1 and 6.5 percent of all adults, respectively (Table A.5A in Appendix A).26

Figure 7. Need for Substance Use Treatment in the Past Year among Adults Aged 18 or Older, by Age Group: 2015
Figure 7     D

By Age Group

Aged 18 to 25

About 5.4 million young adults aged 18 to 25 in 2015 needed treatment for a substance use problem in the past year, representing 15.5 percent of young adults (Figure 7). Stated another way, about 1 in 6 young adults in 2015 needed substance use treatment in the past year.

Among the 5.4 million young adults in 2015 who needed substance use treatment in the past year, about 2.6 million needed treatment for an illicit drug use problem, and 3.9 million needed treatment for an alcohol use problem (Table A.5A in Appendix A).26 In 2015, about 1 in 13 young adults (7.5 percent) needed treatment for an illicit drug use problem, and 1 in 9 young adults (11.2 percent) needed treatment for problems related to their alcohol use.

Aged 26 or Older

In 2015, about 15.0 million adults aged 26 or older needed substance use treatment in the past year (Figure 7). This number represents 7.2 percent of adults in this age group.

Among the 15.0 million adults aged 26 or older in 2015 who needed substance use treatment in the past year, about 4.9 million needed treatment for an illicit drug use problem, and 11.9 million needed treatment for an alcohol use problem (Table A.5A in Appendix A).26 The numbers of adults aged 26 or older in 2015 who needed treatment for an illicit drug use problem and those who needed treatment for an alcohol use problem represent 2.4 and 5.7 percent of adults in this age group, respectively.

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Receipt of Specialty Treatment among Adults Who Needed Substance Use Treatment

The number of adults aged 18 or older who were classified as needing substance use treatment but who did not receive treatment at a specialty facility is one indication of the extent of the unmet need for substance use treatment. This section focuses on the receipt or lack of receipt of specialty treatment among adults who needed substance use treatment.

In 2015, an estimated 2.3 million adults aged 18 or older who needed treatment received substance use treatment at a specialty facility in the past year (Figure 8). This number represents 0.9 percent of adults aged 18 or older in 2015 and 11.1 percent of the 20.4 million adults who needed substance use treatment (Table A.5A in Appendix A). Conversely, in 2015, about 18.1 million adults aged 18 or older needed substance use treatment but did not receive treatment at a specialty facility; this number represents 88.9 percent of adults in need of substance use treatment in the past year.27

Figure 8. Receipt of Specialty Treatment in the Past Year among Adults Aged 18 or Older Who Needed Substance Use Treatment in the Past Year: 2015
Figure 8     D

By Age Group

Among adults in specific age groups in 2015 who needed substance use treatment, 7.7 percent of young adults aged 18 to 25 and 12.3 percent of adults aged 26 or older received substance use treatment at a specialty facility in the past 12 months (Figure 9). In other words, 92.3 percent of young adults and 87.7 percent of adults aged 26 or older who needed substance use treatment in the past year did not receive specialty treatment (Table A.5A in Appendix A).

Figure 9. Received Substance Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older Who Needed Substance Use Treatment in the Past Year, by Age Group: 2015
Figure 9     D

Receipt of Specialty Treatment for Illicit Drug Use among Adults Who Needed Illicit Drug Use Treatment

Among the 7.5 million adults aged 18 or older in 2015 who needed treatment for an illicit drug use problem (Table A.5A in Appendix A), about 1.5 million received treatment at a specialty facility in the past year for an illicit drug use problem (Figure 10).28 Thus, an estimated 6.1 million adults aged 18 or older who needed treatment for an illicit drug use problem did not receive specialty treatment in the past 12 months, representing 80.4 percent of those who were classified as needing illicit drug use treatment in the past year.29

Figure 10. Receipt of Specialty Treatment in the Past Year for an Illicit Drug Use Problem among Adults Aged 18 or Older Who Needed Treatment for Illicit Drug Use in the Past Year: 2015
Figure 10     D

By Age Group

Among adults in specific age groups in 2015 who needed treatment for an illicit drug use problem, 11.2 percent of young adults aged 18 to 25 and 24.1 percent of adults aged 26 or older received treatment at a specialty facility in the past 12 months (Figure 11). Stated another way, almost 9 out of 10 young adults (88.8 percent) and about three fourths of adults aged 26 or older (75.9 percent) who needed treatment for their use of illicit drugs did not receive specialty treatment in the past year (Table A.5A in Appendix A).

Figure 11. Received Illicit Drug Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older Who Needed Illicit Drug Use Treatment in the Past Year, by Age Group: 2015
Figure 11     D

Receipt of Specialty Treatment for Alcohol Use among Adults Who Needed Alcohol Use Treatment

In 2015, 1.3 million adults aged 18 or older received treatment at a specialty facility for an alcohol use problem in the past year, which represents 8.3 percent of the 15.8 million adults who needed treatment for an alcohol use problem (Figure 12).30 Thus, an estimated 14.4 million adults aged 18 or older who needed treatment for an alcohol use problem (or 91.7 percent of the adults in this group) did not receive specialty treatment (Table A.5A in Appendix A).31

Figure 12. Receipt of Specialty Treatment in the Past Year for an Alcohol Use Problem among Adults Aged 18 or Older Who Needed Alcohol Use Treatment in the Past Year: 2015
Figure 12     D

By Age Group

Among adults in specific age groups in 2015 who needed treatment for an alcohol use problem, 5.4 percent of young adults aged 18 to 25 and 9.3 percent of adults aged 26 or older received treatment at a specialty facility in the past 12 months (Figure 13). In other words, in 2015, about 9 out of 10 young adults and a similar proportion of adults aged 26 or older who were classified as needing treatment for alcohol use did not receive specialty treatment in the past year.

Figure 13. Received Alcohol Use Treatment at a Specialty Facility in the Past Year Among Adults Aged 18 or Older Who Needed Alcohol Use Treatment in the Past Year, by Age Group: 2015
Figure 13     D

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Perceived Need for Substance Use Treatment

NSDUH respondents who used alcohol or illicit drugs in their lifetime and did not receive substance use treatment in the past 12 months are asked whether they felt they needed substance use treatment (i.e., treatment for problems related to their use of alcohol or illicit drugs). These respondents are asked whether they felt they needed substance use treatment regardless of whether they had an SUD in the past year.32 Because a variety of factors are important for determining the type of treatment that is most appropriate for an individual (e.g., specific SUD diagnoses, prior history of treatment, the degree of support for recovery in an individual's environment), NSDUH does not ask whether respondents felt that they needed specialty or nonspecialty substance use treatment. In this report, estimates for the perceived need for substance use treatment are discussed only for adults who were classified as needing treatment but who did not receive specialty treatment for their use of alcohol or illicit drugs. Similarly, estimates for making efforts to get treatment are discussed only of those who were classified as needing treatment but who did not receive specialty substance use treatment and perceived a need for treatment.

In 2015, among the estimated 18.1 million adults aged 18 or older who were classified as needing substance use treatment but did not receive specialty treatment in the past year (Figure 8), about 863,000 perceived a need for treatment for their use of illicit drugs or alcohol. The estimated 863,000 adults who perceived a need for substance use treatment correspond to about 4.8 percent of the adults who needed but did not receive specialty substance use treatment in the past year. The large majority (95.2 percent) of the 18.1 million adults aged 18 or older who needed substance use treatment but did not receive specialty treatment did not think that they needed treatment in the past 12 months for their substance use (Figure 14).

Figure 14. Perceived Need for Substance Use Treatment among Adults Aged 18 or Older Who Needed Substance Use Treatment but Did Not Receive Substance Use Treatment in the Past Year: 2015
Figure 14     D

Similarly, most adults aged 18 or older in 2015 who needed but did not receive specialty treatment specifically for an illicit drug use problem or for an alcohol use problem did not feel that they needed treatment. Of the 6.1 million adults aged 18 or older in 2015 who needed treatment for their use of illicit drugs but who did not receive specialty treatment, 507,000 adults (8.4 percent) perceived a need for treatment for their use of illicit drugs, and 5.6 million did not perceive a need for treatment (Figure 15). Among the 14.4 million adults in 2015 who needed treatment for their use of alcohol but who did not receive specialty treatment, 435,000 adults (3.0 percent) felt they needed treatment for their alcohol use (Figure 16). Conversely, 97.0 percent of the adults who needed treatment for their use of alcohol but who did not receive specialty treatment did not feel that they needed treatment.

Figure 15. Perceived Need for Illicit Drug Use Treatment among Adults Aged 18 or Older Who Needed Treatment for an Illicit Drug Use Problem but Did Not Receive Illicit Drug Use Treatment in the Past Year: 2015
Figure 15     D
Figure 16. Perceived Need for Alcohol Use Treatment among Adults Aged 18 or Older Who Needed Treatment for an Alcohol Use Problem but Did Not Receive Alcohol Use Treatment in the Past Year: 2015
Figure 16     D

Among the 863,000 adults aged 18 or older in 2015 who needed treatment for their use of illicit drugs or alcohol but who did not receive specialty treatment despite perceiving a need for treatment, about one third (309,000 adults) reported making an effort to get treatment in the past year, and the remaining (554,000 adults) did not report making an effort to get treatment (Figure 14). Of the 507,000 adults who felt a need for treatment for their use of illicit drugs but who did not receive specialty treatment, close to 40 percent (194,000 adults) reported making an effort to get treatment (Figure 15). Of the 435,000 adults who perceived a need for treatment for their use of alcohol but did not receive specialty treatment, slightly less than one third (135,000 adults) made an effort to get treatment, but the remaining 300,000 adults did not (Figure 16).

By Age Group

Aged 18 to 25

Among the estimated 5.0 million young adults aged 18 to 25 in 2015 who needed substance use treatment but did not receive treatment at a specialty facility in the past year (Table A.5A in Appendix A), about 138,000 perceived a need for treatment for their illicit drug or alcohol use (Table A.6A). This number of young adults who perceived a need for substance use treatment represents 2.7 percent of young adults in 2015 who needed but did not receive specialty treatment in the past year. Among the estimated 138,000 young adults who felt a need for substance use treatment but who did not receive specialty treatment, 71,000 young adults made an effort to get treatment, and 67,000 young adults did not.

Most young adults in 2015 who needed but did not receive specialty treatment specifically for their use of illicit drugs or for their use of alcohol did not perceive a need for treatment. Of the estimated 2.3 million young adults in 2015 who needed treatment for an illicit drug use problem but did not receive specialty treatment (Table A.5A in Appendix A), about 87,000 (3.7 percent) perceived a need for treatment for their use of illicit drugs, and 2.2 million (96.3 percent) did not (Table A.7A). Among the estimated 3.7 million young adults in 2015 who needed treatment for an alcohol use problem but did not receive specialty treatment, about 74,000 (2.0 percent) perceived a need for treatment for their alcohol use (Table A.8A).

Aged 26 or Older

In 2015, the estimated 13.1 million adults aged 26 or older who needed substance use treatment but did not receive specialty treatment in the past year (Table A.5A in Appendix A) include approximately 725,000 adults in this age group who perceived a need for treatment for their illicit drug or alcohol use (Table A.6A). This number of adults aged 26 or older in 2015 who perceived a need for substance use treatment represents 5.5 percent of adults in this age group who needed but did not receive specialty treatment. The 725,000 adults aged 26 or older in 2015 who felt a need for treatment but who did not receive specialty treatment include 237,000 adults who made an effort to get treatment and 487,000 adults who did not report making an effort to get treatment.

Of the estimated 3.7 million adults aged 26 or older in 2015 who needed treatment for an illicit drug use problem but did not receive specialty treatment (Table A.5A), about 420,000 (11.2 percent) perceived a need for treatment for their illicit drug use, and 3.3 million (88.8 percent) did not (Table A.7A). Of the estimated 10.7 million adults in this age group in 2015 who needed treatment for an alcohol use problem but did not receive specialty treatment, about 360,000 (3.4 percent) felt that they needed treatment for their alcohol use, and 10.4 million (96.6 percent) did not (Table A.8A).

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Reasons for Not Receiving Specialty Substance Use Treatment

As noted in the previous section, about 9 out of 10 adults aged 18 or older in 2015 who were classified as needing substance use treatment but who did not receive specialty substance use treatment did not think that they needed treatment. For adults with substance use problems who feel that they needed treatment, however, barriers that may keep people from receiving treatment could affect whether they make an effort to obtain treatment or persist in their efforts to obtain treatment.

If NSDUH respondents did not receive substance use treatment (i.e., treatment for their illicit drug or alcohol use) in the past 12 months but they felt that they needed treatment, they were asked to report the reasons for not receiving treatment. Information on commonly reported reasons for not receiving substance use treatment despite perceiving a need for treatment is important for identifying and addressing barriers to treatment receipt.

Reasons for Not Receiving Specialty Treatment among Adults Who Perceived a Need for Substance Use Treatment

In 2015, the two most common reasons for not receiving substance use treatment among adults aged 18 or older who perceived a need for treatment but who did not receive treatment at a specialty facility were that they were not ready to stop using (40.7 percent) or that they had no health care coverage and could not afford the cost of treatment (30.6 percent) (Figure 17 and Table A.9B in Appendix A). About 1 in 6 adults who felt a need for treatment but who did not receive treatment at a specialty facility were concerned about possible negative effects on their jobs (16.4 percent), and about 1 in 8 did not know where to go for treatment (12.6 percent).

Figure 17. Reasons for Not Receiving Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Felt They Needed Treatment in the Past Year: Percentages, 2015
Figure 17     D

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Mental Health Service Utilization among Adults

This section presents data on the receipt of mental health services among adults aged 18 or older. Estimates of mental health service use among adults are shown for the following age groups: young adults aged 18 to 25, adults aged 26 to 49, and those aged 50 or older. Adults in NSDUH are asked whether they received treatment or counseling for any problem with emotions, nerves, or mental health in the past year. Adults are asked if they received services in any inpatient or outpatient setting or if they took any prescription medication in the past year for a mental or emotional condition.33 Adult respondents were specifically instructed not to include treatment for alcohol or illicit drug use when answering these questions on their use of mental health services in the past year. Also, these NSDUH questions do not ask about treatment that was received for a particular mental disorder. Consequently, references to treatment or counseling for any problem with emotions, nerves, or mental health are described broadly as "mental health service" or "mental health care."

Questions in NSDUH on mental health service utilization are asked of all adults aged 18 or older and are not limited to those with past year mental illness. Therefore, estimates of mental health service use are presented for all adults aged 18 or older as well as among adults who had any mental illness (AMI) or serious mental illness (SMI) in the past year. Adults are defined as having AMI if they had any mental, behavioral, or emotional disorder in the past year that met DSM-IV criteria (excluding developmental and substance use disorders).34 Adults with AMI were defined as having SMI if they had any mental, behavioral, or emotional disorder in the past year that substantially interfered with or limited one or more major life activities.35

Changes to the NSDUH questionnaire for 2015 that were described previously (see the "Notable 2015 NSDUH Questionnaire Changes" section) did not affect the questions about adults' use of mental health services. Therefore, unlike the preceding sections for the receipt of substance use treatment, trends between 2015 and prior years are presented for the receipt of mental health services among adults.

Mental Health Service Utilization among All Adults in 2015

In 2015, an estimated 34.2 million adults aged 18 or older (14.2 percent of adults) received mental health care during the past 12 months (Figure 18). The type of mental health service that adults most commonly used in the past year was prescription medication (11.8 percent of adults), followed by outpatient services (7.1 percent), then by inpatient services (0.9 percent).36 These percentages correspond to 28.5 million adults who used prescription medication, 17.1 million adults who used outpatient services, and 2.2 million adults who used inpatient services.

Figure 18. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2015
Figure 18     D
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Figure 18 Table. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2015
Type 02 03 04 05 06 07 08 09 10 11 12 13 14 15
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Any Mental
  Health
  Services
13.0+ 13.2+ 12.8+ 13.0+ 12.9+ 13.3+ 13.5   13.4+ 13.8   13.6   14.5   14.6   14.8+ 14.2  
Inpatient   0.7+   0.8     0.9     1.0     0.7+   1.0     0.9     0.8     0.8     0.8     0.8     0.9     1.0     0.9  
Outpatient   7.4     7.1     7.1     6.8     6.7     7.0     6.8     6.4+   6.6     6.7     6.6     6.6     6.7     7.1  
Prescription
  Medication
10.5+ 10.9+ 10.5+ 10.7+ 10.9+ 11.2  11.4  11.3  11.7  11.5  12.4  12.5+ 12.6+ 11.8 

By Age Group

The percentage of adults in 2015 who received mental health services in the past year was lower among young adults aged 18 to 25 (11.7 percent) than among adults aged 26 to 49 (15.3 percent) and those aged 50 or older (13.9 percent) (Figure 19). These percentages correspond to 4.0 million young adults, 15.1 million adults aged 26 to 49, and 15.1 million adults aged 50 or older who received mental health services in the past year.

