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Highlights of Recent Reports on Mental Health

bulletPrevalence of mental illness

bulletTreatment and mental health issues

bulletYouth and mental health issues

bulletChildren's mental health

bulletAll mental health reports and data
 

Highlights of Reports on Prevalence of Mental Illness

 

  • newThe NSDUH Report: Major Depressive Episode among Youths Aged 12 to 17   Based on SAMHSA's National Survey on Drug Use and Health, 8.5% of youth (about 2.1 million youth) had experienced at least one major depressive episode during the past year. Rates of depression varied by gender and age.   Female youth were more than twice as likely as males to have experienced a major depressive episode in the past year (12.7% vs. 4.6%).   Over 91% of the youth who experienced at least one major depressive episode in the past year reported more than one period in their lifetime during which for 2 weeks or longer they felt sadness, discouragement, or boredom and also had other problems.   Nearly half (48.3%) of the youth with a major depressive episode in the past year reported severe impairment in at least one of four major role domains (home, school/work, family relationships, or social life) and 21% reported very severe impairment in at least one of the domains.   Youth with a major depressive episode who reported a very severe impairment were unable to carry out normal activities on about 5 times more days in the past year than those reporting no more than mild impairment (58.4 days vs. 11.7 days).
  • newThe NSDUH Report:  Nonmedical Stimulant Use, Other Drug Use, Delinquent Behaviors, and Depression Among Adolescents   SAMHSA's National Survey on Drug Use and Health estimated that about 510,000 youth aged 12 to 17 (2%) used stimulants (including methamphetamines) nonmedically in the past year in 2006. Nonmedical use is defined as the use of prescription-type psychotherapeutic drugs that were not prescribed for the respondent by a physician or were used only for the experience or feeling they caused.   Over 71% of youth who used stimulants nonmedically in the past year compared with 34% of youth who did not use stimulants nonmedically also engaged in at least one of the six types of delinquent behaviors in the past year that were included in SAMHSA's National Survey of Drug Use. These delinquent behaviors were: (1) got into a serious fight, (2) took part in a group fight against another group, (3) sold drugs, (4) stole anything valued more than $50, (5) attacked someone, and (6) carried a handgun.   Youth who used stimulants nonmedically in the past year were also more likely than youth who did not use stimulants nonmedically to have experienced a major depressive episode in the past year (23% vs. 8.1%).
  • The NSDUH Report: Depression and the Initiation of Alcohol and Other Drug Use among Young Adults  Combined data from SAMHSA's 2005 and 2006 National Surveys on Drug Use and Health found an annual average of 9.4% of young adults (about 3 million) had experienced at least one major depressive episode during the past year. Rates of major depressive episode varied by gender, racial group, and Hispanic status.  About 1.5 million young adults (25.1% of the young adults who had not used alcohol previously) used alcohol for the first time in the past year.   About 870,000 young adults (6.1% of the young adults who had not used an illicit drug previously) used at least one illicit drug in the past year.  Among young adults who had not used alcohol previously, 33.7% of those with a major depressive episode started using alcohol compared with 24.8% of the young adults who had not experienced a major depressive episode in the past year.  Among young adults who had not used any illicit drug previously, those who experienced a major depressive episode in the past year were twice as likely to have initiated use of an illicit drug than young adults who had not experienced a major depressive episode in the past year (12.0% vs. 5.8%). 
