Any Mental Illness (AMI) aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These estimates are based on indicators of AMI rather than direct measures of diagnostic status. For details, see Section B of 2021-2022 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-2022-nsduh-guide-state-tables-and-summary-sae-methodology. 

Data survey years: 2021-2022.

Substance use disorder (SUD) estimates are based on DSM-5 criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in this table include prescription drug use disorder data from all past year users of prescription drugs.

Respondents were classified as needing substance use treatment if they met Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for a drug or alcohol use disorder or received treatment for drug or alcohol use through inpatient treatment/counseling, outpatient treatment/counseling, medication-assisted treatment, telehealth treatment, or treatment received in a prison, jail, or juvenile detention center. Substance use treatment questions are asked of respondents who used drugs or alcohol in their lifetime.

Not receiving substance use treatment among those needing treatment (%) = 100 * [X1 ÷ (X1 + X2)], where X1 is the number of people not receiving treatment who needed treatment, X2 is the number people receiving treatment who needed treatment, and (X1+ X2) denotes the number of people who needed treatment.

Data survey year: 2022.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health,

https://www.samhsa.gov/data/release/2022-national-survey-drug-use-and-health-nsduh-releases

For IRINSUR4, a respondent is classified as having any health insurance (IRINSUR4=1) if they satisfied ANY of the following conditions:

1. Covered by Medicare (IRMEDICR=1); 2. Covered by Medicaid/CHIP (IRMCDCHP=1); 3. Covered by Tricare, Champus, ChampVA, VA, or Military (IRCHMPUS=1); 4. Covered by private insurance (IRPRVHLT=1); 5. Covered by other health insurance (IROTHHLT=1).

A respondent is classified as NOT having any health insurance (IRINSUR4=2) if they meet EVERY one of the following conditions:

1. Not covered by Medicare (IRMEDICR=2); 2. Not covered by Medicaid/CHIP (IRMCDCHP=2); 3. Not covered by Tricare, Champus, ChampVA, VA, or Military (IRCHMPUS=2); 4. Not covered by private insurance (IRPRVHLT=2); 5. Not covered by other health insurance (IROTHHLT=2).

Data survey years: 2021-2022.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health,

https://www.samhsa.gov/data/release/2022-national-survey-drug-use-and-health-nsduh-releases

Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 National Survey on Drug Use and Health, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year.

Data survey years: 2021-2022.

Adults Reporting 14+ Mentally Unhealthy Days a Month Who Could Not See a Doctor Due to Costs

This indicator is derived from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System (BRFSS) core questionnaire. Mentally unhealthy days were determined using the calculated variable _MENT14D. _MENT14D is calculated from the following BRFSS question: “Now thinking about mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?” (MENTHLTH). The calculated variable, _MENT14D, contains four values: Zero days when mental health was not good, 1-13 days when mental health was not good, 14+ days when mental health was not good, and don’t know/refused/missing. 

Respondents were also asked: “Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?” (MEDCOST). The measure was calculated based on individuals who answered “yes” to MEDCOST among those who answered “14+ days when mental health was not good” to _MENT14D.

Data survey year: 2022.

Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System Survey Data 2022, https://www.cdc.gov/brfss/annual_data/annual_2022.html

Downloaded and calculated on 5/8/2024.

Adults ages 18 or older were asked: “At any time in the past 12 months, did you seriously think about trying to kill yourself?” If they answered “Yes,” they were categorized as having serious thoughts of suicide in the past year.

Data survey years: 2021-2022.

Youth with private insurance that did not cover mental or emotional problems is defined as any individual ages 12-17 responding “No” to HLTINMNT. HLTINMNT is defined as: “Does [SAMPLE MEMBER POSS] private health insurance include coverage for treatment for mental or emotional problems?”

Data survey years: 2021-2022.

Mental health workforce availability is the ratio of the county population to the number of mental health providers, including psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, and advanced practice nurses specializing in mental health care. In 2015, marriage and family therapists and mental health providers that treat alcohol and other drug abuse were added to this measure. 

These data come from the National Provider Identification data file, which has some limitations. Providers who transmit electronic health records are required to obtain an identification number, but very small providers may not obtain a number. While providers have the option of deactivating their identification number, some mental health professionals included in this list may no longer be practicing or accepting new patients. This may result in an overestimation of active mental health professionals in some communities. It is also true that mental health providers may be registered with an address in one county while practicing in another county.

Data survey year: 2022. 