Figure 19. Mental Health Service Use in the Past Year among Adults Aged 18 or Older, by Age Group: 2015
Figure 19     D

Among all three adult age groups in 2015, prescription medication was the most commonly used type of mental health service in the past year (Table A.12B in Appendix A). Specifically, the following percentages and numbers of adults in different age groups used prescription medication in the past year for a mental health issue:

The second most common type of mental health service that adults in all three age groups used in the past year was outpatient services. The following percentages and numbers of adults in different age groups received mental health services in outpatient settings in the past year:

In 2015, staying overnight or longer in a hospital or other inpatient settings was the least common type of mental health service that adults used in the past year. An estimated 1.4 percent of young adults (483,000 young adults), 0.9 percent of adults aged 26 to 49 (867,000 adults in this age group), and 0.8 percent of adults aged 50 or older (848,000 adults in this age group) used inpatient mental health services in the past year.

Trends in Mental Health Service Utilization among All Adults

The estimate of 14.2 percent of adults aged 18 or older in 2015 who received mental health care in the past 12 months was similar to the estimates in most years from 2010 to 2014 (Figure 18). However, the estimate in 2015 was greater than the estimates in most years between 2002 and 2009. In 2004, for example, 12.8 percent of adults received mental health care in the past 12 months.

The estimate of 11.8 percent of adults in 2015 who took prescription medication for mental health conditions also was greater than the estimates from 2002 to 2006. The 2015 estimate was similar to the estimates in 2007 to 2012, but it was lower than the estimates in 2013 and 2014. The estimate of 7.1 percent of adults in 2015 who used outpatient services in the past year was similar to the estimates in most years from 2002 to 2014. The estimate of 0.9 percent of adults in 2015 who received inpatient mental health services also was similar to the estimates in most years from 2002 to 2014.

By Age Group

The percentage of young adults aged 18 to 25 in 2015 who used any mental health services in the past year (11.7 percent) was higher than the percentages in most years between 2002 and 2007 (Table A.12B in Appendix A). However, the estimate in 2015 was similar to the estimates from 2008 to 2014. Similarly, the percentage of adults aged 26 to 49 in 2015 who received any mental health services in the past year was higher than the percentages in most years between 2002 and 2008, but it was similar to the estimates from 2009 to 2014. Among adults aged 50 or older, the 2015 estimate of adults receiving any mental health services also was higher than the estimates from 2002 to 2006, but the estimate in 2015 was similar to the estimates in most years from 2007 to 2014.

The estimate of 8.6 percent of young adults in 2015 who used prescription medication for mental health issues was greater than the estimate of 7.5 percent in 2002, but it was comparable with the estimates in most years from 2003 to 2014 (Table A.12B in Appendix A). Among adults aged 26 to 49, the estimate of 12.6 percent in 2015 who used prescription medication was greater than the estimates in most years between 2002 and 2008, but it was similar to the estimates from 2009 to 2014. Among adults aged 50 or older, the estimate of 12.0 percent in 2015 who used prescription medication was greater than the estimates in 2002 (10.5 percent) and 2004 (10.1 percent), but it was similar to the estimates in most years from 2005 to 2014.

The estimate of 7.9 percent of adults aged 26 to 49 in 2015 who received outpatient mental health services was lower than the estimates in 2002 to 2004, but it was similar to the estimates from 2005 to 2014 (Table A.12B in Appendix A). Percentages of adults who received outpatient services were relatively stable across the years between 2002 and 2015 for young adults aged 18 to 25 and adults aged 50 or older.

The percentage of adults aged 18 to 25 in 2015 who received inpatient services was higher than the percentages in most years between 2002 and 2011, and it was similar to the percentages in 2012 to 2014 (Table A.12B in Appendix A). Among adults aged 26 to 49 and those aged 50 or older, the percentages of adults who received inpatient services were relatively stable during the period from 2002 to 2015. For example, the percentages who received inpatient services ranged from 0.7 to 1.1 percent for adults aged 26 to 49 and from 0.5 to 1.0 percent for adults aged 50 or older.

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Mental Health Service Utilization among Adults with AMI or SMI in 2015

Data from NSDUH on mental health service utilization among adults with mental illness in the past year are presented in this section. In order to provide context for this section, the percentages and numbers of adults with mental illness in the United States are first presented. In 2015, 43.4 million adults aged 18 or older (17.9 percent of adults) had AMI in the past year, including 9.8 million with past year SMI (4.0 percent of adults).14 About 7.6 million young adults aged 18 to 25 in 2015 (21.7 percent of young adults) had AMI in the past year, including 1.8 million (5.0 percent of young adults) with SMI in that period. Among adults aged 26 to 49 in 2015, 20.6 million had AMI in the past year (20.9 percent of adults aged 26 to 49), including 4.9 million adults aged 26 to 49 with SMI in the past year (5.0 percent of adults aged 26 to 49). Among adults aged 50 or older, 15.3 million (14.0 percent of adults in this age group) had AMI in the past year, including 3.1 million with SMI (2.8 percent of adults in this age group).

Among the 43.4 million adults with AMI in the past year, 18.6 million (43.1 percent) received mental health services in the past year (Figure 20). About 6.4 million of the 9.8 million adults with past year SMI (65.3 percent) received mental health services in the past year (Figure 21).

Figure 20. Mental Health Service Use in the Past Year among Adults Aged 18 or Older with Past Year Any Mental Illness, by Age Group: 2015
Figure 20     D
Figure 21. Mental Health Service Use in the Past Year among Adults Aged 18 or Older with Past Year Serious Mental Illness, by Age Group: 2015
Figure 21     D

In 2015, among adults aged 18 or older with AMI in the past year, 36.7 percent used prescription medication, 25.4 percent used outpatient services, and 3.4 percent used inpatient services (Figure 22). Among adults with past year SMI who received mental health care in the past year, 57.3 percent used prescription medication, 43.6 percent used outpatient services, and 7.0 percent used inpatient services (Figure 23).

Figure 22. Specific Types of Mental Health Services Received by Adults Aged 18 or Older with Past Year Any Mental Illness, by Age Group: Percentages, 2015
Figure 22     D
Figure 23. Specific Types of Mental Health Services Received by Adults Aged 18 or Older with Past Year Serious Mental Illness, by Age Group: Percentages, 2015
Figure 23     D

By Age Group

In 2015, the percentage of adults with AMI in the past year who used mental health services in that period was lower among adults aged 18 to 25 (32.0 percent) than among adults aged 26 to 49 (43.3 percent) and those aged 50 or older (48.3 percent) who had AMI in the past year (Figure 20 and Table A.11B in Appendix A). Stated another way, among adults with past year AMI, about two thirds of young adults, more than half of adults aged 26 to 49, and about half of adults aged 50 or older did not receive mental health services in the past year.

The percentage of adults with SMI who used mental health services in the past year also was lower among adults aged 18 to 25 (50.7 percent) than among adults aged 26 to 49 (66.1 percent) and those aged 50 or older (72.2 percent) (Figure 21). Thus, only about half of young adults in 2015 who had past year SMI received mental health services in the past year. Among adults aged 26 or older in 2015 who had past year SMI, about one third of adults aged 26 to 49 and close to 30 percent of adults aged 50 or older did not receive mental health services in the past year.

In 2015, among young adults aged 18 to 25 who had AMI in the past year, about 1 in 4 (24.3 percent) used prescription medication in the past year, and about 1 in 5 (20.6 percent) used outpatient services for mental health issues (Figure 22 and Table A.13B in Appendix A). In addition, 4.3 percent of young adults with AMI used inpatient services. Among young adults with past year SMI, 40.0 percent used prescription medication, 36.0 percent used outpatient services, and 8.9 percent used inpatient services in the past year for mental health issues (Figure 23).

Among adults aged 26 to 49 in 2015 with AMI in the past year, more than one third (36.4 percent) used prescription medication in the past year, about one fourth (26.1 percent) used outpatient services, and about 1 in 30 (3.1 percent) used inpatient services for mental health issues (Table A.13B in Appendix A). Among adults aged 26 to 49 with past year SMI, 58.2 percent used prescription medication, 44.8 percent used outpatient services, and 7.3 percent used inpatient services in the past year for mental health issues.

In 2015, among adults aged 50 or older with AMI in the past year who used mental health services in that period, 43.2 percent used prescription medication in the past year, 27.0 percent used outpatient services, and 3.5 percent used inpatient services (Table A.13B in Appendix A). Among adults aged 50 or older with past year SMI, 65.6 percent used prescription medication, 46.0 percent used outpatient services, and 5.5 percent used inpatient services in the past year for mental health issues.

Trends in Mental Health Service Utilization among Adults with AMI or SMI

The percentage of adults with AMI remained stable from 2008 to 2015 (17.9 percent of adults in 2015).14 The percentage of adults with SMI in 2015 (4.0 percent) also was similar to the percentages from 2008 to 2014. The percentage of adults with AMI in 2015 who received mental health care in the past year (43.1 percent) also was similar to the percentages in most years from 2008 to 2014. (Figure 24). The percentage of adults with SMI who received mental health services in the past year remained relatively steady from 2008 to 2015. In any given year, about two thirds of adults with past year SMI received mental health services in the past year (Figure 25).

Figure 24. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Past Year Any Mental Illness: Percentages, 2008-2015
Figure 24     D
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Figure 24 Table. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Past Year Any Mental Illness: Percentages, 2008-2015
Type of Service 2008 2009 2010 2011 2012 2013 2014 2015
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Any Mental Health Services 40.9    40.2+ 42.4    40.8+ 41.0    44.7    44.7    43.1   
Inpatient   3.7      3.2    2.7+   3.3      3.0      3.3      3.8      3.4   
Outpatient 24.1    22.5+ 23.4+ 24.0    22.4+ 24.4    24.3    25.4   
Prescription Medication 35.5    34.8    36.9    35.6    35.3    38.9    38.7+ 36.7   
Figure 25. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Past Year Serious Mental Illness: Percentages, 2008-2015
Figure 25     D
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Figure 25 Table. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Past Year Serious Mental Illness: Percentages, 2008-2015
Type of Service 2008 2009 2010 2011 2012 2013 2014 2015
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Any Mental Health Services 65.7    66.5    67.5    64.9    62.9    68.5    68.5    65.3   
Inpatient   8.6      8.6      6.7      8.8      6.2      8.3      8.8      7.0   
Outpatient 46.2    44.6    42.5    44.1    39.0+ 46.9    44.2    43.6   
Prescription Medication 59.7    61.1    61.0    58.2    57.8    62.1+ 61.4+ 57.3   

The estimate of 36.7 percent of adults with past year AMI in 2015 who received prescription medication for mental health issues was similar to the estimates in most years from 2008 to 2014, ranging from 34.8 to 38.9 percent (Figure 24). Similarly, the percentage of adults with AMI who received inpatient care remained relatively stable from 2008 to 2015, ranging from 2.7 to 3.8 percent. In contrast, the percentage of adults with AMI who received outpatient care in 2015 (25.4 percent) was higher than the percentages in most years between 2008 and 2012. However, the percentage in 2015 was similar to the percentages in 2013 and 2014 (24.4 and 24.3 percent, respectively).

Among adults with SMI, the percentages of adults who received different types of mental health care were relatively similar across the years from 2008 to 2015 (Figure 25). For example, the percentage in 2015 of adults with SMI who received prescription medication (57.3 percent) was similar to the percentages in most years from 2008 to 2014. With the exception of 2012, the percentage of adults with SMI in 2015 who received outpatient services (43.6 percent) was similar to the estimates from 2008 to 2014. The percentage of adults with SMI in 2015 who received inpatient services (7.0 percent) was similar to the percentages in all years between 2008 and 2014.

By Age Group

Among young adults aged 18 to 25 with AMI in the past year, the percentage in 2015 who reported using prescription medication for mental health conditions (24.3 percent) was similar to the percentages in most years between 2008 to 2014 (Table A.13B in Appendix A). The percentage of adults aged 26 to 49 with AMI who used prescription medication also was stable from 2008 to 2015, ranging from 35.3 to 38.0 percent. In addition, the percentage of adults aged 50 or older with AMI in 2015 who used prescription medication (43.2 percent) was similar to the percentages in most years from 2008 to 2015.

Among adults with SMI, the percentages of adults in all three age groups in 2015 who used prescription medication were similar to the percentages in most years between 2008 and 2014 (Table A.13B in Appendix A). About 6 out of 10 adults aged 26 to 49 with SMI and about two thirds of adults aged 50 or older with SMI used prescription medication in the past year for mental health issues.

Percentages of adults with AMI or SMI in each age group in 2015 who received outpatient care were similar to the percentages in most or all years from 2008 to 2014. For example, the 2015 estimates of adults with AMI who received outpatient care among young adults (20.6 percent), adults aged 26 to 49 (26.1 percent), and adults aged 50 or older (27.0 percent) were similar to the estimates in most or all years from 2008 to 2014, respectively (Table A.13B in Appendix A). In 2015, the percentages of adults who had past year SMI and received outpatient care were 36.0 percent for young adults aged 18 to 25, 44.8 percent for adults aged 26 to 49, and 46.0 percent for adults aged 50 or older. The 2015 percentage of adults in each age group with SMI who received outpatient care was similar to the corresponding percentages in all years from 2008 to 2014.

Percentages of adults with AMI in all three age groups in 2015 who received inpatient care also were similar to the corresponding percentages in all years from 2008 to 2014. Among adults with AMI in 2015, for example, 4.3 percent of young adults aged 18 to 25, 3.1 percent of adults aged 26 to 49, and 3.5 percent of adults aged 50 or older received inpatient care (Table A.13B in Appendix A). Similarly, the 2015 estimates of adults with SMI who received inpatient care among young adults (8.9 percent), adults aged 26 to 49 (7.3 percent), and adults aged 50 or older (5.5 percent) were comparable with the estimates in all years from 2008 to 2014.

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Perceived Unmet Need for Mental Health Services among Adults

This section discusses estimates of the perceived unmet need for mental health services among adults aged 18 or older. The section also discusses reasons for not receiving these services among adults with a perceived unmet need. Perceived unmet need is described among adults aged 18 or older overall and among adults with AMI or SMI.

In contrast to the procedures that were described previously for estimating the perceived unmet need for substance use treatment (see the "Perceived Need for Substance Use Treatment" section), the perceived unmet need for mental health services is estimated from a question that asks all adults whether there was any time in the past 12 months when they thought they needed treatment or counseling for mental health issues but they did not receive services; all adults are asked this question regardless of whether they had AMI in the past year or whether they received any mental health services in the past 12 months. Therefore, this measure for the perceived unmet need for mental health services includes adults who may have received some type of mental health service in the past 12 months. Adults who received mental health services in the past 12 months could have felt an unmet need for services before or after they received services. An unmet need for services after adults had received some services would indicate a perceived need for additional services that they did not receive.

Perceived Unmet Need for Mental Health Services among All Adults in 2015

In 2015, there were an estimated 11.2 million adults aged 18 or older with a perceived unmet need for mental health care at any time in the past year, including 5.2 million adults who did not receive any mental health services in the past year (Figure 26). The 11.2 million adults who perceived an unmet need for mental health care represent 4.6 percent of all adults.

Figure 26. Perceived Unmet Need for Mental Health Services in the Past Year among Adults Aged 18 or Older, by Mental Illness Level (in Millions): 2015
Figure 26     D
AMI = any mental illness; SMI = serious mental illness.
Note: The bottom number in each bar is the estimated number of adults with a perceived unmet need for mental health services who did not receive any mental health services in the past year. The top number in each bar is the total estimated number of adults with any perceived unmet need for mental health services, including those who did not receive any mental health services and those who had an unmet need for additional services.

By Age Group

Among the 11.2 million adults in 2015 who perceived an unmet need for mental health care in the past year, about 2.9 million were young adults aged 18 to 25, 5.7 million were aged 26 to 49, and 2.6 million were aged 50 or older (Table A.14A in Appendix A). These numbers of adults who perceived an unmet need for mental health care at any time in the past year represent 8.4 percent of young adults, 5.8 percent of adults aged 26 to 49, and 2.4 percent of adults aged 50 or older (Table A.14B in Appendix A). In addition, there were 1.6 million young adults, 2.5 million adults aged 26 to 49, and close to 1.0 million adults aged 50 or older who perceived an unmet need for mental health services but did not receive any services in the past year.

Trends in Perceived Unmet Need for Mental Health Services among All Adults

In each of the years from 2002 to 2015, about 1 in 20 adults in the general population perceived an unmet need for mental health care (Figure 27). The percentages in 2002 to 2015 correspond to 10.5 million to 12.1 million adults each year who had a perceived unmet need for mental health care (Table A.14A in Appendix A).

Figure 27. Perceived Unmet Need for Mental Health Services in the Past Year among Adults Aged 18 or Older, by Mental Illness Level: Percentages, 2002-2015
Figure 27     D
AMI = any mental illness; SMI = serious mental illness.
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Figure 27 Table. Perceived Unmet Need for Mental Health Services in the Past Year among Adults Aged 18 or Older, by Mental Illness Level: Percentages, 2002-2015
MI Level 02 03 04 05 06 07 08 09 10 11 12 13 14 15
AMI = any mental illness; MI = mental illness; N/A = not available; SMI = serious mental illness.
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
All Adults 5.4+ 5.1+ 5.1+ 5.1+ 4.8    4.9      4.7      5.3+   4.9      4.6      4.9      4.6      4.9    4.6   
Adults with AMI N/A    N/A    N/A    N/A    N/A    N/A    20.6    22.1+ 21.0    20.7    20.8    19.3    20.8    20.3   
Adults with SMI N/A    N/A    N/A    N/A    N/A    N/A    43.7+ 46.3+ 42.0    43.1+ 41.6    38.6    42.9+ 38.2   

In 2015, 4.6 percent of adults perceived an unmet need for mental health care in the past year (Figure 27). This percentage was similar to the estimated percentages in most years between 2006 and 2014. However, the percentage of adults with a perceived unmet need for mental health care in 2015 was somewhat lower than the percentages in 2002 to 2005 (ranging from 5.1 to 5.4 percent).