  • The NSDUH Report: Depression and the Initiation of Alcohol and Other Drug Use among Youths Aged 12 to 17   Data from SAMHSA's 2005 National Survey on Drug Use and Health were used to examine the following in the past year: major depressive episode, initiation of alcohol or illicit drug use, and the association between such new alcohol and/or illicit drug use and major depressive episode. In 2005, 8.8% of youth (about 2.2 million youth) had experienced at least one major depressive episode during the past year.   Rates of major depressive episode varied by gender and age. About 2.7 million youth (15.4% of the youth who had not used alcohol previously) used alcohol for the first time in the past year.   About 1.5 million youth (7.6% of the youth who had not used an illicit drug previously) used at least one illicit drug in the past year. Among youth who had not used alcohol or an illicit drug previously, those with a major depressive episode were about twice as likely to start using alcohol or an illicit drug as youth who had not experienced a major depressive episode in the past year.   Among youth who had not used alcohol previously, 29.2% of those with a major depressive episode initiated alcohol use compared with 14.5% youth who had not experienced a major depressive episode in the past year. Among youth who had not used an illicit drug previously, 16.1% of those with a major depressive episode initiated illicit drug use compared with 6.9% youth who had not experienced a major depressive episode in the past year. 
  • The NSDUH Report:  Substance Use Disorder and Serious Psychological Distress by Employment Status    Among full time employed adults aged 18 to 64 in SAMHSA's National Survey on Drug Use and Health, 10.6% were classified as having a past year substance use disorder, 10.2% experienced serious psychological distress during the past year, and 2.4% had co-occurring serious psychological distress and a substance use disorder.   Full time employed males in this age group were nearly twice as likely to have a past year substance use disorder than their female counterparts (13.2% vs. 6.9%).   In contrast, females were nearly twice as likely to have experienced serious psychological distress during the past year than were the males (14.2% vs. 7.3%). Of the 2.9 million adults aged 18 to 64 employed full time who had co-occurring serious psychological distress and a substance use disorder, nearly 60% were not treated for either problem and less than 5% were treated for both problems.
  • The New DAWN Report:  Emergency Department Visits Involving Patients with Co-occurring Disorders  During 2004, an estimated 192,690 patients in drug-related emergency department visits were diagnosed with co-occurring substance use and mental disorders.  When emergency department visits involved co-occurring disorders, 40.4% were treated and released home or referred to detoxification or other drug treatment and 42.2% were admitted to inpatient units including chemical dependency or detoxification units.   Of the emergency department visits with co-occurring diagnosis, the drug most frequently reported were cocaine (31.8%), alcohol (29.3%), opiates/opioids (18.0%),  and marijuana (16.3%). 
  • The New DAWN Report:  Disposition of Emergency Department Visits for Drug-Related Suicide Attempts by Adolescents, 2004   According to SAMHSA's Drug Abuse Warning Network (DAWN),  in 2004 there were over 15,000 emergency department visits by adolescents aged 12 to 17 whose suicide attempts involved drugs.    Pain medications were involved in about half of the suicide attempts.  Almost three quarters of the drug related suicide attempts were serious enough to merit the patient's admission to the same hospital or transfer to another health care facility.  Antidepressants or other psychotherapeutic medications were involved in over 40% of the suicide attempts by adolescents who were admitted to the hospital.   
  • The NSDUH Report:  Serious Psychological Distress and Substance Use among Young Adult Males   SAMHSA's National Survey on Drug Use and Health in 2002 through 2004 assessed whether respondents met criteria for serious psychological distress during the month in the past year when respondents were at their worst emotionally. An estimated 10.3% of males aged 18 to 25 (1.6 million persons) experienced serious psychological distress during the past year. Divorced or separated males aged 18 to 25 (20.9%) were more likely to have experienced serious psychological distress during the past year than those who were married (7.3%) or never married (10.5%). Males aged 18 to 25 with serious psychological distress during the past year were more likely than those without past year serious psychological distress to have engaged in heavy alcohol use (27.2% vs. 20.7%), binge alcohol use (56.7% vs. 49.9%), and illicit drug use (35.6% vs. 22.1%) in the past month.