County Health Rankings and Roadmaps.http://www.countyhealthrankings.org/

This measure was calculated from data provided by IDEA Part B Child Count and Educational Environments, Common Core of Data. Under IDEA regulation, emotional disturbance is identified as a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which adversely affects a child’s educational performance: 1. an inability to learn, which cannot be explained by intellectual, sensory or health factors; 2. an inability to build or maintain satisfactory interpersonal relationships with peers and teachers; 3. inappropriate behavior or feelings under normal circumstances; 4. a general pervasive mood of unhappiness or depression; or 5. a tendency to develop physical symptoms or fears associated with personal or school problems. This term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined they have an emotional disturbance.

Percent of Students Identified with Emotional Disturbance for an Individualized Education Program was calculated as the percent of children identified as having an emotional disturbance among all enrolled students of “school age,” which includes kindergarten, grades 1-12, and “ungraded.” 

 

Data survey years: 2022-2023.

IDEA Data Center, 2022 IDEA Section 618, State Level Data Files, Child Count and Educational Environments. https://data.ed.gov/dataset/idea-section-618-state-part-b-child-count-and-educational-environments/resources

U.S. Department of Education, National Center for Education Statistics, Common Core of Data. https://nces.ed.gov/ccd/files.asp

Downloaded and calculated on 2/21/2024.

Among youth ages 12-17, Major Depressive Episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. For details, see Section B of 2021-2022 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-2022-nsduh-guide-state-tables-and-summary-sae-methodology. 

Data survey years: 2021-2022.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/release/2022-national-survey-drug-use-and-health-nsduh-releases

Among youth ages 12-17, substance use disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 National Survey on Drug Use and Health, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. Drug Use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year.

Data survey years: 2021-2022.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/release/2022-national-survey-drug-use-and-health-nsduh-releases

Youth with Past Year MDE Who Did Not Receive Treatment is defined as those who apply to having past year MDE as defined above (“Youth With At Least One Past Year Major Depressive Episode,” YMDEYR) and respond “No” to YMDETXRX.

YMDETXRX is a recoded variable from combining the data from the variables YTXMDEYR and YRXMDEYR. YTXMDEYR is calculated from the question, “At any time in the past 12 months, did you see or talk to a medical doctor or other professional about your [FEELNOUN]?” YRXMDEYR is calculated from the question. “During the past 12 months, did you take prescription medication that was prescribed for [NUMPROBS]?” A response of “No” to YMDETXRX includes all youth 12-17 who answered “No” to both YTXMDEYR and YRXMDEYR.

Data survey years: 2021-2022.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health,

https://www.samhsa.gov/data/release/2022-national-survey-drug-use-and-health-nsduh-releases

Youth ages 12-17 were asked: “At any time in the past 12 months, did you seriously think about trying to kill yourself?” If they answered “Yes,” they were categorized as having serious thoughts of suicide in the past year.

Data survey years: 2021-2022.

For children ages 6-17 years, three questions were asked that aimed to capture curiosity and discovery about learning, resilience, and self-regulation. The survey question asked, "How often does this child: show interest and curiosity in learning new things (K6Q71_R), work to finish tasks they start (K7Q84_R), and (3) stay calm and in control when faced with a challenge?" (K7Q85_R). The "Always" or "Usually" responses to the question indicate the child meets the flourishing item criteria. Questions were developed based on a review of positive health indicators by a Technical Expert Panel (TEP). This TEP included a representative group of experts in the field of survey methodology, children's health, community organizations, and family leaders. Additionally, there was a public comment period which yielded more interest in this concept.

Youth were considered to be flourishing on this measure if they reached all three flourishing items. 

Data survey years: 2021-2022.

Child and Adolescent Health Measurement Initiative. 2021-2022 National Survey of Children’s Health (NSCH) data query. 

Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). 

Retrieved 5/1/2024 from www.childhealthdata.org

Adults with AMI with private insurance that did not cover mental or emotional problems is defined as adults ages 18+ with AMI responding “No” to HLTINMNT. For more information on what classifies adults with AMI, see the indicator Adults with Any Mental Illness (AMI). 

HLTINMNT is defined as: “Does [SAMPLE MEMBER POSS] private health insurance include coverage for treatment for mental or emotional problems?”

Data survey years: 2021-2022.

Youth who reported receiving treatment or counseling for their mental health in the past 12 months were asked the question, “During the past 12 months, how much has treatment or counseling helped you?” [YOTMTHLP]. The options for this question were 1=Not at all, 2=A little, 3=Some, 4=A lot, and 5=Extremely. 

Youth with MDE Reporting Treatment or Counseling Helped Them was calculated from youth (ages 12-17) with at least one past year MDE and answered 3=Some, 4=A lot, or 5=Extremely to YOTMTHLP. 

For more information on what classifies youth with MDE, see the indicator Youth with at Least One Past Year Major Depressive Episode (MDE).

Data survey years: 2021-2022.