Among young adults aged 18 to 25, the percentage of those with a perceived unmet need in 2015 (8.4 percent) was higher than the percentages in most years from 2006 to 2013 (Table A.14B in Appendix A). In 2010 to 2013, for example, 7.4 to 7.6 percent of young adults had a perceived unmet need for mental health care. For adults aged 26 to 49, the percentage of adults in 2015 with a perceived unmet need (5.8 percent) was similar to the percentages in all of the years from 2010 to 2014. However, the percentage in 2015 was lower than the percentages in several years from 2002 to 2009. For example, 6.8 percent of adults aged 26 to 49 in 2002 had a perceived unmet need for mental health care. The percentage of adults aged 50 or older with a perceived unmet need for mental health care remained relatively stable between 2002 and 2015, ranging from 2.1 to 3.0 percent.

Perceived Unmet Need for Mental Health Services among Adults with AMI or SMI in 2015

In 2015, approximately 8.8 million adults aged 18 or older with past year AMI perceived an unmet need for mental health care in the past year, including 3.6 million adults with AMI who did not receive any mental health services in the past year (Figure 26). About 1 in 5 adults with past year AMI in 2015 (20.3 percent) perceived an unmet need for mental health care in the past year.

About 3.7 million adults with past year SMI in 2015 perceived an unmet need for mental health care in the past year, including 1.1 million adults with SMI who did not receive any mental health services in the past year (Figure 26). Nearly 2 out of 5 adults with SMI (38.2 percent) perceived an unmet need for mental health services in the past year.

By Age Group

In 2015, among the 8.8 million adults with past year AMI who perceived an unmet need for mental health care in the past year, about 2.2 million were young adults aged 18 to 25, 4.6 million were aged 26 to 49, and 2.0 million were aged 50 or older (Table A.14A in Appendix A). These numbers of adults with AMI who perceived an unmet need for mental health care correspond to 29.0 percent of young adults, 22.5 percent of adults aged 26 to 49, and 13.0 percent of those aged 50 or older (Table A.14B).

About half of the 2.2 million young adults with AMI who perceived an unmet need for mental health care did not receive any mental health services in the past year (1.1 million young adults with AMI, or 52.7 percent) (Table A.15B in Appendix A).37 Among adults aged 26 to 49 with AMI who had a perceived unmet need for mental health care, 40.3 percent (1.9 million adults) did not receive any mental health services in the past year. Among adults aged 50 or older with AMI who had a perceived unmet need for mental health care, 28.7 percent (567,000 adults) did not receive any mental health services in the past year.

Among adults in 2015 with past year SMI, an estimated 878,000 young adults aged 18 to 25, 2.1 million adults aged 26 to 49, and 717,000 adults aged 50 or older perceived an unmet need for mental health care in the past year (Table A.14A in Appendix A). About 43.3 percent (379,000) of the 878,000 young adults with SMI who perceived an unmet need for mental health services (Table A.14B in Appendix A) and 30.7 percent (649,000) of the 2.1 million adults aged 26 to 49 with SMI who perceived an unmet need for mental health care in the past year did not receive any mental health services (Table A.15B). (Estimates for adults aged 50 or older with SMI who perceived an unmet need but did not receive mental health services were not reported because of low precision.15)

Trends in Perceived Unmet Need for Mental Health Services among Adults with AMI or SMI

The estimate of 20.3 percent of adults in 2015 with past year AMI who perceived an unmet need for mental health care in that period was similar to the percentages in most years from 2008 to 2014 (Figure 27). Across these 7 years, about 1 in 5 adults with AMI perceived an unmet need for mental health care. In each age group, the percentages of adults with AMI who perceived an unmet need for mental health services remained steady between 2008 and 2015 (Table A.14B in Appendix A). For example, the percentage of adults with AMI who perceived an unmet need for mental health services ranged from 27.8 to 30.2 percent for young adults, from 21.7 to 24.8 percent for adults aged 26 to 49, and from 11.8 to 15.2 percent for those aged 50 or older.

The percentage of adults with SMI who perceived an unmet need for mental health services in 2015 (38.2 percent) was lower than the percentages in most years between 2008 and 2011 (Figure 27). Nevertheless, about 2 out of 5 adults with past year SMI in 2015 reported that they had an unmet need for mental health services. The estimate of the perceived unmet need for mental health services among adults aged 50 or older with SMI in 2015 was lower than the estimates in most years from 2008 and 2011. However, about 1 in 4 adults aged 50 or older with SMI in 2015 (23.2 percent) had a perceived unmet need for mental health services (Table A.14B in Appendix A). For adults with SMI in younger age groups, the estimates for the perceived unmet need for mental health services remained relatively stable between 2008 and 2015. Each year, about 1 in 2 young adults aged 18 to 25 with SMI and 2 out of 5 adults aged 26 to 49 with SMI perceived an unmet need for mental health services.

Reasons for Not Receiving Mental Health Services in 2015 among Adults with a Perceived Unmet Need

In 2015, among the 5.2 million adults aged 18 or older with a perceived unmet need for mental health services who did not receive any mental health services in the past year, 43.6 percent reported that they did not receive the services because they could not afford the cost of care (Figure 28). In addition, 30.6 percent believed at the time that they could handle the problem without treatment, 26.9 percent did not know where to go for mental health services, and 20.5 percent did not think that they had the time to go for care.

Figure 28. Reasons for Not Receiving Mental Health Services in the Past Year among Adults Aged 18 or Older with a Perceived Unmet Need for Mental Health Care Who Did Not Receive Mental Health Services: Percentages, 2015
Figure 28     D

Among adults with AMI in the past year and those with SMI in the past year in 2015 who had a perceived unmet need for mental health services but who did not receive services in the past year, the most common reason for not receiving the needed services was that they could not afford the cost of care (Figure 29). Specifically, about half or more of adults with AMI (49.5 percent) and those with SMI (54.6 percent) perceived an unmet need for mental health services and did not receive services because they could not afford the cost of care.

Figure 29. Reasons for Not Receiving Mental Health Services in the Past Year among Adults Aged 18 or Older with a Perceived Unmet Need for Mental Health Care Who Did Not Receive Mental Health Services, by Mental Illness Status: Percentages, 2015
Figure 29     D
AMI = any mental illness; SMI = serious mental illness.

Other reasons for not receiving mental health care among adults with mental illness included not knowing where to go for services and believing that they could handle the problem without treatment (Figure 29). In 2015, among adults with AMI who had a perceived unmet need for mental health care and did not receive services in the past year, 28.0 percent did not know where to go for services, and 30.0 percent believed at the time that they could handle the problem without treatment. Among corresponding adults with SMI, 33.4 percent did not know where to go for services, and 27.4 percent believed at the time they could handle the problem without treatment. In addition, 20.1 percent of adults with AMI who had a perceived unmet need for mental health care and did not receive mental health services in the past year reported that they did not have the time to go for care. Among adults with SMI who had a perceived unmet need and did not receive mental health services in the past year, 22.3 percent were concerned about being committed to a psychiatric hospital or having to take medication.

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Receipt of Services among Adults with Co-Occurring Mental Illness and a Substance Use Disorder

The coexistence of both a mental disorder and an SUD is referred to as co-occurring disorders. Because NSDUH collects information on both the presence of a mental disorder (as defined by AMI and SMI) and SUDs, it is possible to estimate the percentages of adults with co-occurring disorders and the percentage of adults with co-occurring disorders who received treatment or counseling services. Therefore, this section presents data from NSDUH on the receipt of mental health care or specialty substance use treatment among adults with co-occurring disorders.

Receipt of Services among Adults with Co-Occurring Disorders in 2015

An estimated 8.1 million adults aged 18 or older in 2015 had co-occurring AMI and an SUD in the past year, corresponding to 3.3 percent of all adults. In addition, about 2.3 million adults had SMI and an SUD in the past year, representing 1.0 percent of all adults.14

Among the 8.1 million adults with co-occurring AMI and an SUD in the past year, 48.0 percent received either mental health care or substance use treatment at a specialty facility38 in the past year. In other words, about half of the adults with co-occurring AMI and an SUD in the past year did not receive either type of service (Figure 30).39 An estimated 6.8 percent of adults with these co-occurring disorders received both mental health care and specialty substance use treatment, 36.7 percent received only mental health care, and 4.4 percent received only specialty substance use treatment.

Figure 30. Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Had Past Year Any Mental Illness and Substance Use Disorders: Percentages, 2015
Figure 30     D
Note: Mental health care is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Specialty substance use treatment refers to treatment at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop drug or alcohol use, or for medical problems associated with drug or alcohol use.
Note: The percentages do not add to 100 percent due to rounding.

Among the 2.3 million adults who had co-occurring SMI and an SUD in the past year, 62.6 percent received either substance use treatment at a specialty facility or mental health care in the past year. Stated another way, about 1 in 3 adults with co-occurring SMI and an SUD did not receive either type of care in the past year (Figure 31). Among adults with co-occurring SMI and an SUD, 11.0 percent received both mental health care and specialty substance use treatment, 47.4 percent received only mental health care, and 4.2 percent received only specialty substance use treatment.

Figure 31. Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Had Past Year Serious Mental Illness and Substance Use Disorders: Percentages, 2015
Figure 31     D
Note: Mental health care is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Specialty substance use treatment refers to treatment at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop drug or alcohol use, or for medical problems associated with drug or alcohol use.

By Age Group

In 2015, an estimated 2.1 million young adults aged 18 to 25, 4.3 million adults aged 26 to 49, and 1.7 million adults aged 50 or older had co-occurring AMI and an SUD in the past year. These numbers represent 5.9 percent of young adults, 4.3 percent of adults aged 26 to 49, and 1.6 percent of adults aged 50 or older who had AMI and an SUD in the past year.14

Among adults in 2015 who had co-occurring AMI and an SUD in the past year, 35.2 percent of young adults aged 18 to 25, 50.5 percent of adults aged 26 to 49, and 57.1 percent of those aged 50 or older received mental health care or substance use treatment at a specialty facility in the past year (Table A.17B in Appendix A). Among adults in all three age groups in 2015 who had co-occurring AMI and an SUD in the past year, the most common type of service was receipt of only mental health care. Specifically, 26.5 percent of young adults, 37.6 percent of those aged 26 to 49, and 46.8 percent of those aged 50 or older who had co-occurring AMI and an SUD received only mental health care. In addition, 5.4 percent of young adults, 7.6 percent of adults aged 26 to 49, and 6.6 percent of adults aged 50 or older who had co-occurring AMI and an SUD received both mental health care and specialty substance use treatment. About 3.1 percent of young adults, 5.3 percent of adults aged 26 to 49, and 3.6 percent of those aged 50 or older with co-occurring AMI and an SUD received only specialty substance use treatment in the past year.

In 2015, about 593,000 young adults, 1.3 million adults aged 26 to 49, and 422,000 adults aged 50 or older had SMI and an SUD in the past year. These numbers correspond to 1.7 percent of young adults, 1.3 percent of adults aged 26 to 49, and 0.4 percent of adults aged 50 or older who had co-occurring SMI and an SUD in the past year.14

Among adults with co-occurring SMI and an SUD in 2015, 53.1 percent of young adults aged 18 to 25 and 68.0 percent of those aged 26 to 49 received either mental health care or specialty substance treatment in the past year (Table A.17B in Appendix A). In addition, 9.3 percent of young adults and 12.4 percent of adults aged 26 to 49 who had co-occurring SMI and an SUD received both mental health care and specialty substance use treatment. An estimated 41.6 percent of young adults aged 18 to 25 with co-occurring SMI and an SUD and 49.0 percent of adults aged 26 to 49 received only mental health care. (Estimates for the receipt of services among adults aged 50 or older with co-occurring SMI and an SUD were not reported because of low precision.15)

Author Affiliations

Eunice Park-Lee, Rachel N. Lipari, and Sarra L. Hedden are with the Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, Rockville, MD. Elizabeth A. P. Copello and Larry A. Kroutil are with RTI International (a registered trademark and a trade name of Research Triangle Institute), Research Triangle Park, NC.

Acknowledgments of Reviewers

The authors would like to thank Jonaki Bose of the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, and Kathryn R. Batts, Kristen Brown, Jennifer Cooney, Julia Gable, and Kayla Nowak at RTI International for reviewing previous drafts of this Data Review.

Suggested Citation

Park-Lee, E., Lipari, R. N., Hedden, S. L., Copello, E. A. P., & Kroutil, L. A. (2016, September). Receipt of services for substance use and mental health issues among adults: Results from the 2015 National Survey on Drug Use and Health. NSDUH Data Review. Retrieved from http://www.samhsa.gov/data/

Endnotes

1 Glasheen, C., Hedden, S. L., Kroutil, L. A., Pemberton, M. R., & Goldstrom, I. (2012, November). Past year arrest among adults in the United States: Characteristics of and association with mental illness and substance use. CBHSQ Data Review. Retrieved from http://www.samhsa.gov/data/

2 Feucht, T. E., & Gfroerer, J. (2011, Summer). Mental and substance use disorders among adult men on probation or parole: Some success against a persistent challenge (NCJ 235637). SAMHSA Data Review. Retrieved from http://www.samhsa.gov/data/

3 Clarke, D. M., & Currie, K. (2009). Depression, anxiety and their relationship with chronic diseases: A review of the epidemiology, risk and treatment evidence. Medical Journal of Australia, 190(7 Suppl.), S54-S60.

4 McCusker, J., Cole, M., Ciampi, A., Latimer, E., Windholz, S., & Belzile, E. (2007). Major depression in older medical inpatients predicts poor physical and mental health status over 12 months. General Hospital Psychiatry, 29, 340-348. doi:10.1016/j.genhosppsych.2007.03.007

5 This report occasionally presents estimated numbers of people with a specific characteristic (e.g., estimated numbers of substance users). Some of these estimated numbers are not included in figures or tables in the report but may be found in the detailed tables for the 2015 NSDUH available at http://www.samhsa.gov/data/.

6 In this report, terms such as "Americans," "people in this country," "general population," or similar terms are used broadly to refer to the civilian, noninstitutionalized population that is covered by NSDUH. Although some people in the general population of the United States are outside of the civilian, noninstitutionalized population, information from the 2010 census suggests that the civilian, noninstitutionalized population includes at least 97 percent of the total U.S. population. See the following reference: Lofquist, D., Lugaila, T., O'Connell, M., & Feliz, S. (2012, April). Households and families: 2010 (C2010BR-14, 2010 Census Briefs). Retrieved from https://www.census.gov/prod/cen2010/briefs/c2010br-14.pdf

7 Details about the sample design, weighting, and interviewing results for the 2015 NSDUH are provided in Sections A.1, A.3.4, and B.3.1 of CBHSQ (2016). In particular, Tables A.1 and A.2 in CBHSQ (2016) provide sample design information on the targeted numbers of completed interviews by state and by age group, respectively. See the following reference: Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from http://www.samhsa.gov/data/

8 The screening procedure involves listing all household members in order to determine whether zero, one, or two individuals aged 12 or older should be selected for the interview.

9 An overall response rate is not calculated for adults because the screening response rate is not specific to age groups.

10 See the CBHSQ (2016) reference in endnote 7.

11 Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: Summary of the effects of the 2015 NSDUH questionnaire redesign: Implications for data users. Retrieved from http://www.samhsa.gov/data/

12 Center for Behavioral Health Statistics and Quality. (2015, August). National Survey on Drug Use and Health: 2014 and 2015 redesign changes. Retrieved from http://www.samhsa.gov/data/

13 See Section C in CBHSQ (2016). See endnote 7 for the reference.

14 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16 4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/

15 For a discussion of the criteria for suppressing (i.e., not publishing) unreliable estimates, see Section B.2.2 in CBHSQ (2016). See endnote 7 for the reference.

16 The term "most years" is used when the 2015 estimate is either similar to or significantly different from the estimates in the majority of prior years. However, estimates may not follow the overall pattern in up to 3 nonsequential years for estimates that are available in 2002 to 2015 and in up to 1 or 2 nonsequential years for mental health estimates that are available in 2008 (or 2009) to 2015.

17 Anomalous differences between 2 years of data usually "correct" themselves with 1 or 2 additional years of data.

18 Misuse of prescription drugs is defined as use in any way not directed by a doctor, including use without a prescription of one's own medication; use in greater amounts, more often, or longer than told to take a drug; or use in any other way not directed by a doctor. Prescription drugs do not include over-the-counter drugs.

19 American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: Author.

20 The most recent treatment refers to treatment people were receiving at the time of the interview or last treatment if they were not currently receiving treatment at the time of the interview.

21 Data on the substances for which people received their most recent treatment are not mutually exclusive because respondents could indicate that they received treatment for their use of more than one substance during their most recent substance use treatment.