  • The DASIS Report:  Facilities Offering Special Programs or Groups for Clients with Co-Occurring Disorders,  2004   Of the 13,454 facilities that responded to SAMHSA's National Survey of Substance Abuse Treatment Services (N-SSATS), 4756 facilities (35%) had special programs or groups for clients with co-occurring psychiatric and substance use disorders in 2004. Facilities operated by State governments were most likely to offer special programs or groups for clients with co-occurring substance abuse and psychiatric disorders (50%), followed by those operated by local governments (44%), the Federal government (41%) and private non-profit organizations (36%). Facilities operated by private-for-profit organizations (31%) and Tribal governments (29%) were least likely to offer special programs or groups for clients with co-occurring substance abuse and psychiatric disorders Facilities with special programs or groups for clients with co-occurring substance abuse and psychiatric disorders were more likely than those not offering such special programs or groups to offer a number of services, including family counseling (83% vs. 73%), Hepatitis B testing (30% vs. 19%), transitional social services (65% vs. 49%), domestic violence services (40% vs. 29%), and HIV testing (38% vs. 28%).
  • The NSDUH Report:  Depression among Adolescents    An estimated 9% of adolescents aged 12 to 17 (approximately 2.2 million adolescents) had experienced at least one major depressive episode during the past year as reported in SAMHSA's 2004 National Survey on Drug Use and Health. Among adolescents aged 12 to 17 who experienced at least one major depressive episode during the past year, 40.3% reported having received treatment for depression during the past year. Adolescents who had experienced a major depressive episode in the past year were more than twice as likely to have used illicit drugs in the past month than their peers who had not experienced a major depressive episode in the past year (21.2% vs. 9.6%).
  • The NSDUH Report:  Depression among Adults    As reported in SAMHSA's 2004 National Survey on Drug Use and Health, an estimated 8% of adults aged 18 or older (approximately 17.1 million adults) had experienced at least one major depressive episode during the past year. Among adults aged 18 or older who experienced at least one major depressive episode during the past year, 65.1% reported having received treatment for depression during the past year. The rate of past month illicit drug use was nearly twice as high among adults who had experienced a major depressive episode in the past year (14.2%) compared with adults who had not experienced a major depressive episode in the past year (7.3%).
  • The NSDUH Report:  Mother's Serious Mental Illness and Substance Use among Youths   Based on SAMHSA's National Survey on Drug Use and Health in 2002 and 2003, an annual average of 18 million women aged 18 or older lived with a biological, foster, step, or adoptive child aged 12 to 17. About 11.9% of mothers (2.1 million) living with youths aged 12 to 17 had serious mental illness during the past year. About 3.2% of the mothers had both serious mental illness and also reported illicit drug use, binge alcohol use, or heavy alcohol use during the past month. Youths living with a mother who had serious mental illness (SMI) were more likely to have used alcohol or an illicit drug during the past month (26.7%) than youths living with a mother who did not have SMI (18.8%).
  • The NSDUH Report:  Suicidal Thoughts among Youths Aged 12 to 17 with Major Depressive Episode   In SAMHSA's 2004 National Survey on Drug Use and Health, an estimated 14% of youths aged 12 to 17, approximately 3.5 million youths, had experienced at least one major depressive episode in their lifetime. Over 7%, an estimated 1.8 million youths, had lifetime major depressive episode and thought about killing themselves at the time of their worst or most recent episode. An estimated 712,000 youths had tried to kill themselves during their worst or most recent major depressive episode; this represents 2.9% of those aged 12 to 17.
  • The NSDUH Report:  Male Veterans with Co-Occurring Serious Mental Illness and a Substance Use Disorder   Among males aged 18 and older in 2002 and 2003, SAMHSA's National Survey on Drug Use and Health found an estimated 8% (2 million) of veterans and 14.6% (11.1 million) nonveterans were dependent on or abusing alcohol or illicit drugs. An estimated 4.6% (1.2 million) of veterans and 7% (5.3 million) nonveterans had a serious mental illness. An estimated 340,000 male veterans had co-occurring serious mental illness (SMI) and a substance use disorder in 2002 and 2003. Although not statistically significant, within each age group of males the veterans had higher rates of these co-occurring disorders than nonveterans: aged 18 to 25 (6.4% veterans vs. 4.5% nonveterans); aged 26 to 54 (2.5% veterans vs. 2% nonveterans); and aged 55 or older (0.6% veterans vs. 0.3% nonveterans).
