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News and Notes   |    
SAMHSA's Latest Report on the Nation's Mental Health
Psychiatric Services 2012; doi: 10.1176/appi.ps.20120p619
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Copyright © 2012 by the American Psychiatric Association.

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Every two years since 1980 the Substance Abuse and Mental Health Services Administration (SAMHSA) has published a new volume in the Mental Health, United States series. The latest report, Mental Health, United States, 2010, compiles statistics from 35 data sources on the mental health of Americans, on service providers and settings, and on payers and payment mechanisms. As the nation implements health reform and parity, the need to monitor the service delivery system by collecting accurate data and conducting more targeted research is particularly pressing, the report notes.

In this regard, Section 6 of the 350-page report describes key gaps in available data sources and identifies areas in which further study is indicated. The authors note that despite the strengths of the data sources used to compile the report, the nation lacks a robust public health surveillance system that can track over time the population's overall mental health status; capacity of, access to, and receipt of treatment; and the degree to which the need for treatment is met. Existing surveillance systems that track other diseases, such as HIV-AIDS, could serve as examples for mental health.

Recovery from mental illness is an area singled out for more research. Data are needed to monitor and track mental illness from the onset of a person's symptoms through the period of recovery. Surveillance data are also needed for people in vulnerable subpopulations, the report notes. No reliable national or subnational-level data are available to monitor the mental health of children, people who are homeless, military families, and people in jails and prisons. As health care reforms broaden access in the next few years, researchers will also need to assess gaps in treatment capacity. This entails collecting data on treatment need and treatment receipt and then combining them. In this regard, the authors lament the lack of a single data source of data on the mental health workforce. Data are also lacking with which to reliably and regularly estimate Medicaid mental health spending. Also unreliable are current estimates of the amount of mental health care being provided by nonspecialty physicians, such as primary care physicians, and better data are needed.

Several new features of the 2010 volume enhance its usefulness. Perhaps the most significant addition is the state-level estimates section, which helps address the need for state-level data to inform day-to-day decisions on budgeting, planning, and care provision. Other new features provide expanded information on some special populations, such as children and members of the military; on mental health service provision in nontraditional settings, such as clubhouses; and on the impact of the recent recession on service provision.

The following are highlights of the data presented in Mental Health, United States, 2010:

  • Approximately 11 million adults (4.8%) had a serious mental illness in 2009, more than a quarter of these adults had a co-occurring substance use disorder, and 40% reported not receiving any treatment.

  • During the 2001–2004 period, one out of eight U.S. children aged 8 to 15 (or 13.1%) had a past-year mental disorder, and more than half of these children received treatment in a hospital, clinic, or office.

  • In 2007, more than 34,000 deaths in the United States were due to suicide.

  • In 2009, more than one in eight adults received some type of mental health treatment in the past year.

  • Although mental health expenditures have increased (from $32 billion in 1986 to $132 billion in 2005), they have fallen as a share of all health expenditures (from 7.2% in 1986 to 6.1% in 2005).

  • During the 2005–2009 period, utilization rates of outpatient specialty mental health treatment by state ranged from 3.0% to 9.5% for adults and from 8.0% to 16.9% for youths age 12 to 17.

The scope of the next volume in the series, Behavioral Health, United States, 2012, will be broadened to include information on substance use disorders. The authors note that this larger perspective on behavioral health will help strengthen the series' utility as a key resource for decision making in a changing and challenging health care landscape. The new report is available for download on the SAMHSA Web site at www.samhsa.gov/data/2k12/MHUS2010/index.aspx.




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