22 The estimated numbers of adults aged 18 or older in 2015 who received their most recent treatment in the past year for methamphetamine use (436,000 adults) or the misuse of prescription stimulants (122,000 adults) (Table A.2A in Appendix A) differ because methamphetamine is not considered a prescription stimulant in 2015.

23 People increasingly may seek treatment from private doctors for problems related to their use of alcohol or illicit drugs, especially with implementation of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148 (March 23, 2010). The definition for specialty substance use treatment facilities for 2015 continues to exclude private doctors' offices for consistency with the measures in previous years.

24 The estimate for people who received any substance use treatment in the past year includes those who received treatment at an unknown facility type. Unknown facility type includes all respondents with insufficient information to definitively classify in which facility type(s) they received treatment regardless of whether they received treatment for alcohol, illicit drugs, or both.

25 The NSDUH definition of the need for substance use treatment does not explicitly indicate the need for treatment at a specialty facility. People who had an SUD in the past year can be considered to need some form of assistance for their problems with substance use. However, individuals who met DSM-IV criteria for abuse but not dependence may not necessarily need treatment at a specialty facility (see endnote 19's DSM-IV reference). For more information about the DSM-IV criteria for having an SUD, see Section B.4.2 and the definitions for abuse and dependence in Section D of CBHSQ (2016). See endnote 7 for the reference.

26 Numbers of people who needed treatment specifically for illicit drug use or for alcohol use are not mutually exclusive and therefore do not sum to the total number of people who needed treatment for an illicit drug use problem or an alcohol use problem.

27 People who are classified as needing substance use treatment may receive treatment at a nonspecialty facility for their problems with substance use; however, the majority of people who need treatment may not receive any substance use treatment. For example, about 679,000 people aged 12 or older in 2015 who needed substance use treatment received nonspecialty treatment, while 18.6 million people did not receive any treatment.

28 Individuals who needed treatment for an illicit drug use problem were defined as receiving treatment for their illicit drug use problem only if they reported receiving specialty treatment for illicit drug use in the past year. Thus, individuals who needed treatment for illicit drug use but received specialty treatment only for alcohol use in the past year or who received treatment for illicit drug use only at a facility not classified as a specialty facility were not counted as receiving specialty treatment for illicit drug use. However, these individuals still were counted among those who needed treatment for illicit drug use or alcohol use and who received treatment at a specialty facility for their illicit drug use problem or alcohol use problem.

29 People who are classified as needing illicit drug use treatment may receive treatment at a nonspecialty facility for their problems with illicit drug use; however, the majority of people who needed treatment do not receive any treatment. For example, of the 8.4 million people aged 12 or older in 2015 who needed illicit drug use treatment, about 312,000 received nonspecialty treatment for illicit drug use, while 6.6 million did not receive any treatment.

30 Individuals who needed treatment for an alcohol use problem were defined as receiving treatment for their alcohol use problem only if they reported receiving specialty treatment for alcohol use in the past year. Thus, individuals who needed treatment for alcohol use but received specialty treatment only for illicit drug use in the past year or who received treatment for alcohol use only at a facility not classified as a specialty facility were not counted as receiving specialty treatment for alcohol use. However, these individuals still were counted among those who needed treatment for illicit drug use or alcohol use and who received treatment at a specialty facility for their illicit drug use problem or alcohol use problem.

31 People who are classified as needing alcohol use treatment may receive treatment at a nonspecialty facility for their problems with alcohol use; however, the majority of people who needed treatment do not receive any treatment. For example, of the 16.4 million people aged 12 or older in 2015 who needed treatment for their problems with alcohol use, about 376,000 received nonspecialty treatment for alcohol use, while 14.7 million did not receive any treatment.

32 Determination of whether NSDUH respondents had an SUD in the past year (i.e., one of the components of defining individuals as needing substance use treatment) is made subsequent to the interview.

33 For services in an inpatient setting, adult respondents were asked whether they stayed overnight or longer in a hospital or other facility in the past 12 months to receive treatment or counseling for any problems they were having with their emotions, nerves, or mental health. For services in an outpatient setting, adult respondents were presented with the following examples of locations for outpatient mental health care: (a) an outpatient mental health clinic or center; (b) the office of a private therapist, psychologist, psychiatrist, social worker, or counselor that was not part of a clinic; (c) a doctor's office that was not part of a clinic; (d) an outpatient medical clinic; (e) a partial day hospital or day treatment program; or (f) some other place. Based on these examples, adults were asked whether they received any outpatient treatment or counseling in the past 12 months for any problems they were having with their emotions, nerves, or mental health.

34 For details, see the reference in endnote 19.

35 In order to generate estimates of AMI and SMI in the United States, SAMHSA designed and implemented the Mental Health Surveillance Study (MHSS). Over the 5-year period from 2008 to 2012, a subsample of adults was selected from the main study to participate in a follow-up telephone interview that obtained a detailed mental health assessment administered by trained mental health clinicians. The MHSS interview used the Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). A prediction model created from clinical interview data that were collected in 2008 to 2012 was applied to data from the 2008 to 2015 NSDUHs to produce estimates of AMI for the entire NSDUH adult sample in these years. For details about the SCID-I/NP, see the following reference: First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). New York, NY: New York State Psychiatric Institute, Biometrics Research.

36 Estimates for the types of mental health care that adults received are not mutually exclusive because adults could have received more than one type of care.

37 Percentages that readers calculate from estimated numbers of adults with a perceived unmet need for mental health services may not agree with reported percentages because the estimated numbers are rounded to the nearest 0.1 million adults.

38 A specialty facility refers to a hospital (only as an inpatient), a drug or alcohol rehabilitation facility (as an inpatient or outpatient), or a mental health center.

39 Percentages for the receipt of specific types of services do not sum to the total percentage who received any type of service due to rounding.

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Appendix A: Supplemental Tables of Estimates for Receipt of Services for Substance Use and Mental Health Issues among Adults