  • The NSDUH Report:  Women with Co-Occurring Serious Mental Illness and a Substance Use Disorder   Based on SAMHSA's 2002 National Survey on Drug Use and Health, nearly 2 million women aged 18 or older were estimated to have both serious mental illness (SMI) and a substance use disorder during the past year. Women with co-occurring SMI and a substance use disorder were more likely than men with co-occurring SMI and a substance use disorder to have received treatment for a mental disorder and/or specialty substance use treatment during the past year.
  • The NSDUH Report:  Age at First Use of Marijuana and Past Year Serious Mental Illness   Based on SAMHSA's 2002 and 2003 National Surveys on Drug Use & Health (NSDUH), an estimated 90.8 million adults (42.9%) aged 18 or older had used marijuana at least once in their lifetime. Among lifetime marijuana users aged 18 or older, 2.1% reported that they first used marijuana before age 12; 52.7% reported first marijuana use between ages 12 and 17, and 45.2% reported first marijuana use at age 18 or older. About 12.5 % of persons aged 18 or older who reported lifetime marijuana use were classified as having a serious mental illness (SMI) in the past year. Adults who first used marijuana before age 12 (21%) were twice as likely as adults who first used marijuana at age 18 or older (10.5%) to be classified as having a serious mental illness in the past year.
  • Serious Mental Illness and Its Co-Occurrence with Substance Use Disorders, 2002   Based on SAMHSA's National Survey on Drug Use and Health, in 2002, there were 17.5 million adults aged 18 or older with serious mental illness (SMI) during the 12 months prior to being interviewed. This represents 8.3% of all adults in the United States. On average, adults with SMI were younger, less educated, and more likely to be female than adults without SMI.  The two racial/ethnic groups with the highest prevalence of SMI were those reporting more than one race (13.6%) and American Indians and Alaska Natives (12.5%).  The prevalence of SMI was more than twice as high among those who used an illicit drug during the past year than it was among those who did not (17.1 vs. 6.9%). This relationship was observed across most demographic and socioeconomic subgroups and across most types of illicit drugs used.  In 2002, there were 5 million adults aged 18 or older who had SMI and used an illicit drug in the past year; this represented 28.9% of all persons with SMI. 
  • 2001 State Estimates of Substance Use.   For the first time, SAMHSA's National Household Survey on Drug Abuse provides state-level estimates of serious mental illness and includes maps showing the prevalence ranks by States.  The States with the highest rates of serious mental illness among adults age 18 and older were mostly in the South.  However, Oklahoma had the highest rate and Hawaii had the lowest rate of serious mental illness among adults.  Also, State-level data and the average yearly change between 1999 and 2001 are presented for 18 measures of substance use, dependence, and treatment. 
  • The NHSDA Report:  Risk of Suicide Among Hispanic Females Aged 12 to 17    In 2000, Hispanic females aged 12 to 17 were at higher risk for suicide than other youths.  Rates of suicide risk were similar among Hispanic female youths across regions and ethnic subgroups (e.g., Mexican, Puerto Rican, Central or South American and Cuban).  Only 32 percent of Hispanic female youths at risk for suicide during the past year, however, received mental health treatment during this same time period.
  • 2001 National Household Survey on Drug Abuse   In 2001, an estimated 15.9 million Americans age 12 years or older used an illicit drug in the month immediately prior to the survey interview.  About 10.1 million persons age 12 to 20 years  reported current alcohol use, i.e., were underage drinkers.  In the 12 months preceding the interview in 2001, an estimated 3.1 million persons age 12 or older received some kind of treatment for a problem related to the use of alcohol or illicit drugs; of these, 1.6 million received treatment at a self-help group.  In 2001, there were an estimated 14.8 million adults age 18 or older with a serious mental illness; an estimated 3 million had both a serious mental illness and substance abuse or dependence problems during the year. 