Table A.1A – Received Substance Use Treatment at Any Treatment Location or at a Specialty Facility in the Past Year among Adults Aged 18 or Older, by Age Group
Treatment Facility Type Aged 18 or Older,
Numbers1
(2015)
Percentage among
Adults Aged
18 or Older2
(2015)
Aged 18-25,
Numbers1
(2015)
Percentage among
Adults Aged
18-252
(2015)
Aged 26 or Older,
Numbers1
(2015)
Percentage among
Adults Aged
26 or Older2
(2015)
1 Estimates shown are numbers in thousands with standard errors included in parentheses.
2 Estimates shown are percentages with standard errors included in parentheses.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
Any Treatment Location 3,481  (170) 1.4  (0.07) 669  (47) 1.9  (0.14) 2,812  (161) 1.4  (0.08)
Specialty Facility 2,266  (134) 0.9  (0.06) 417  (37) 1.2  (0.11) 1,849  (127) 0.9  (0.06)
Table A.2A – Substances for Which Last or Current Treatment Was Received among Adults Aged 18 or Older Who Received Substance Use Treatment in the Past Year, by Age Group
Substance for Which Last or Current
Treatment Was Received1
Aged 18 or Older
(2015)
Aged 18-25
(2015)
Aged 26 or Older
(2015)
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
1 Respondents could indicate multiple substances for which they received their last or current treatment; thus, these response categories are not mutually exclusive.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
TOTAL POPULATION 3,481  (172) 669  (48) 2,812  (162)
Marijuana    926    (87) 266  (31)    660    (80)
Cocaine    600    (76) 142  (23)    457    (71)
Heroin    633    (72) 133  (21)    499    (68)
Hallucinogens    253    (45)   95  (21)    158    (37)
Inhalants    158    (33)   65  (15)      94    (29)
Methamphetamine    436    (58)   88  (20)    348    (53)
Pain Relievers    797    (78) 165  (24)    632    (75)
Tranquilizers    274    (44)   89  (20)    185    (41)
Stimulants    122    (26)   46  (13)      76    (22)
Sedatives    109    (29)   28    (8)      81    (28)
Alcohol 1,923  (129) 338  (32) 1,585  (125)
Table A.3A – Receipt of Substance Use Treatment at a Specialty Facility and/or a Nonspecialty Facility in the Past Year among Adults Aged 18 or Older, by Age Group
Treatment Facility Type Aged 18 or Older,
Numbers1
(2015)
Percentage among
Adults Aged 18 or
Older2
(2015)
Aged 18-25,
Numbers1
(2015)
Percentage among
Adults Aged 18-252
(2015)
Aged 26 or Older,
Numbers1
(2015)
Percentage among
Adults Aged 26 or Older2
(2015)
1 Estimates shown are numbers in thousands with standard errors included in parentheses.
2 Estimates shown are percentages with standard errors included in parentheses.
3 Unknown Facility Type includes all respondents with insufficient information to definitively classify in which facility type(s) they received treatment regardless of whether they received treatment for alcohol, illicit drugs, or both.
4 No Substance Use Treatment includes respondents who either did not receive substance use treatment for any substance in the past year or have unknown substance use treatment information.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
Specialty Facility Only        535    (65)   0.2  (0.03)      112  (19)   0.3  (0.05)        423    (61)   0.2  (0.03)
Nonspecialty Facility Only        924    (96)   0.4  (0.04)      189  (24)   0.5  (0.07)        736    (92)   0.4  (0.04)
Both Specialty and Nonspecialty Facility     1,726  (115)   0.7  (0.05)      304  (32)   0.9  (0.09)     1,422  (110)   0.7  (0.05)
Unknown Facility Type3        296    (49)   0.1  (0.02)        64  (14)   0.2  (0.04)        232    (47)   0.1  (0.02)
No Substance Use Treatment4 239,320  (170) 98.6  (0.07) 34,238  (47) 98.1  (0.14) 205,082  (161) 98.6  (0.08)
Table A.4A – Receipt of Substance Use Treatment at a Specialty Facility and/or a Nonspecialty Facility in the Past Year among Adults Aged 18 or Older Who Received Any Substance Use Treatment in the Past Year, by Age Group
Treatment Facility Type Aged 18 or Older,
Numbers1
(2015)
Percentage among
Adults Aged 18 or
Older Who Received
Any Substance Use
Treatment2
(2015)
Aged 18-25,
Numbers1
(2015)
Percentage among
Adults Aged 18-25
Who Received Any
Substance Use
Treatment2
(2015)
Aged 26 or Older,
Numbers1
(2015)
Percentage among
Adults Aged 26 or
Older Who Received
Any Substance Use
Treatment2
(2015)
1 Estimates shown are numbers in thousands with standard errors included in parentheses.
2 Estimates shown are percentages with standard errors included in parentheses.
3 Unknown Facility Type includes all respondents with insufficient information to definitively classify in which facility type(s) they received treatment regardless of whether they received treatment for alcohol, illicit drugs, or both.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
Specialty Facility Only    535    (65) 15.4  (1.70) 112  (19) 16.8  (2.55)    423    (62) 15.0  (2.02)
Nonspecialty Facility Only    924    (96) 26.6  (2.28) 189  (25) 28.2  (3.06)    736    (92) 26.2  (2.71)
Both Specialty and Nonspecialty Facility 1,726  (115) 49.6  (2.46) 304  (32) 45.5  (3.48) 1,422  (111) 50.6  (2.96)
Unknown Facility Type3    296    (49)   8.5  (1.35)   64  (14)   9.6  (1.94)    232    (47)   8.2  (1.62)
Table A.5A – Need for and Receipt of Treatment at a Specialty Facility for a Substance Use Problem in the Past Year among Adults Aged 18 or Older, by Age Group
Substance for Which Treatment Was
Needed/Treatment Receipt Status
Aged
18 or Older,
Numbers1
(2015)
Percentage
among
18 or Older2
(2015)
Percentage
among
18 or Older
Who Needed
Treatment2
(2015)
Aged 18-25,
Numbers1
(2015)
Percentage
among
18-252
(2015)
Percentage
among 18-25
Who Needed
Treatment2
(2015)
Aged
26 or Older,
Numbers1
(2015)
Percentage
among
26 or Older2
(2015)
Percentage
among
26 or Older
Who Needed
Treatment2
(2015)
NOTE: Respondents were classified as needing treatment for a substance use problem if they met the criteria for substance use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or received treatment for substance use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or mental health center).
1 Estimates shown are numbers in thousands with standard errors included in parentheses.
2 Estimates shown are percentages with standard errors included in parentheses.
3 Did Not Receive Treatment at a Specialty Facility includes respondents who either did not receive substance use treatment at a specialty facility in the past year or had unknown substance use treatment information.
4 Estimates include individuals who received treatment specifically for illicit drugs or alcohol, as well as individuals who received treatment but did not specify for what substance(s).
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
NEEDED TREATMENT FOR ILLICIT DRUG USE   7,545  (235) 3.1  (0.10) 100.0  (0.00) 2,631    (92)   7.5  (0.26) 100.0  (0.00)   4,914  (216) 2.4  (0.10) 100.0  (0.00)
Received Treatment at a Specialty Facility   1,478  (106) 0.6  (0.04)   19.6  (1.22)    296    (33)   0.8  (0.09)   11.2  (1.17)   1,182  (101) 0.6  (0.05)   24.1  (1.73)
Did Not Receive Treatment at a Specialty Facility3   6,067  (205) 2.5  (0.08)   80.4  (1.22) 2,335    (86)   6.7  (0.25)   88.8  (1.17)   3,732  (183) 1.8  (0.09)   75.9  (1.73)
NEEDED TREATMENT FOR ALCOHOL USE 15,760  (355) 6.5  (0.15) 100.0  (0.00) 3,909  (113) 11.2  (0.32) 100.0  (0.00) 11,851  (329) 5.7  (0.16) 100.0  (0.00)
Received Treatment at a Specialty Facility   1,315  (106) 0.5  (0.04)     8.3  (0.64)    210    (25)   0.6  (0.07)     5.4  (0.63)   1,105  (102) 0.5  (0.05)     9.3  (0.82)
Did Not Receive Treatment at a Specialty Facility3 14,445  (340) 5.9  (0.14)   91.7  (0.64) 3,699  (110) 10.6  (0.32)   94.6  (0.63) 10,747  (315) 5.2  (0.15)   90.7  (0.82)
NEEDED TREATMENT FOR ILLICIT DRUG OR ALCOHOL USE 20,398  (399) 8.4  (0.16) 100.0  (0.00) 5,422  (130) 15.5  (0.37) 100.0  (0.00) 14,976  (369) 7.2  (0.18) 100.0  (0.00)
Received Treatment at a Specialty Facility4   2,266  (134) 0.9  (0.06)   11.1  (0.61)    417    (37)   1.2  (0.11)     7.7  (0.67)   1,849  (127) 0.9  (0.06)   12.3  (0.78)
Did Not Receive Treatment at a Specialty Facility3 18,133  (368) 7.5  (0.15)   88.9  (0.61) 5,005  (126) 14.3  (0.36)   92.3  (0.67) 13,127  (338) 6.3  (0.16)   87.7  (0.78)
Table A.6A – Perceived Need for Substance Use Treatment and Whether Made an Effort to Get Treatment in the Past Year among Adults Aged 18 or Older Classified as Needing But Not Receiving Treatment for an Illicit Drug Use Problem or Alcohol Use Problem, by Age Group
Age Group Felt Need
for Treatment
(2015)
Felt Need and Made
Effort
to Get Treatment
(2015)
Felt Need and Made No
Effort
to Get Treatment
(2015)
Did Not
Feel Need for Treatment
(2015)
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
NOTE: Respondents were classified as needing treatment for an illicit drug use problem or alcohol use problem if they met the criteria for a substance use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or received treatment for illicit drug use or alcohol use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or mental health center).
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
TOTAL 863  (86) 309  (55) 554  (69) 17,270  (364)
AGE        
18-25 138  (21)   71  (15)   67  (14)   4,868  (143)
26 or Older 725  (83) 237  (53) 487  (68) 12,402  (335)
Table A.7A – Perceived Need for Illicit Drug Use Treatment and Whether Made an Effort to Get Treatment in the Past Year among Adults Aged 18 or Older Classified as Needing But Not Receiving Treatment for an Illicit Drug Use Problem, by Age Group
Age Group Felt Need
for Treatment
(2015)
Felt Need and Made
Effort
to Get Treatment
(2015)
Felt Need and Made No
Effort
to Get Treatment
(2015)
Did Not
Feel Need for Treatment
(2015)
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
NOTE: Respondents were classified as needing treatment for an illicit drug use problem if they met the criteria for an illicit drug use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or received treatment for illicit drug use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or mental health center).
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
TOTAL 507  (67) 194  (42) 313  (53) 5,560  (194)
AGE        
18-25   87  (15)   52  (12)   35  (10) 2,248    (91)
26 or Older 420  (65) 141  (40) 278  (52) 3,312  (172)
Table A.8A – Perceived Need for Alcohol Use Treatment and Whether Made an Effort to Get Treatment in the Past Year among Adults Aged 18 or Older Classified as Needing But Not Receiving Treatment for an Alcohol Use Problem, by Age Group
Age Group Felt Need
for Treatment
(2015)
Felt Need and Made
Effort
to Get Treatment
(2015)
Felt Need and Made No
Effort
to Get Treatment
(2015)
Did Not
Feel Need for Treatment
(2015)
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
NOTE: Respondents were classified as needing treatment for an alcohol use problem if they met the criteria for an alcohol use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or received treatment for alcohol use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or mental health center).
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
TOTAL 435  (61) 135  (33) 300  (52) 14,010  (337)
AGE        
18-25   74  (17)   25  (10)   49  (13)   3,624  (122)
26 or Older 360  (59) 110  (32) 251  (50) 10,386  (315)
Table A.9B – Detailed Reasons for Not Receiving Substance Use Treatment in the Past Year among Adults Aged 18 or Older Classified as Needing But Not Receiving Substance Use Treatment at a Specialty Facility and Who Felt a Need for Treatment in the Past Year
Reason for Not Receiving Substance Use Treatment1 Total
(2015)
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents were classified as needing treatment for a substance use problem if they met the criteria for substance use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or received treatment for substance use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or mental health center).
1 Respondents could indicate multiple reasons for not receiving treatment; thus, these response categories are not mutually exclusive.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
No Health Care Coverage and Could Not Afford Cost 30.6  (4.06)
Had Health Care Coverage But Did Not Cover Treatment or Did Not Cover Full Cost   4.6  (1.58)
No Transportation/Programs Too Far Away/Hours Inconvenient 11.8  (2.57)
Did Not Find a Program Having Type of Treatment That Was Wanted 11.0  (3.20)
Not Ready to Stop Using 40.7  (4.89)
No Openings in a Program   4.6  (2.31)
Did Not Know Where to Go for Treatment 12.6  (2.88)
Might Cause Neighbors/Community to Have Negative Opinion   8.3  (2.49)
Might Have Negative Effect on Job 16.4  (3.76)
Did Not Feel Need for Treatment at the Time   6.7  (2.07)
Could Handle the Problem without Treatment   8.2  (2.26)
Treatment Would Not Help   3.4  (1.36)
Did Not Have Time   9.0  (2.55)
Did Not Want Others to Find Out   9.8  (2.73)
Some Other Reason   2.1  (1.27)
Table A.10B – Received Mental Health Services in the Past Year among Adults Aged 18 or Older, by Age Group and Health Insurance Type
Age Group/Health
Insurance Type
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
-- Not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health service information were excluded.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
1 Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive.
2 CHIP is the Children's Health Insurance Program. Individuals aged 19 or younger are eligible for this plan.
3 Other is defined as having Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other type of health insurance.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOTAL 13.0*  (0.27) 13.2*  (0.26) 12.8*  (0.26) 13.0*  (0.26) 12.9*  (0.26) 13.3*  (0.27) 13.5    (0.29) 13.4*  (0.27) 13.8    (0.27) 13.6    (0.26) 14.5    (0.28) 14.6    (0.28) 14.8*  (0.23) 14.2  (0.23)
AGE                            
18-25 10.5*  (0.25) 11.1    (0.28) 10.8*  (0.26) 11.2    (0.27) 10.8*  (0.28) 10.4*  (0.28) 11.0    (0.28) 11.2    (0.27) 11.0    (0.27) 11.4    (0.30) 12.0    (0.29) 12.2    (0.32) 11.9    (0.34) 11.7  (0.31)
26-49 14.5    (0.36) 14.5    (0.35) 14.4*  (0.34) 13.9*  (0.34) 14.0*  (0.37) 14.3*  (0.35) 14.1*  (0.34) 14.6    (0.36) 14.9    (0.37) 14.9    (0.36) 15.2    (0.38) 15.5    (0.40) 15.3    (0.28) 15.3  (0.29)
50 or Older 12.0*  (0.54) 12.3*  (0.53) 11.7*  (0.51) 12.5*  (0.53) 12.4*  (0.48) 13.2    (0.53) 13.7    (0.57) 12.9    (0.52) 13.6    (0.52) 13.2    (0.47) 14.8    (0.51) 14.6    (0.52) 15.4*  (0.42) 13.9  (0.40)
HEALTH INSURANCE1                            
Private 12.8*  (0.30) 12.9*  (0.33) 12.5*  (0.30) 12.0*  (0.30) 12.7*  (0.31) 12.6*  (0.32) 13.2*  (0.36) 12.8*  (0.32) 13.5    (0.33) 13.1*  (0.32) 14.2    (0.34) 14.3    (0.35) 13.9    (0.28) 14.2  (0.27)
Medicaid/CHIP2 19.2   (1.08) 22.8*  (1.18) 23.2*  (1.18) 25.2*  (1.20) 21.7*  (1.11) 24.0*  (1.20) 22.0*  (1.16) 23.6*  (1.07) 21.7*  (1.05) 22.2*  (0.93) 21.4*  (1.05) 23.1*  (0.99) 22.8*  (0.75) 18.7  (0.62)
Other3     --        (--) 13.0*  (0.68) 12.6*  (0.66) 13.7*  (0.67) 13.2*  (0.63) 14.9    (0.70) 15.2    (0.74) 14.0    (0.67) 14.9    (0.66) 14.6    (0.60) 16.4    (0.66) 15.7    (0.69) 18.1*  (0.56) 15.6  (0.51)
No Coverage   9.7*  (0.63)   9.1*  (0.51)   8.7*  (0.45)   9.5*  (0.48)   8.7*  (0.48)   8.8*  (0.50)   9.2*  (0.50)   9.2*  (0.49)   9.2*  (0.53)   8.8*  (0.50) 10.4*  (0.55) 10.1*  (0.57)   9.6*  (0.47)   7.0  (0.42)
Table A.11B – Received Mental Health Services in the Past Year among Adults Aged 18 or Older, by Past Year Level of Mental Illness and Age Group
Level of Mental Illness/
Age Group
2008 2009 2010 2011 2012 2013 2014 2015
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health service information were excluded.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2015.
ANY MENTAL ILLNESS 40.9  (0.93) 40.2*  (0.86) 42.4  (0.89) 40.8*  (0.82) 41.0    (0.82) 44.7    (0.91) 44.7  (0.72) 43.1  (0.72)
18-25 30.3  (0.94) 32.0    (0.97) 32.6  (0.93) 32.9    (0.98) 34.5    (0.96) 34.7*  (0.98) 33.6  (1.05) 32.0  (0.91)
26-49 41.4  (1.09) 40.8    (1.10) 43.3  (1.07) 41.1    (1.09) 42.0    (1.10) 43.5    (1.15) 44.2  (0.83) 43.3  (0.89)
50 or Older 45.2  (2.26) 42.8*  (1.92) 45.1  (1.93) 43.6*  (1.75) 42.4*  (1.67) 50.5    (1.95) 49.9  (1.48) 48.3  (1.54)
SERIOUS MENTAL ILLNESS 65.7  (1.76) 66.5    (1.68) 67.5  (1.67) 64.9    (1.70) 62.9    (1.65) 68.5    (1.78) 68.5  (1.33) 65.3  (1.33)
18-25 45.9  (2.28) 55.0    (2.20) 53.7  (2.32) 52.1    (2.27) 53.1    (2.14) 54.0    (2.30) 53.9  (2.13) 50.7  (2.14)
26-49 67.2  (2.08) 64.5    (2.06) 67.4  (2.05) 63.6    (2.20) 63.5    (2.27) 68.4    (2.29) 66.2  (1.72) 66.1  (1.68)
50 or Older 73.2  (4.33) 76.1    (3.74) 74.0  (3.74) 73.2    (3.60) 66.3    (3.62) 74.9    (3.51) 79.2  (2.59) 72.2  (3.09)
ANY MENTAL ILLNESS EXCLUDING SERIOUS MENTAL ILLNESS 34.4  (1.06) 33.4*  (0.94) 35.1  (0.95) 34.1*  (0.93) 34.9    (0.92) 37.7    (1.03) 37.7  (0.79) 36.6  (0.81)
18-25 26.4  (1.00) 26.8    (1.01) 26.7  (0.98) 28.0    (1.02) 29.5*  (1.00) 29.4*  (1.07) 27.2  (1.12) 26.3  (0.97)
26-49 33.7  (1.16) 33.8    (1.18) 35.3  (1.18) 33.7    (1.24) 35.0    (1.22) 35.3    (1.25) 37.3  (0.96) 36.2  (0.98)
50 or Older 39.1  (2.53) 35.8*  (2.08) 38.1  (2.09) 37.0*  (1.87) 36.8*  (1.84) 44.1    (2.20) 42.5  (1.60) 42.2  (1.71)
Table A.12B – Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older, by Age Group
Mental Health Services
Received1/
Age Group
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health service information were excluded.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
1 Respondents could indicate multiple service sources; thus, these response categories are not mutually exclusive.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
INPATIENT, OUTPATIENT, OR
   PRESCRIPTION MEDICATION
13.0*  (0.27) 13.2*  (0.26) 12.8*  (0.26) 13.0*  (0.26) 12.9*  (0.26) 13.3*  (0.27) 13.5    (0.29) 13.4*  (0.27) 13.8    (0.27) 13.6    (0.26) 14.5  (0.28) 14.6    (0.28) 14.8*  (0.23) 14.2  (0.23)
18-25 10.5*  (0.25) 11.1    (0.28) 10.8*  (0.26) 11.2    (0.27) 10.8*  (0.28) 10.4*  (0.28) 11.0    (0.28) 11.2    (0.27) 11.0    (0.27) 11.4    (0.30) 12.0  (0.29) 12.2    (0.32) 11.9    (0.34) 11.7  (0.31)
26-49 14.5    (0.36) 14.5    (0.35) 14.4*  (0.34) 13.9*  (0.34) 14.0*  (0.37) 14.3*  (0.35) 14.1*  (0.34) 14.6    (0.36) 14.9    (0.37) 14.9    (0.36) 15.2  (0.38) 15.5    (0.40) 15.3    (0.28) 15.3  (0.29)
50 or Older 12.0*  (0.54) 12.3*  (0.53) 11.7*  (0.51) 12.5*  (0.53) 12.4*  (0.48) 13.2    (0.53) 13.7    (0.57) 12.9    (0.52) 13.6    (0.52) 13.2    (0.47) 14.8  (0.51) 14.6    (0.52) 15.4*  (0.42) 13.9  (0.40)
INPATIENT   0.7*  (0.06)   0.8    (0.07)   0.9    (0.07)   1.0    (0.08)   0.7*  (0.06)   1.0    (0.08)   0.9    (0.10)   0.8    (0.07)   0.8    (0.07)   0.8    (0.06)   0.8  (0.06)   0.9    (0.07)   1.0    (0.06)   0.9  (0.06)
18-25   0.9*  (0.08)   1.0*  (0.09)   1.2    (0.10)   1.1*  (0.09)   1.1*  (0.08)   1.1    (0.09)   1.1    (0.10)   1.1*  (0.10)   1.0*  (0.09)   1.1*  (0.09)   1.1  (0.10)   1.3    (0.11)   1.2    (0.11)   1.4  (0.12)
26-49   0.8    (0.09)   0.9    (0.10)   0.8    (0.09)   0.9    (0.10)   0.8    (0.09)   1.1    (0.11)   0.8    (0.09)   1.0    (0.11)   0.8    (0.09)   0.8    (0.09)   0.7  (0.08)   1.0    (0.10)   1.0    (0.08)   0.9  (0.07)
50 or Older   0.5*  (0.10)   0.7    (0.14)   0.9    (0.14)   1.0    (0.17)   0.5    (0.10)   0.7    (0.15)   0.9    (0.22)   0.6    (0.11)   0.7    (0.13)   0.7    (0.11)   0.8  (0.12)   0.7    (0.11)   1.0    (0.12)   0.8  (0.11)
OUTPATIENT   7.4    (0.21)   7.1    (0.19)   7.1    (0.19)   6.8    (0.20)   6.7    (0.20)   7.0    (0.19)   6.8    (0.20)   6.4*  (0.19)   6.6    (0.20)   6.7    (0.19)   6.6  (0.19)   6.6    (0.21)   6.7    (0.16)   7.1  (0.17)
18-25   6.7    (0.21)   6.6    (0.21)   6.2    (0.21)   6.4    (0.22)   5.9*  (0.23)   5.6*  (0.21)   5.9*  (0.21)   6.1    (0.20)   5.7*  (0.21)   6.2    (0.22)   6.5  (0.22)   6.3    (0.22)   6.4    (0.25)   6.6  (0.24)
26-49   8.9*  (0.29)   8.7*  (0.28)   8.6*  (0.27)   7.8    (0.27)   7.6    (0.27)   8.0    (0.28)   7.9    (0.26)   7.5    (0.27)   7.8    (0.28)   7.8    (0.28)   7.6  (0.26)   7.4    (0.29)   7.5    (0.20)   7.9  (0.22)
50 or Older   5.7    (0.39)   5.3*  (0.35)   5.6    (0.36)   5.9    (0.39)   6.0    (0.37)   6.3    (0.37)   6.0    (0.39)   5.3*  (0.34)   5.7    (0.35)   5.7    (0.34)   5.7  (0.33)   6.0    (0.37)   6.1    (0.29)   6.4  (0.29)