Youth & Mental Health Issues

 

  • newThe NSDUH Report: Major Depressive Episode among Youths Aged 12 to 17   Based on SAMHSA's National Survey on Drug Use and Health, 8.5% of youth (about 2.1 million youth) had experienced at least one major depressive episode during the past year. Rates of depression varied by gender and age.   Female youth were more than twice as likely as males to have experienced a major depressive episode in the past year (12.7% vs. 4.6%).   Over 91% of the youth who experienced at least one major depressive episode in the past year reported more than one period in their lifetime during which for 2 weeks or longer they felt sadness, discouragement, or boredom and also had other problems.   Nearly half (48.3%) of the youth with a major depressive episode in the past year reported severe impairment in at least one of four major role domains (home, school/work, family relationships, or social life) and 21% reported very severe impairment in at least one of the domains.   Youth with a major depressive episode who reported a very severe impairment were unable to carry out normal activities on about 5 times more days in the past year than those reporting no more than mild impairment (58.4 days vs. 11.7 days).
  • newThe NSDUH Report:  Nonmedical Stimulant Use, Other Drug Use, Delinquent Behaviors, and Depression Among Adolescents   SAMHSA's National Survey on Drug Use and Health estimated that about 510,000 youth aged 12 to 17 (2%) used stimulants (including methamphetamines) nonmedically in the past year in 2006. Nonmedical use is defined as the use of prescription-type psychotherapeutic drugs that were not prescribed for the respondent by a physician or were used only for the experience or feeling they caused.   Over 71% of youth who used stimulants nonmedically in the past year compared with 34% of youth who did not use stimulants nonmedically also engaged in at least one of the six types of delinquent behaviors in the past year that were included in SAMHSA's National Survey of Drug Use. These delinquent behaviors were: (1) got into a serious fight, (2) took part in a group fight against another group, (3) sold drugs, (4) stole anything valued more than $50, (5) attacked someone, and (6) carried a handgun.   Youth who used stimulants nonmedically in the past year were also more likely than youth who did not use stimulants nonmedically to have experienced a major depressive episode in the past year (23% vs. 8.1%).
  • The NSDUH Report: Depression and the Initiation of Alcohol and Other Drug Use among Youths Aged 12 to 17   Data from SAMHSA's 2005 National Survey on Drug Use and Health were used to examine the following in the past year: major depressive episode, initiation of alcohol or illicit drug use, and the association between such new alcohol and/or illicit drug use and major depressive episode. In 2005, 8.8% of youth (about 2.2 million youth) had experienced at least one major depressive episode during the past year.   Rates of major depressive episode varied by gender and age. About 2.7 million youth (15.4% of the youth who had not used alcohol previously) used alcohol for the first time in the past year.   About 1.5 million youth (7.6% of the youth who had not used an illicit drug previously) used at least one illicit drug in the past year. Among youth who had not used alcohol or an illicit drug previously, those with a major depressive episode were about twice as likely to start using alcohol or an illicit drug as youth who had not experienced a major depressive episode in the past year.   Among youth who had not used alcohol previously, 29.2% of those with a major depressive episode initiated alcohol use compared with 14.5% youth who had not experienced a major depressive episode in the past year. Among youth who had not used an illicit drug previously, 16.1% of those with a major depressive episode initiated illicit drug use compared with 6.9% youth who had not experienced a major depressive episode in the past year. 
  • The New DAWN Report:  Disposition of Emergency Department Visits for Drug-Related Suicide Attempts by Adolescents, 2004  According to SAMHSA's Drug Abuse Warning Network (DAWN),  in 2004 there were over 15,000 emergency department visits by adolescents aged 12 to 17 whose suicide attempts involved drugs.    Pain medications were involved in about half of the suicide attempts.  Almost three quarters of the drug related suicide attempts were serious enough to merit the patient's admission to the same hospital or transfer to another health care facility.  Antidepressants or other psychotherapeutic medications were involved in over 40% of the suicide attempts by adolescents who were admitted to the hospital. 
  •  The NSDUH Report:  Depression among Adolescents   An estimated 9% of adolescents aged 12 to 17 (approximately 2.2 million adolescents) had experienced at least one major depressive episode during the past year as reported in SAMHSA's 2004 National Survey on Drug Use and Health. Among adolescents aged 12 to 17 who experienced at least one major depressive episode during the past year, 40.3% reported having received treatment for depression during the past year. Adolescents who had experienced a major depressive episode in the past year were more than twice as likely to have used illicit drugs in the past month than their peers who had not experienced a major depressive episode in the past year (21.2% vs. 9.6%).
  • The DASIS Report:  Adolescents with Co-Occurring Psychiatric Disorders:  2003   Of the approximately 78,000 admissions aged 12 to 17 in the 26 States that reported presence or absence of co-occurring problems to SAMHSA's Treatment Episode Data Set (TEDS), about 16,000 (21%) were admissions with a co-occurring psychiatric problem in addition to an alcohol and/or drug problem. Adolescent admissions with co-occurring disorders were more likely to be female than adolescent admissions for only substance use disorders (38% vs. 28%). Nearly three-quarters of adolescent admissions with co-occurring disorders were White (72%) compared to half of adolescent admissions for only substance use disorders (51%). Criminal justice system referrals for treatment were the most common source of referral for both adolescent admissions with co-occurring disorders (48%) and adolescent admissions for only substance use disorders (57%).
  • The NSDUH Report:  Mother's Serious Mental Illness and Substance Use among Youths   Based on SAMHSA's National Survey on Drug Use and Health in 2002 and 2003, an annual average of 18 million women aged 18 or older lived with a biological, foster, step, or adoptive child aged 12 to 17. About 11.9% of mothers (2.1 million) living with youths aged 12 to 17 had serious mental illness during the past year. About 3.2% of the mothers had both a serious mental illness and also reported illicit drug use, binge alcohol use, or heavy alcohol use during the past month. Youths living with a mother who had serious mental illness (SMI) were more likely to have used alcohol or an illicit drug during the past month (26.7%) than youths living with a mother who did not have SMI (18.8%).
  • The NSDUH Report:  Suicidal Thoughts among Youths Aged 12 to 17 with Major Depressive Episode   In SAMHSA's 2004 National Survey on Drug Use and Health, an estimated 14% of youths aged 12 to 17, approximately 3.5 million youths, had experienced at least one major depressive episode in their lifetime. Over 7%, an estimated 1.8 million youths, had lifetime major depressive episode and thought about killing themselves at the time of their worst or most recent episode. An estimated 712,000 youths had tried to kill themselves during their worst or most recent major depressive episode; this represents 2.9% of those aged 12 to 17.
  • The NSDUH Report:  Age at First Use of Marijuana and Past Year Serious Mental Illness   Based on SAMHSA's 2002 and 2003 National Surveys on Drug Use & Health (NSDUH), an estimated 90.8 million adults (42.9%) aged 18 or older had used marijuana at least once in their lifetime. Among lifetime marijuana users aged 18 or older, 2.1% reported that they first used marijuana before age 12; 52.7% reported first marijuana use between ages 12 and 17, and 45.2% reported first marijuana use at age 18 or older. About 12.5 % of persons aged 18 or older who reported lifetime marijuana use were classified as having a serious mental illness (SMI) in the past year. Adults who first used marijuana before age 12 (21%) were twice as likely as adults who first used marijuana at age 18 or older (10.5%) to be classified as having a serious mental illness in the past year.
  • The NSDUH Report:  Substance Use Among Youths Who Had Run Away From Home    Based on SAMHSA's 2002 National Survey on Drug Use and Health, approximately 1.6 million youth (7%) aged 12 to 17 had run away from home and slept on the street in the past 12 months. Among youths aged 12 or 13, 6% had run away and among those aged 16 or 17, 10% had run away from home in the past 12 months. Youths who had run away from home in the past 12 months were more likely to have used alcohol, marijuana, or an illicit drug other than marijuana in the past year than youths who had not run away. Alcohol was used in the past year by 50% of the runaway youths aged 12 to 17 and 33% of those who had not run away from home. Marijuana was used in the past year by 23% of the runaways aged 12 to 18 and 12% of those who had not run away from home.