PRESCRIPTION MEDICATION 10.5*  (0.25) 10.9*  (0.25) 10.5*  (0.23) 10.7*  (0.24) 10.9*  (0.24) 11.2    (0.25) 11.4    (0.27) 11.3    (0.25) 11.7    (0.24) 11.5    (0.25) 12.4  (0.26) 12.5*  (0.27) 12.6*  (0.21) 11.8  (0.21)
18-25   7.5*  (0.22)   8.3    (0.25)   8.1    (0.23)   8.3    (0.23)   8.0    (0.24)   8.0    (0.24)   8.1    (0.24)   8.5    (0.23)   8.4    (0.24)   8.8    (0.25)   9.0  (0.25)   9.4*  (0.27)   8.8    (0.30)   8.6  (0.27)
26-49 11.4*  (0.32) 11.9    (0.32) 11.7*  (0.31) 11.4*  (0.31) 11.7*  (0.34) 11.8*  (0.32) 11.7*  (0.32) 12.3    (0.33) 12.5    (0.33) 12.3    (0.33) 13.0  (0.36) 13.1    (0.37) 12.8    (0.26) 12.6  (0.26)
50 or Older 10.5*  (0.51) 10.9    (0.51) 10.1*  (0.48) 10.8    (0.49) 11.0    (0.45) 11.7    (0.50) 12.2    (0.53) 11.3    (0.49) 12.0    (0.49) 11.8    (0.45) 12.9  (0.49) 12.9    (0.49) 13.5*  (0.39) 12.0  (0.38)
Table A.13B – Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older, by Past Year Level of Mental Illness and Age Group
Level of Mental Illness/Mental Health
Services Received1/Age Group
2008 2009 2010 2011 2012 2013 2014 2015
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health service information were excluded.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
1 Respondents could indicate multiple service sources; thus, these response categories are not mutually exclusive.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2015.
ANY MENTAL ILLNESS                
Inpatient, Outpatient, or Prescription Medication 40.9  (0.93) 40.2*  (0.86) 42.4    (0.89) 40.8*  (0.82) 41.0    (0.82) 44.7    (0.91) 44.7    (0.72) 43.1  (0.72)
18-25 30.3  (0.94) 32.0    (0.97) 32.6    (0.93) 32.9    (0.98) 34.5    (0.96) 34.7*  (0.98) 33.6    (1.05) 32.0  (0.91)
26-49 41.4  (1.09) 40.8    (1.10) 43.3    (1.07) 41.1    (1.09) 42.0    (1.10) 43.5    (1.15) 44.2    (0.83) 43.3  (0.89)
50 or Older 45.2  (2.26) 42.8*  (1.92) 45.1    (1.93) 43.6*  (1.75) 42.4*  (1.67) 50.5    (1.95) 49.9    (1.48) 48.3  (1.54)
Inpatient   3.7  (0.51)   3.2    (0.29)   2.7*  (0.25)   3.3    (0.31)   3.0    (0.28)   3.3    (0.29)   3.8    (0.26)   3.4  (0.26)
18-25   3.5  (0.39)   4.1    (0.45)   3.3    (0.35)   3.9    (0.40)   3.8    (0.39)   4.2    (0.40)   3.7    (0.37)   4.3  (0.42)
26-49   2.9  (0.38)   3.7    (0.43)   2.8    (0.38)   2.9    (0.38)   2.3    (0.30)   3.3    (0.37)   3.7    (0.34)   3.1  (0.31)
50 or Older   5.2  (1.42)   2.1    (0.50)   2.1    (0.44)   3.5    (0.63)   3.6    (0.65)   2.9    (0.60)   3.9    (0.56)   3.5  (0.59)
Outpatient 24.1  (0.78) 22.5*  (0.74) 23.4*  (0.78) 24.0    (0.74) 22.4*  (0.68) 24.4    (0.84) 24.3    (0.61) 25.4  (0.63)
18-25 18.9  (0.80) 20.3    (0.80) 19.9    (0.82) 20.9    (0.84) 21.9    (0.84) 21.0    (0.82) 21.3    (0.92) 20.6  (0.82)
26-49 26.0  (0.89) 23.6*  (0.90) 24.9    (0.92) 25.1    (0.98) 23.6*  (0.89) 24.3    (0.99) 25.8    (0.71) 26.1  (0.77)
50 or Older 23.5  (1.85) 21.9*  (1.63) 22.8    (1.63) 23.8    (1.60) 21.0*  (1.40) 26.1    (1.83) 23.9    (1.26) 27.0  (1.41)
Prescription Medication 35.5  (0.91) 34.8    (0.82) 36.9    (0.90) 35.6    (0.82) 35.3    (0.79) 38.9    (0.91) 38.7*  (0.71) 36.7  (0.71)
18-25 23.3  (0.84) 25.3    (0.88) 25.5    (0.89) 25.3    (0.92) 26.8*  (0.88) 27.2*  (0.90) 25.5    (1.00) 24.3  (0.85)
26-49 35.9  (1.07) 35.3    (1.08) 37.7    (1.07) 35.6    (1.05) 37.1    (1.10) 37.7    (1.11) 38.0    (0.81) 36.4  (0.86)
50 or Older 40.8  (2.25) 38.1*  (1.84) 40.7    (1.94) 39.8    (1.77) 36.7*  (1.65) 45.5    (1.92) 45.3    (1.46) 43.2  (1.49)
SERIOUS MENTAL ILLNESS                
Inpatient, Outpatient, or Prescription Medication 65.7  (1.76) 66.5    (1.68) 67.5    (1.67) 64.9    (1.70) 62.9    (1.65) 68.5    (1.78) 68.5    (1.33) 65.3  (1.33)
18-25 45.9  (2.28) 55.0    (2.20) 53.7    (2.32) 52.1    (2.27) 53.1    (2.14) 54.0    (2.30) 53.9    (2.13) 50.7  (2.14)
26-49 67.2  (2.08) 64.5    (2.06) 67.4    (2.05) 63.6    (2.20) 63.5    (2.27) 68.4    (2.29) 66.2    (1.72) 66.1  (1.68)
50 or Older 73.2  (4.33) 76.1    (3.74) 74.0    (3.74) 73.2    (3.60) 66.3    (3.62) 74.9    (3.51) 79.2    (2.59) 72.2  (3.09)
Inpatient   8.6  (1.29)   8.6    (0.98)   6.7    (0.77)   8.8    (1.11)   6.2    (0.77)   8.3    (0.93)   8.8    (0.85)   7.0  (0.71)
18-25   7.9  (1.18) 11.4    (1.81)   8.1    (1.06)   8.0    (1.19)   8.5    (1.18) 10.3    (1.27)   8.2    (1.05)   8.9  (1.17)
26-49   6.9  (1.19)   9.7    (1.44)   7.0    (1.04)   8.0    (1.17)   4.8    (0.82)   8.4    (1.22)   8.0    (0.93)   7.3  (0.95)
50 or Older 12.4  (3.65)   4.9    (1.47)   5.5    (1.50) 10.8    (2.61)   7.3    (1.90)   7.3    (1.93) 10.2    (2.07)   5.5  (1.51)
Outpatient 46.2  (1.86) 44.6    (1.97) 42.5    (1.89) 44.1    (1.78) 39.0*  (1.68) 46.9    (1.97) 44.2    (1.39) 43.6  (1.44)
18-25 33.0  (2.05) 38.6    (2.27) 36.2    (2.30) 37.2    (2.20) 35.8    (2.08) 37.3    (2.13) 39.2    (2.12) 36.0  (2.10)
26-49 48.2  (2.23) 43.8    (2.21) 42.9    (2.13) 42.8    (2.17) 40.3    (2.23) 47.1    (2.33) 43.8    (1.74) 44.8  (1.78)
50 or Older 49.0  (4.66) 49.0    (4.74) 44.6    (4.48) 49.7    (4.14) 38.2    (3.62) 50.7    (4.21) 47.3    (3.15) 46.0  (3.25)
Prescription Medication 59.7  (1.81) 61.1    (1.77) 61.0    (1.80) 58.2    (1.80) 57.8    (1.65) 62.1*  (1.91) 61.4*  (1.42) 57.3  (1.43)
18-25 35.9  (2.12) 43.4    (2.22) 44.0    (2.31) 41.0    (2.22) 45.5    (2.09) 46.2*  (2.21) 42.4    (2.02) 40.0  (2.03)
26-49 60.1  (2.22) 59.5    (2.17) 61.2    (2.15) 57.2    (2.26) 58.7    (2.25) 60.7    (2.42) 60.1    (1.79) 58.2  (1.78)
50 or Older 71.5  (4.32) 72.6    (4.00) 68.4    (4.10) 68.1    (3.76) 61.9    (3.66) 71.3    (3.74) 72.9    (2.89) 65.6  (3.27)
Table A.14A – Perceived Unmet Need for Mental Health Services in the Past Year among Adults Aged 18 or Older, by Level of Mental Illness and Age Group, Numbers in Thousands
Level of Mental Illness/
Age Group
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
-- Not available.
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
NOTE: Respondents were excluded if information on their perception of unmet need was missing.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOTAL POPULATION 11,272    (330) 10,781    (317) 10,902    (348) 11,170  (360) 10,498    (328) 10,974    (330) 10,636    (322) 12,059    (373) 11,177    (358) 10,768    (338) 11,490    (354) 10,965    (356) 11,795    (292) 11,238  (281)
18-25   2,621*    (75)   2,628*    (76)   2,614*    (75)   2,688    (73)   2,436*    (77)   2,472*    (75)   2,618*    (84)   2,630*    (79)   2,565*    (80)   2,581*    (85)   2,565*    (79)   2,575*    (85)   2,796      (95)   2,917    (95)
26-49   6,783*  (251)   6,349*  (236)   6,564*  (250)   6,049  (230)   5,838    (233)   6,444*  (238)   6,018    (234)   6,642*  (245)   5,825    (234)   5,968    (246)   6,104    (238)   5,905    (244)   5,815    (188)   5,708  (181)
50 or Older   1,868*  (202)   1,804*  (186)   1,724*  (204)   2,432  (243)   2,225    (216)   2,058*  (209)   1,999*  (206)   2,787    (268)   2,786    (247)   2,219    (196)   2,821    (241)   2,485    (227)   3,185*  (198)   2,613  (189)
ANY MENTAL ILLNESS         --       (--)         --       (--)         --       (--)         --      (--)         --       (--)         --       (--)   8,173    (296)   9,092    (328)   8,680    (322)   8,541    (298)   9,092    (318)   8,422    (320)   9,037    (252)   8,798  (245)
18-25         --       (--)         --       (--)         --       (--)         --      (--)         --       (--)         --       (--)   1,839*    (75)   1,773*    (69)   1,826*    (74)   1,829*    (77)   1,898*    (81)   1,870*    (77)   2,021      (84)   2,184    (87)
26-49         --       (--)         --       (--)         --       (--)         --      (--)         --       (--)         --       (--)   4,805    (222)   5,300*  (230)   4,633    (211)   4,910    (224)   5,064    (232)   4,551    (220)   4,654    (172)   4,631  (173)
50 or Older         --       (--)         --       (--)         --       (--)         --      (--)         --       (--)         --       (--)   1,529    (181)   2,019    (209)   2,222    (227)   1,802    (179)   2,130    (205)   2,001    (207)   2,362    (172)   1,983  (164)
SERIOUS MENTAL ILLNESS         --       (--)         --       (--)         --       (--)         --      (--)         --       (--)         --       (--)   3,642    (199)   3,874    (205)   3,910    (226)   3,883    (204)   3,973    (200)   3,858    (207)   4,205*  (174)   3,713  (150)
18-25         --       (--)         --       (--)         --       (--)         --      (--)         --       (--)         --       (--)      617*    (40)      587*    (37)      706*    (45)      712*    (50)      709*    (42)      756      (45)      900      (53)      878    (52)
26-49         --       (--)         --       (--)         --       (--)         --      (--)         --       (--)         --       (--)   2,133    (138)   2,386    (148)   2,271    (152)   2,235    (148)   2,335    (153)   2,201    (157)   2,179    (121)   2,118  (113)
50 or Older         --       (--)         --       (--)         --       (--)         --      (--)         --       (--)         --       (--)      891    (144)      901    (131)      933    (158)      936    (124)      928    (132)      902    (124)   1,127*  (117)      717    (94)
Table A.14B – Perceived Unmet Need for Mental Health Services in the Past Year among Adults Aged 18 or Older, by Level of Mental Illness and Age Group, Percentages
Level of Mental Illness/Age Group 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
-- Not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents were excluded if information on their perception of unmet need was missing.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOTAL POPULATION 5.4*  (0.16) 5.1*  (0.15) 5.1*  (0.16) 5.1*  (0.17) 4.8    (0.15) 4.9    (0.15)   4.7    (0.14)   5.3*  (0.16)   4.9    (0.16)   4.6    (0.15)   4.9    (0.15)   4.6    (0.15)   4.9    (0.12)   4.6  (0.12)
18-25 8.5    (0.24) 8.3    (0.24) 8.1    (0.23) 8.3    (0.23) 7.5*  (0.23) 7.6*  (0.23)   8.0    (0.25)   7.9    (0.24)   7.6*  (0.24)   7.6*  (0.25)   7.4*  (0.23)   7.4*  (0.24)   8.0    (0.27)   8.4  (0.27)
26-49 6.8*  (0.25) 6.4    (0.24) 6.6*  (0.25) 6.1    (0.23) 5.8    (0.23) 6.5*  (0.24)   6.0    (0.23)   6.7*  (0.25)   5.9    (0.24)   6.1    (0.25)   6.2    (0.24)   6.0    (0.25)   5.9    (0.19)   5.8  (0.18)
50 or Older 2.4    (0.26) 2.2    (0.23) 2.1    (0.25) 2.9    (0.29) 2.5    (0.25) 2.3    (0.23)   2.2    (0.22)   3.0    (0.28)   2.9    (0.26)   2.2    (0.20)   2.8    (0.24)   2.4    (0.22)   3.0*  (0.19)   2.4  (0.17)
ANY MENTAL ILLNESS    --       (--)    --       (--)    --       (--)    --       (--)    --       (--)    --       (--) 20.6    (0.66) 22.1*  (0.70) 21.0    (0.70) 20.7    (0.66) 20.8    (0.63) 19.3    (0.65) 20.8    (0.52) 20.3  (0.52)
18-25    --       (--)    --       (--)    --       (--)    --       (--)    --       (--)    --       (--) 30.2    (0.97) 29.4    (0.94) 29.8    (0.93) 28.8    (0.93) 28.1    (0.91) 27.8    (0.93) 28.9    (0.99) 29.0  (0.95)
26-49    --       (--)    --       (--)    --       (--)    --       (--)    --       (--)    --       (--) 23.3    (0.92) 24.8    (0.93) 22.5    (0.90) 24.6    (0.95) 24.4    (0.94) 21.7    (0.93) 23.3    (0.73) 22.5  (0.74)
50 or Older    --       (--)    --       (--)    --       (--)    --       (--)    --       (--)    --       (--) 11.8    (1.32) 14.8    (1.40) 15.2    (1.44) 12.0    (1.13) 13.2    (1.15) 12.6    (1.21) 14.3    (0.96) 13.0  (1.01)
SERIOUS MENTAL ILLNESS    --       (--)    --       (--)    --       (--)    --       (--)    --       (--)    --       (--) 43.7*  (1.84) 46.3*  (1.81) 42.0    (1.81) 43.1*  (1.72) 41.6    (1.69) 38.6    (1.80) 42.9*  (1.45) 38.2  (1.31)
18-25    --       (--)    --       (--)    --       (--)    --       (--)    --       (--)    --       (--) 50.0    (2.31) 52.2    (2.32) 53.1    (2.27) 55.0    (2.35) 49.8    (2.13) 51.5    (2.08) 53.6    (2.12) 50.3  (2.00)
26-49    --       (--)    --       (--)    --       (--)    --       (--)    --       (--)    --       (--) 44.8    (2.26) 49.2*  (2.20) 44.3    (2.20) 45.2    (2.13) 46.2    (2.28) 42.4    (2.35) 45.4    (1.82) 43.3  (1.79)
50 or Older    --       (--)    --       (--)    --       (--)    --       (--)    --       (--)    --       (--) 38.2*  (4.63) 37.5*  (4.42) 32.7    (4.29) 33.9*  (3.75) 30.1    (3.41) 27.1    (3.49) 33.9*  (2.93) 23.2  (2.64)
Table A.15B – Did Not Receive Mental Health Services in the Past Year among Adults Aged 18 or Older with a Perceived Unmet Need for Mental Health Services in the Past Year, by Past Year Level of Mental Illness and Age Group
Level of Mental Illness/Age Group 2008 2009 2010 2011 2012 2013 2014 2015
**Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health service information and/or unknown perception of unmet need information were excluded.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2015.
ANY MENTAL ILLNESS 42.1  (1.65) 44.9  (1.66) 40.1  (1.82) 42.1  (1.65) 42.1  (1.72) 39.9  (1.77) 40.3  (1.43) 40.8  (1.38)
18-25 55.3  (1.92) 56.7  (1.98) 52.4  (1.85) 53.7  (1.86) 52.0  (1.96) 53.0  (1.92) 50.1  (2.01) 52.7  (1.94)
26-49 41.4  (2.17) 43.3  (2.05) 37.0  (2.16) 43.2  (2.23) 44.0  (2.28) 38.5  (2.25) 43.7  (1.87) 40.3  (1.71)
50 or Older 28.1  (5.05) 38.8  (5.05) 36.4  (4.88) 27.4  (4.49) 28.9  (4.38) 30.8  (4.70) 25.4  (3.19) 28.7  (4.00)
SERIOUS MENTAL ILLNESS 30.1  (2.39) 29.7  (2.21) 27.9  (2.32) 31.8  (2.31) 34.2  (2.57) 32.7  (2.49) 31.5  (2.01) 30.7  (1.81)
18-25 49.1  (3.21) 47.5  (3.28) 42.3  (3.12) 43.5  (3.01) 41.8  (3.11) 43.6  (3.11) 40.6  (2.95) 43.3  (3.05)
26-49 27.4  (2.93) 32.8  (2.88) 26.8  (2.86) 33.8  (3.00) 36.3  (3.44) 29.6  (3.41) 34.1  (2.52) 30.7  (2.33)
50 or Older    **     (**)    **     (**)    **     (**)    **     (**)    **     (**)    **     (**) 19.3  (4.32)    **     (**)
Table A.16B – Detailed Reasons for Not Receiving Mental Health Services in the Past Year among Adults Aged 18 or Older with a Perceived Unmet Need for Mental Health Services Who Did Not Receive Mental Health Services in the Past Year, by Past Year Level of Mental Illness
Reason for Not Receiving Services1 Total
(2015)
Any Mental Illness
(2015)
Serious Mental Illness
(2015)
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown reason for not receiving mental health service and/or unknown perception of unmet information were excluded.
1 Respondents could indicate multiple reasons for not receiving mental health services; thus, these response categories are not mutually exclusive.
2 Respondents with unknown or invalid responses to the other-specify question on Some Other Reason for Not Receiving Mental Health Services were classified as not having received mental health services for Some Other Reason.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
Could Not Afford Cost 43.6  (1.82) 49.5  (2.21) 54.6  (3.35)
Might Cause Neighbors/Community to Have Negative Opinion 12.6  (1.13) 13.9  (1.37) 15.6  (2.34)
Might Have Negative Effect on Job   8.5  (1.01) 10.9  (1.37) 14.2  (2.31)
Health Insurance Does Not Cover Any Mental Health Service   7.0  (0.83)   7.5  (1.01)   9.7  (2.09)
Health Insurance Does Not Pay Enough for Mental Health Services 10.8  (1.16) 11.4  (1.42) 11.2  (2.05)
Did Not Know Where to Go for Services 26.9  (1.60) 28.0  (1.81) 33.4  (3.19)
Concerned about Counselor Not Keeping Information Confidential   7.9  (0.84) 10.0  (1.14) 13.2  (2.08)
Concerned about Being Committed to a Psychiatric Hospital or Having
   to Take Medicine
10.6  (1.00) 13.4  (1.35) 22.3  (2.86)
Did Not Feel Need for Treatment at the Time 10.1  (0.97)   9.9  (1.19) 11.1  (2.46)
Thought Could Handle the Problem without Treatment 30.6  (1.62) 30.0  (1.96) 27.4  (3.23)
Did Not Think Treatment Would Help 12.9  (1.25) 13.8  (1.38) 17.8  (2.62)
Did Not Have Time 20.5  (1.38) 20.1  (1.58) 18.9  (2.87)
Did Not Want Others to Find Out   9.2  (0.91) 10.3  (1.19) 12.5  (2.35)
No Transportation/Treatment Too Far Away/Hours Inconvenient   3.9  (0.69)   5.2  (0.96)   8.8  (2.35)
Some Other Reason2   7.4  (1.19)   7.2  (1.21)   8.4  (2.10)
Table A.17B – Received Mental Health Services or Substance Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older with Past Year Substance Use Disorder, by Past Year Level of Mental Illness and Age Group
Level of Mental Illness/Age Group Mental Health Services
or Substance Use
Treatment at
a Specialty Facility1
(2015)
Mental Health Services
But Not Substance Use
Treatment at a Specialty
Facility1
(2015)
Substance Use
Treatment at
a Specialty Facility But
Not Mental Health
Services1
(2015)
Mental Health Services
and Substance Use
Treatment at a Specialty
Facility1
(2015)
**Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
1 Respondents with unknown mental health service information were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
ANY MENTAL ILLNESS 48.0  (1.58) 36.7  (1.57) 4.4  (0.59)   6.8  (0.71)
18-25 35.2  (1.85) 26.5  (1.68) 3.1  (0.69)   5.4  (0.89)
26-49 50.5  (2.02) 37.6  (1.93) 5.3  (0.86)   7.6  (1.05)
50 or Older 57.1  (4.73) 46.8  (4.65) 3.6  (1.67)   6.6  (1.92)
SERIOUS MENTAL ILLNESS 62.6  (2.59) 47.4  (2.77) 4.2  (1.09) 11.0  (1.55)
18-25 53.1  (3.54) 41.6  (3.51) 2.2  (1.01)   9.3  (1.95)
26-49 68.0  (3.25) 49.0  (3.53) 6.6  (1.87) 12.4  (2.24)
50 or Older    **     (**)    **     (**)  **     (**)    **     (**)
Table A.18B – Received Mental Health Services or Substance Use Treatment at a Specialty Facility in the Past Year among Adults 18 or Older, by Substance Use Disorder  (SUD) Status and Major Depressive Episode  (MDE) Status and Age Group
Past Year SUD Status/MDE Status/
Age Group
Mental Health Service Use or
Substance Use Treatment at a
Specialty Facility1
(2015)
Mental Health Service Use But
Not Substance Use Treatment
at a Specialty Facility1
(2015)
Substance Use Treatment at a
Specialty Facility
But Not Mental Health Service
Use1
(2015)
Mental Health Service Use and
Substance Use Treatment at a
Specialty Facility1
(2015)
**Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
1 Respondents with unknown mental health service information were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
SUD AND MDE 56.7  (2.24) 45.1  (2.26) 3.1  (0.69)   8.5  (1.15)
18-25 41.9  (2.77) 33.2  (2.58) 2.6  (0.98)   6.1  (1.26)
26-49 63.2  (2.88) 48.7  (3.00) 4.4  (1.18) 10.1  (1.77)
50 or Older    **     (**)    **     (**)  **     (**)    **     (**)
SUD AND NO MDE 22.5  (0.94) 16.1  (0.84) 3.9  (0.41)   2.5  (0.36)
18-25 16.5  (1.03) 11.1  (0.87) 3.1  (0.45)   2.3  (0.42)
26-49 22.9  (1.22) 15.5  (1.02) 4.7  (0.61)   2.7  (0.53)
50 or Older 28.3  (2.85) 22.7  (2.56) 3.1  (1.04)   2.5  (0.91)
MDE AND NO SUD 57.5  (1.31) 56.3  (1.31) 0.2  (0.07)   1.1  (0.31)
18-25 39.5  (1.61) 38.7  (1.59) 0.3  (0.19)   0.5  (0.28)
26-49 58.4  (1.59) 57.0  (1.59) 0.2  (0.13)   1.2  (0.44)
50 or Older 66.5  (2.86) 65.3  (2.87)  **     (**)   1.2  (0.66)
NO SUD AND NO MDE 10.7  (0.22) 10.4  (0.22) 0.2  (0.03)   0.1  (0.02)
18-25   7.8  (0.29)   7.6  (0.28) 0.1  (0.04)   0.1  (0.04)
26-49 11.5  (0.27) 11.0  (0.27) 0.3  (0.04)   0.1  (0.03)
50 or Older 10.8  (0.38) 10.6  (0.38) 0.2  (0.05)   0.0  (0.02)
Table A.19B – Sources of Payment for Outpatient Mental Health Services among Adults Aged 18 or Older Who Received Outpatient Mental Health Services in the Past Year, by Age Group
Source of Payment1 Total
(2015)
Aged 18-25
(2015)
Aged 26-49
(2015)
Aged 50+
(2015)
NOTE: Estimates shown are percentages with standard errors included in parentheses.
1 Respondents could indicate multiple sources of payment for outpatient mental health services; thus, these response categories are not mutually exclusive.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
Self or Family Member Living in Household 34.3  (1.13) 40.7  (1.94) 36.7  (1.36) 29.6  (2.16)
Family Member Not Living in Household   2.3  (0.25)   9.0  (1.03)   1.8  (0.35)   0.6  (0.28)
Private Health Insurance 40.7  (1.16) 34.0  (1.79) 42.7  (1.46) 40.5  (2.21)
Medicare 15.6  (0.95)   7.0  (0.93)   9.1  (0.84) 25.7  (2.02)
Medicaid 12.5  (0.72) 10.8  (1.16) 14.5  (1.00) 10.8  (1.29)
Rehabilitation Program   0.1  (0.05)   0.2  (0.16)   0.2  (0.10)   0.0  (0.02)
Employer   6.5  (0.54)   1.8  (0.47)   8.8  (0.76)   5.4  (1.02)
VA or Other Military Program   6.6  (0.62)   1.5  (0.45)   5.0  (0.67) 10.2  (1.31)
Other Public Source   2.3  (0.32)   3.6  (0.71)   2.5  (0.40)   1.7  (0.59)
Other Private Source   0.7  (0.19)   1.8  (0.48)   0.6  (0.21)   0.5  (0.40)
Free Treatment   5.0  (0.43) 14.0  (1.28)   4.7  (0.57)   2.4  (0.71)

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Long Descriptions – Figures

Long description, Figure 1: Figure 1 is titled "Past Year Substance Use Disorder (SUD) and Receipt of Any Substance Use Treatment in the Past Year among Adults Aged 18 or Older: 2015." It is a Venn diagram that shows overlapping larger and smaller circles. The larger circle on the left represents adults aged 18 or older who had an SUD in the past year. The smaller circle on the right represents adults who received substance use treatment in the past year. The intersection of the two circles represents adults who had an SUD and received substance use treatment.

The number of adults aged 18 or older in 2015 with a past year SUD was 19.6 million, and the number of adults who received substance use treatment in the past year was 3.5 million. The number of people who had an SUD and also received substance use treatment in the past year was 2.1 million.

Long description end. Return to Figure 1.

Long description, Figure 2: Figure 2 is titled "Received Any Substance Use Treatment in the Past Year among People Aged 18 or Older, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in thousands, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the three age groups (18 or older, 18 to 25, 26 or older).

There were 3,481,000 adults aged 18 or older in 2015 who received any substance use treatment in the past year, or 1.4 percent.

There were 669,000 adults aged 18 to 25 who received any substance use treatment in the past year, or 1.9 percent.

There were 2,812,000 adults aged 26 or older who received any substance treatment in the past year, or 1.4 percent.

Long description end. Return to Figure 2.

Long description, Figure 3: Figure 3 is titled "Substances for Which Last or Current Treatment Was Received in the Past Year among Adults Aged 18 or Older (in Thousands): 2015." It is a bar graph, with the number of adults in thousands who have received treatment on the horizontal axis and 11 types of substances for which their last or current treatment was received in the past year on the vertical axis.

The number of adults aged 18 or older in 2015 whose last or current treatment in the past year was for alcohol was 1,923,000.

The number of adults aged 18 or older whose last or current treatment in the past year was for marijuana was 926,000.

The number of adults aged 18 or older whose last or current treatment in the past year was for prescription pain relievers was 797,000.

The number of adults aged 18 or older whose last or current treatment in the past year was for heroin was 633,000.

The number of adults aged 18 or older whose last or current treatment in the past year was for cocaine was 600,000.

The number of adults aged 18 or older whose last or current treatment in the past year was for methamphetamine was 436,000.

The number of adults aged 18 or older whose last or current treatment in the past year was for prescription tranquilizers was 274,000.

The number of adults aged 18 or older whose last or current treatment in the past year was for hallucinogens was 253,000.

The number of adults aged 18 or older whose last or current treatment in the past year was for inhalants was 158,000.

The number of people aged 18 or older whose last or current treatment in the past year was for prescription stimulants was 122,000.

The number of people aged 18 or older whose last or current treatment in the past year was for prescription sedatives was 109,000.

Long description end. Return to Figure 3.

Long description, Figure 4: Figure 4 is titled "Type of Substance Use Treatment Received in the Past Year among Adults 18 or Older Who Received Any Substance Use Treatment in the Past Year, by Treatment Facility Type: Percentages, 2015." It is a pie chart, which shows the percentage who received substance use treatment at each of the four different treatment facility types. The following is written below the chart: "3.5 Million Adults Received Substance Use Treatment in the Past Year." A note below the figure says, "The percentages do not add to 100 percent due to rounding." Additionally, there is a footnote below the figure. The footnote applies to the unknown facility type and says "Unknown Facility Type includes all respondents with insufficient information to definitively classify in which facility type(s) they received treatment regardless of whether they received treatment for alcohol, illicit drugs, or both."

Of the 3.5 million adults who received substance use treatment in the past year in 2015, 49.6% received treatment at a specialty and nonspecialty facility, 15.4% received treatment at a specialty facility only, 8.5% received treatment at an unknown facility type, and 26.6% received treatment at a nonspecialty facility only.

Long description end. Return to Figure 4.

Long description, Figure 5: Figure 5 is titled "Received Substance Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in thousands, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the 3 age groups (18 or older, 18 to 25, 26 or older).

There were 2,266,000 adults aged 18 or older in 2015 who received substance use treatment at a specialty facility in the past year, or 0.9 percent.

There were 417,000, adults aged 18 to 25 who received substance use treatment at a specialty facility in the past year, or 1.2 percent.

There were 1,849,000 adults aged 26 or older who received substance use treatment at a specialty facility in the past year, or 0.9 percent.

Long description end. Return to Figure 5.

Long description, Figure 6: Figure 6 is titled "Need for Substance Use Treatment in the Past Year among Adults Aged 18 or Older, by Substance (in Millions): 2015." It is a bar graph, where the type of treatment (Total [Illicit Drugs or Alcohol], Illicit Drugs, and Alcohol) is on the horizontal axis and the number of adults aged 18 or older in millions who needed substance use treatment in the past year is shown on the vertical axis. A note below the figure says, "Numbers of adults who needed treatment specifically for illicit drug use or for alcohol use are not mutually exclusive."

The number of adults aged 18 or older in 2015 who needed substance use treatment in the past year for illicit drugs or alcohol was 20.4 million.

The number of adults aged 18 or older who needed substance use treatment in the past year for illicit drugs was 7.5 million.

The number of adults aged 18 or older who needed substance use treatment in the past year for alcohol was 15.8 million.

Long description end. Return to Figure 6.

Long description, Figure 7: Figure 7 is titled "Need for Substance Use Treatment in the Past Year among Adults Aged 18 or Older, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in thousands, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the three age groups (18 or older, 18 to 25, 26 or older).

There were 20,398,000 adults aged 18 or older in 2015 who needed substance use treatment in the past year, or 8.4 percent.

There were 5,422,000 adults aged 18 to 25 who needed substance use treatment in the past year, or 15.5 percent.

There were 14,976,000 adults aged 26 or older who needed substance treatment in the past year, or 7.2 percent.

Long description end. Return to Figure 7.

Long description, Figure 8: Figure 8 is titled "Receipt of Specialty Treatment in the Past Year among Adults Aged 18 or Older Who Needed Substance Use Treatment in the Past Year: 2015." It is a pie chart, with the following written below the chart: "20.4 Million Adults Needed Substance Use Treatment." For people who needed substance use treatment, the pie chart shows the number in millions and the percentage who received treatment at a specialty facility for a substance use problem, as well as the number in millions and the percentage who did not receive treatment at a specialty facility.

Of the 20.4 million adults aged 18 or older who needed substance use treatment in 2015, 2.3 million (11.1 percent) received treatment at a specialty facility for a substance use problem, and 18.1 million (88.9 percent) did not receive treatment at a specialty facility for a substance use problem.

Long description end. Return to Figure 8.

Long description, Figure 9: Figure 9 is titled "Received Substance Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older Who Needed Substance Use Treatment in the Past Year, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in thousands, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the three age groups (18 or older, 18 to 25, 26 or older).

There were 2,266,000 adults aged 18 or older in 2015 who received substance use treatment at a specialty facility among those who needed substance use treatment in the past year, or 11.1 percent.

There were 417,000 adults aged 18 to 25 who received substance use treatment at a specialty facility among those who needed substance use treatment in the past year, or 7.7 percent.

There were 1,849,000 adults aged 26 or older who received substance use treatment at a specialty facility among those who needed substance use treatment in the past year, or 12.3 percent.

Long description end. Return to Figure 9.

Long description, Figure 10: Figure 10 is titled "Receipt of Specialty Treatment in the Past Year for an Illicit Drug Use Problem among Adults Aged 18 or Older Who Needed Treatment for Illicit Drug Use in the Past Year: 2015." It is a pie chart, with the following written below the chart: "7.5 Million Adults Needed Illicit Drug Use Treatment." For people who needed treatment for an illicit drug use problem, the pie chart shows the number in millions and the percentage who received treatment at a specialty facility for an illicit drug use problem, as well as the number in millions and the percentage who did not receive treatment at a specialty facility.

Of the 7.5 million adults aged 18 or older who needed illicit drug use treatment in 2015, 1.5 million (19.6 percent) received treatment at a specialty facility for an illicit drug use problem, and 6.1 million (80.4 percent) did not receive treatment at a specialty facility for an illicit drug use problem.

Long description end. Return to Figure 10.

Long description, Figure 11: Figure 11 is titled "Received Illicit Drug Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older Who Needed Illicit Drug Use Treatment in the Past Year, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in thousands, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the three age groups (18 or older, 18 to 25, 26 or older).

There were 1,478,000 adults aged 18 or older in 2015 who received illicit use treatment at a specialty facility among those who needed illicit drug use treatment in the past year, or 19.6 percent.

There were 296,000 adults aged 18 to 25 who received illicit drug use treatment at a specialty facility among those who needed illicit drug use treatment in the past year, or 11.2 percent.

There were 1,182,000 adults aged 26 or older who received illicit drug use treatment at a specialty facility among those who needed illicit drug use treatment in the past year, or 24.1 percent.

Long description end. Return to Figure 11.

Long description, Figure 12: Figure 12 is titled "Receipt of Specialty Treatment in the Past Year for an Alcohol Use Problem among Adults Aged 18 or Older Who Needed Alcohol Use Treatment in the Past Year: 2015." It is a pie chart, with the following written below the chart: "15.8 Million Adults Needed Alcohol Use Treatment." For people who needed treatment for an alcohol use problem, the pie chart shows the number in millions and the percentage who received treatment at a specialty facility for an alcohol use problem, as well as the number in millions and the percentage who did not receive treatment at a specialty facility.

Of the 15.8 million adults aged 18 or older who needed alcohol use treatment in 2015, 1.3 million (8.3 percent) received treatment at a specialty facility for an alcohol use problem, and 14.4 million (91.7 percent) did not receive treatment at a specialty facility for an alcohol use problem.

Long description end. Return to Figure 12.

Long description, Figure 13: Figure 13 is titled "Received Alcohol Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older Who Needed Alcohol Use Treatment in the Past Year, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in thousands, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the three age groups (18 or older, 18 to 25, 26 or older).

There were 1,315,000 adults aged 18 or older in 2015 who received alcohol use treatment at a specialty facility among those who needed alcohol use treatment in the past year, or 8.3 percent.

There were 210,000 adults aged 18 to 25 who received alcohol use treatment at a specialty facility among those who needed alcohol use treatment in the past year, or 5.4 percent.

There were 1,105,000 adults aged 26 or older who received alcohol use treatment at a specialty facility among those who needed alcohol use treatment in the past year, or 9.3 percent.

Long description end. Return to Figure 13.

Long description, Figure 14: Figure 14 is titled "Perceived Need for Substance Use Treatment among Adults Aged 18 or Older Who Needed Substance Use Treatment but Did Not Receive Substance Use Treatment in the Past Year: 2015." It is a pie chart, with the following written below the chart: "18.1 Million Adults Needed but Did Not Receive Substance Use Treatment." Among adults who needed but did not receive substance use treatment in the past year, the pie chart shows the number and percentage who felt they needed treatment and did make an effort to get treatment, the number and percentage who felt they needed treatment and did not make an effort to get treatment, and the number and percentage who did not feel they needed treatment.

Of the 18.1 million adults aged 18 or older needing but not receiving treatment for substance use in 2015, 309,000 (1.7 percent) felt they needed treatment and did make an effort to get treatment, 554,000 (3.1 percent) felt they needed treatment and did not make an effort to get treatment, and 17.3 million (95.2 percent) did not feel they needed treatment.

Long description end. Return to Figure 14.

Long description, Figure 15: Figure 15 is titled "Perceived Need for Illicit Drug Use Treatment among Adults Aged 18 or Older Who Needed Treatment for an Illicit Drug Use Problem but Did Not Receive Illicit Drug Use Treatment in the Past Year: 2015." It is a pie chart, with the following written below the chart: "6.1 Million Adults Needed but Did Not Receive Illicit Drug Use Treatment." Among adults who needed but did not receive illicit drug use treatment in the past year, the pie chart shows the number and percentage who felt they needed treatment and did make an effort to get treatment, the number and percentage who felt they needed treatment and did not make an effort to get treatment, and the number and percentage who did not feel they needed treatment.

Of the 6.1 million adults aged 18 or older needing but not receiving treatment for illicit drug use in 2015, 194,000 (3.2 percent) felt they needed treatment and did make an effort to get treatment, 313,000 (5.2 percent) felt they needed treatment and did not make an effort to get treatment, and 5.6 million (91.6 percent) did not feel they needed treatment.

Long description end. Return to Figure 15.

Long description, Figure 16: Figure 16 is titled "Perceived Need for Alcohol Use Treatment among Adults Aged 18 or Older Who Needed Treatment for an Alcohol Use Problem but Did Not Receive Alcohol Use Treatment in the Past Year: 2015." It is a pie chart, with the following written below the chart: "14.4 Million Adults Needed but Did Not Receive Alcohol Use Treatment." Among adults who needed but did not receive alcohol use treatment in the past year, the pie chart shows the number and percentage who felt they needed treatment and did make an effort to get treatment, the number and percentage who felt they needed treatment and did not make an effort to get treatment, and the number and percentage who did not feel they needed treatment.

Of the 14.4 million adults aged 18 or older needing but not receiving treatment for alcohol use in 2015, 135,000 (0.9 percent) felt they needed treatment and did make an effort to get treatment, 300,000 (2.1 percent) felt they needed treatment and did not make an effort to get treatment, and 14.1 million (97.0 percent) did not feel they needed treatment.

Long description end. Return to Figure 16.

Long description, Figure 17: Figure 17 is titled "Reasons for Not Receiving Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Felt They Needed Treatment in the Past Year: Percentages, 2015." It is a bar graph, with the percentages of adults who felt they needed treatment on the horizontal axis and the four types of reasons for not receiving substance use treatment in the past year on the vertical axis.

Among adults aged 18 or older in 2015 who felt they needed substance use treatment in the past year but did not receive it: 40.7 percent were not ready to stop using, 30.6 percent had no health coverage and could not afford the cost, 16.4 percent thought treatment might have a negative effect on their job, and 12.6 percent did not know where to go for treatment.

Long description end. Return to Figure 17.

Long description, Figure 18: Figure 18 is titled "Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage receiving mental health services in the past year is shown on the vertical axis. For each of the four types of mental health services (any mental health services, inpatient, outpatient, and prescription medication), there is a line showing the percentage of adults who received mental health services over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 18.

Long description, Figure 19: Figure 19 is titled "Mental Health Service Use in the Past Year among Adults Aged 18 or Older, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in millions, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the four age groups (18 or older, 18 to 25, 26 to 49, 50 or older).

There were 34.2 million adults aged 18 or older in 2015 who received mental health service in the past year, or 14.2 percent.

There were 4.0 million adults aged 18 to 25 who received metal health service in the past year, or 11.7 percent.

There were 15.1 million adults aged 26 to 49 who received mental health service in the past year, or 15.3 percent.

There were 15.1 million adults aged 50 or older who received mental health service in the past year, or 13.9 percent.

Long description end. Return to Figure 19.

Long description, Figure 20: Figure 20 is titled "Mental Health Service Use in the Past Year among Adults Aged 18 or Older with Past Year Any Mental Illness, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in millions, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the four age groups (18 or older, 18 to 25, 26 to 49, 50 or older).

There were 18.6 million adults aged 18 or older in 2015 who received mental health service in the past year with past year any mental illness, or 43.1 percent.

There were 2.4 million adults aged 18 to 25 who received metal health service in the past year with past year any mental illness, or 32.0 percent.

There were 8.9 million adults aged 26 to 49 who received mental health service in the past year with past year any mental illness, or 43.3 percent.

There were 7.3 million adults aged 50 or older who received mental health service in the past year with past year any mental illness, or 48.3 percent.

Long description end. Return to Figure 20.

Long description, Figure 21: Figure 21 is titled "Mental Health Service Use in the Past Year among Adults Aged 18 or Older with Past Year Serious Mental Illness, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of adults in millions, the horizontal axis on the right shows the percentages that correspond to the number of adults, and the shared vertical axis shows the four age groups (18 or older, 18 to 25, 26 to 49, 50 or older).

There were 6.4 million adults aged 18 or older in 2015 who received mental health service in the past year with past year serious mental illness, or 65.3 percent.

There were 0.9 million adults aged 18 to 25 who received metal health service in the past year with past year serious mental illness, or 50.7 percent.

There were 3.2 million adults aged 26 to 49 who received mental health service in the past year with past year serious mental illness, or 66.1 percent.

There were 2.2 million adults aged 50 or older who received mental health service in the past year with past year serious mental illness, or 72.2 percent.

Long description end. Return to Figure 21.

Long description, Figure 22: Figure 22 is titled "Specific Types of Mental Health Services Received by Adults Aged 18 or Older with Past Year Any Mental Illness, by Age Group: Percentages, 2015." It is a bar graph, where four age groups (18 or older, 18 to 25, 26 to 49, 50 or older) are shown on the horizontal axis and the percentage of adults receiving mental health services with any mental illness in the past year is shown on the vertical axis. For each age, the figure shows four bars representing the type of mental health service. The first bar shows the percentage of adults with any mental illness who received any mental health services in the past year. The second bar shows the percentage of adults with any mental illness who received inpatient services in the past year. The third bar shows the percentage of adults with any mental illness who received outpatient services in the past year. The fourth bar shows the percentage of adults with any mental illness who received prescription medication in the past year.

Among adults aged 18 or older in 2015 who had any mental illness, 43.1 percent received any mental health services in the past year, 3.4 percent received inpatient services, 25.4 percent received outpatient services, and 36.7 percent received prescription medication.

Among adults aged 18 to 25 who had any mental illness, 32.0 percent received any mental health services in the past year, 4.3 percent received inpatient services, 20.6 percent received outpatient services, and 24.3 percent received prescription medication.

Among adults aged 26 to 49 who had any mental illness, 43.3 percent received any mental health services in the past year, 3.1 percent received inpatient services, 26.1 percent received outpatient services, and 36.4 percent received prescription medication.

Among adults aged 50 or older who had any mental illness, 48.3 percent received any mental health services in the past year, 3.5 percent received inpatient services, 27.0 percent received outpatient services, and 43.2 percent received prescription medication.

Long description end. Return to Figure 22.

Long description, Figure 23: Figure 23 is titled "Specific Types of Mental Health Services Received by Adults Aged 18 or Older with Past Year Serious Mental Illness, by Age Group: Percentages, 2015." It is a bar graph, where four age groups (18 or older, 18 to 25, 26 to 49, 50 or older) are shown on the horizontal axis and the percentage of adults receiving mental health services with serious mental illness in the past year is shown on the vertical axis. For each age, the figure shows four bars representing the type of mental health service. The first bar shows the percentage of adults with serious mental illness who received any mental health services in the past year. The second bar shows the percentage of adults with serious mental illness who received inpatient services in the past year. The third bar shows the percentage of adults with serious mental illness who received outpatient services in the past year. The fourth bar shows the percentage of adults with serious mental illness who received prescription medication in the past year.

Among adults aged 18 or older in 2015 who had serious mental illness, 65.3 percent received any mental health services in the past year, 7.0 percent received inpatient services, 43.6 percent received outpatient services, and 57.3 percent received prescription medication.

Among adults aged 18 to 25 who had serious mental illness, 50.7 percent received any mental health services in the past year, 8.9 percent received inpatient services, 36.0 percent received outpatient services, and 40.0 percent received prescription medication.

Among adults aged 26 to 49 who had serious mental illness, 66.1 percent received any mental health services in the past year, 7.3 percent received inpatient services, 44.8 percent received outpatient services, and 58.2 percent received prescription medication.

Among adults aged 50 or older who had serious mental illness, 72.2 percent received any mental health services in the past year, 5.5 percent received inpatient services, 46.0 percent received outpatient services, and 65.6 percent received prescription medication.

Long description end. Return to Figure 23.

Long description, Figure 24: Figure 24 is titled "Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Past Year Any Mental Illness: Percentages, 2008-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage receiving mental health services in the past year is shown on the vertical axis. For each of the four types of mental health services (any mental health services, inpatient, outpatient, and prescription medication), there is a line showing the percentage of adults who received mental health services with any mental illness over the years 2008 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 24.

Long description, Figure 25: Figure 25 is titled "Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Past Year Serious Mental Illness: Percentages, 2008-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage receiving mental health services in the past year is shown on the vertical axis. For each of the four types of mental health services (any mental health services, inpatient, outpatient, and prescription medication), there is a line showing the percentage of adults who received mental health services with serious mental illness over the years 2008 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 25.

Long description, Figure 26: Figure 26 is titled "Perceived Unmet Need for Mental Health Services in the Past Year among Adults Aged 18 or Older, by Mental Illness Level (in Millions): 2015." It is a stacked bar graph, where three levels of mental illness level (all adults, adults with any mental illness, and adults with serious mental illness) are shown on the horizontal axis and the number in millions of adults who had a perceived unmet need for mental health services in the past year is shown on the vertical axis. There are two notes below the figure. The first note says, "AMI = any mental illness; SMI = serious mental illness." The second note below the figure says, "The bottom number in each bar is the estimated number of adults with a perceived unmet need for mental health services who did not receive any mental health services in the past year. The top number in each bar is the total estimated number of adults with any perceived unmet need for mental health services, including those who did not receive any mental health services and those who had an unmet need for additional services."

In addition, each bar is divided into two sections for adults who did not receive any mental health services and adults who perceived an unmet need for additional services. The section of each bar for the perceived unmet need for additional services indicates the difference between the total number of adults who perceived an unmet need for mental health services and the number who did not receive any mental health services.

There were 11.2 million adults aged 18 or older in 2015 with a perceived unmet need for mental health services in the past year, including 5.2 million who did not receive any mental health services.

There were 8.8 million adults with AMI aged 18 or older with a perceived unmet need for mental health services in the past year, including 3.6 million who did not receive any mental health services.

There were 3.7 million adults with SMI aged 18 or older with a perceived unmet need for mental health services in the past year, including 1.1 million who did not receive any mental health services.

Long description end. Return to Figure 26.

Long description, Figure 27: Figure 27 is titled "Perceived Unmet Need for Mental Health Services in the Past Year among Adults Aged 18 or Older, by Mental Illness Level: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage with perceived unmet need for mental health services in the past year is shown on the vertical axis. For each of the three types of mental illness level (all adults, adults with any mental illness, adults with serious mental illness), there is a line showing the percentage of adults with perceived unmet need for mental health services over the years 2002 through 2015. There is note below the figure that says, "AMI = any mental illness; SMI = serious mental illness." Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 27.

Long description, Figure 28: Figure 28 is titled "Reasons for Not Receiving Mental Health Services in the Past Year among All Adults Aged 18 or Older with a Perceived Unmet Need for Mental Health Care Who Did Not Receive Mental Health Services: Percentages, 2015." It is a bar graph, where the percentage reporting a reason is shown on the horizontal axis and the reasons for not receiving mental health services are shown on the vertical axis. Fourteen reasons are shown: (1) could not afford cost, (2) thought could handle the problem without treatment, (3) did not know where to go for services, (4) did not have time, (5) treatment would not help, (6) might cause neighbors/community to have negative opinion, (7) health insurance does not pay enough for mental health treatment/counseling, (8) concerned about being committed/having to take medicine, (9) did not feel need for treatment at the time, (10) did not want others to find out, (11) might have negative effect on job, (12) concerned about confidentiality, (13) health insurance does not cover any mental health treatment/counseling, and (14) no transportation/inconvenient.

Among adults 18 or older in 2015 with a perceived unmet need for mental health care who did not receive mental health services in the past year, the following percentages did not receive mental health services for the following reasons: 43.6 percent because they could not afford the cost of treatment, 30.6 percent because they thought they could handle the problem without treatment, 26.9 percent because they did not know where to go for services, 20.5 percent because they did not have time, 12.9 percent because they thought treatment would not help, 12.6 percent because they thought that treatment might cause their neighbors or community to have a negative opinion of them, 10.8 percent because their health insurance does not pay enough for mental health treatment/counseling, 10.6 percent because they were concerned about being committed or having to take medicine, 10.1 percent because they did not feel the need for treatment at the time, 9.2 percent because they did not want others to find out, 8.5 percent because they thought treatment might have a negative effect on their job, 7.9 percent because they were concerned about confidentiality, 7.0 percent because their health insurance does not cover any mental health treatment/counseling, and 3.9 percent because they had no transportation or treatment was inconvenient.

Long description end. Return to Figure 28.

Long description, Figure 29: Figure 29 is titled "Reasons for Not Receiving Mental Health Services in the Past Year among Adults Aged 18 or Older with a Perceived Unmet Need for Mental Health Care Who Did Not Receive Mental Health Services, by Mental Illness Status: Percentages, 2015." It is a bar graph, where the percentage of adults is shown on the horizontal axis and the reasons for not receiving mental health services are shown on the vertical axis. Fourteen reasons are shown: (1) could not afford cost, (2) thought could handle the problem without treatment, (3) did not know where to go for services, (4) did not have time, (5) might cause neighbors/community to have negative opinion, (6) treatment would not help, (7) concerned about being committed/having to take medicine, (8) health insurance does not pay enough for mental health treatment/counseling, (9) might have negative effect on job, (10) did not want others to find out, (11) concerned about confidentiality, (12) did not feel need for treatment at the time, (13) health insurance does not cover any mental health treatment/counseling, and (14) no transportation/inconvenient. Each reason on the vertical axis has two bars: one is for adults with serious mental illness and the other is for adults with any mental illness. A note below the figure says, "AMI = any mental illness; SMI = serious mental illness."

Among adults aged 18 or older in 2015 who had SMI in the past year and a perceived unmet need for mental health care but who did not receive mental health services in the past year, the following percentages did not receive mental health services for the following reasons: 54.6 percent because they could not afford the cost, 27.4 percent because they thought they could handle the problem without treatment, 33.4 percent because they did not know where to go for services, 18.9 percent because they did not have the time, 15.6 percent because they thought that treatment might cause their neighbors or community to have a negative opinion, 17.8 percent because they thought treatment would not help, 22.3 percent because they were concerned about being committed or having to take medicine, 11.2 percent because their health insurance does not pay enough for mental health treatment/counseling, 14.2 percent because they thought that treatment might have a negative effect on their job, 12.5 percent because they did not want others to find out, 13.2 percent because they were concerned about confidentiality, 11.1 percent because they did not feel the need for treatment at the time, 9.7 percent because their health insurance does not cover any mental health treatment/counseling, and 8.8 percent because they had no transportation or treatment was inconvenient.

Among adults aged 18 or older in 2015 who had AMI in the past year and a perceived unmet need for mental health care but who did not receive mental health services in the past year, the following percentages did not receive mental health services for the following reasons: 49.5 percent because they could not afford the cost, 30.0 percent because they thought they could handle the problem without treatment, 28.0 percent because they did not know where to go for services, 20.1 percent because they did not have the time, 13.9 percent because they thought that treatment might cause their neighbors or community to have a negative opinion, 13.8 percent because they thought treatment would not help, 13.4 percent because they were concerned about being committed or having to take medicine, 11.4 percent because their health insurance does not pay enough for mental health treatment/counseling, 10.9 percent because they thought that treatment might have a negative effect on their job, 10.3 percent because they did not want others to find out, 10.0 percent because they were concerned about confidentiality, 9.9 percent because they did not feel the need for treatment at the time, 7.5 percent because their health insurance does not cover any mental health treatment/counseling, and 5.2 percent because they had no transportation or treatment was inconvenient.

Long description end. Return to Figure 29.

Long description, Figure 30: Figure 30 is titled "Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Had Past Year Any Mental Illness and Substance Use Disorders: Percentages, 2015." It is a pie chart, with the following written below the chart: "8.1 Million Adults with Co-Occurring Any Mental Illness and Substance Use Disorders." The pie chart shows the percentages of adults with co-occurring mental illness and substance use disorders who received no treatment, received mental health care only, received specialty substance use treatment only, and received both mental health care and specialty substance use treatment. There are two notes written below the graph. The first note says, "Mental health care is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Specialty substance use treatment refers to treatment at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop drug or alcohol use, or for medical problems associated with drug or alcohol use." The second note says, "The percentages do not add to 100 percent due to rounding."

Of the 8.1 million adults with co-occurring mental illness and substance use disorders in 2015, 52.0 percent received no treatment, 36.7 percent received mental health care only, 4.4 percent received specialty substance use treatment only, and 6.8 percent received both mental health care and specialty substance use treatment.

Long description end. Return to Figure 30.

Long description, Figure 31: Figure 31 is titled "Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Had Past Year Serious Mental Illness and Substance Use Disorders: Percentages, 2015." It is a pie chart, with the following written below the chart: "2.3 Million Adults with Co-Occurring Serious Mental Illness and Substance Use Disorders." The pie chart shows the percentage of adults with co-occurring serious mental illness and substance use disorders who received no treatment, received mental health care only, received specialty substance use treatment only, and received both mental health care and specialty substance use treatment. A note below the figure says, "Mental health care is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Specialty substance use treatment refers to treatment at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop drug or alcohol use, or for medical problems associated with drug or alcohol use."

Of the 2.3 million adults with co-occurring serious mental illness and substance use disorders in 2015, 37.4 percent received no treatment, 47.4 percent received mental health care only, 4.2 percent received specialty substance use treatment only, and 11.0 percent received both mental health care and specialty substance use treatment.

Long description end. Return to Figure 31.

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