 

Highlights of Reports on Treatment and Mental Health Issues

 

Also see mental health treatment tables

Also see unmet mental health treatment need

  • newThe NSDUH Report: Treatment for Past Year Depression among Adults  Based on SAMHSA's National Survey on Drug Use and Health, 67.4% of the adults who had experienced at least one major depressive episode during the past year had received treatment for depression in the past year.  The types of treatment received for depression in the past year by the adults with past year depression were: 69.4% both talked to a professional and received medication for their depression, 23.8% only talked to a professional about their depression, and 6.7% only received medication for their depression.  Perceived helpfulness of their treatment for depression depended upon which treatment they received. Adults with depression in the past year who received medication as well as talked to a professional were most likely to perceive their treatment as extremely helpful or helped alot.
  • new The NSDUH Report:  Service Utilization for Mental Health Problems among Adults     SAMHSA's National Surveys on Drug Use and Health in 2003 through 2005 were combined to assess the receipt of treatment for mental health problems, the perceived unmet need for such treatment, and the reasons for not receiving treatment for mental health problems among those with an unmet need for treatment. Among adults aged 18 or older, 13% (27.9 million persons) received treatment or counseling for mental health problems in the past 12 months. About 5.1% of all adults and 19.2% of adults who received treatment for mental health problems in the past year perceived an unmet need for treatment or counseling for mental health problems in the past year. Of those adults who perceived an unmet need for treatment for mental health problems in the past year, 48.1% reported cost or insurance issues as a barrier to treatment receipt.
  • The NSDUH Report:  Substance Use Disorder and Serious Psychological Distress by Employment Status    Among full time employed adults aged 18 to 64 in SAMHSA's National Survey on Drug Use and Health, 10.6% were classified as having a past year substance use disorder, 10.2% experienced serious psychological distress during the past year, and 2.4% had co-occurring serious psychological distress and a substance use disorder.   Full time employed males in this age group were nearly twice as likely to have a past year substance use disorder than their female counterparts (13.2% vs. 6.9%).   In contrast, females were nearly twice as likely to have experienced serious psychological distress during the past year than were the males (14.2% vs. 7.3%). Of the 2.9 million adults aged 18 to 64 employed full time who had co-occurring serious psychological distress and a substance use disorder, nearly 60% were not treated for either problem and less than 5% were treated for both problems.
  • The New DAWN Report:  Emergency Department Visits Involving Patients with Co-occurring Disorders   During 2004, an estimated 192,690 patients in drug-related emergency department visits were diagnosed with co-occurring substance use and mental disorders.  When emergency department visits involved co-occurring disorders, 40.4% were treated and released home or referred to detoxification or other drug treatment and 42.2% were admitted to inpatient units including chemical dependency or detoxification units.   Of the emergency department visits with co-occurring diagnosis, the drug most frequently reported were cocaine (31.8%), alcohol (29.3%), opiates/opioids (18.0%),  and marijuana (16.3%). 
  • The New DAWN Report:  Disposition of Emergency Department Visits for Drug-Related Suicide Attempts by Adolescents, 2004   According to SAMHSA's Drug Abuse Warning Network (DAWN),  in 2004 there were over 15,000 emergency department visits by adolescents aged 12 to 17 whose suicide attempts involved drugs.    Pain medications were involved in about half of the suicide attempts.  Almost three quarters of the drug related suicide attempts were serious enough to merit the patient's admission to the same hospital or transfer to another health care facility.  Antidepressants or other psychotherapeutic medications were involved in over 40% of the suicide attempts by adolescents who were admitted to the hospital.   
  • The DASIS Report:  Adolescents with Co-Occurring Psychiatric Disorders:  2003   Of the approximately 78,000 admissions aged 12 to 17 in the 26 States that reported presence or absence of co-occurring problems to SAMHSA's Treatment Episode Data Set (TEDS), about 16,000 (21%) were admissions with a co-occurring psychiatric problem in addition to an alcohol and/or drug problem. Adolescent admissions with co-occurring disorders were more likely to be female than adolescent admissions for only substance use disorders (38% vs. 28%). Nearly three-quarters of adolescent admissions with co-occurring disorders were White (72%) compared to half of adolescent admissions for only substance use disorders (51%). Criminal justice system referrals for treatment were the most common source of referral for both adolescent admissions with co-occurring disorders (48%) and adolescent admissions for only substance use disorders (57%).
  • The DASIS Report:  Male Admissions with Co-Occurring Psychiatric and Substance Use Problems,  2003   Of the approximately 668,000 male admissions in the 29 States that reported presence or absence of co-occurring problems to SAMHSA's Treatment Episode Data Set (TEDS), about 103,000 (15%) were male admissions with co-occurring problems. Male admissions with co-occurring problems were more likely to report alcohol as the primary substance of abuse than male admissions for substance abuse alone (48% vs. 43%). Male admissions with co-occurring problems were more likely to be White than were male admissions for substance abuse alone (69% vs. 57%). Only 28% of male admissions with co-occurring problems were referred to treatment through the criminal justice system compared to 45% of male admissions for substance abuse alone.
  • The NSDUH Report:  Women with Co-Occurring Serious Mental Illness and a Substance Use Disorder    Based on SAMHSA's 2002 National Survey on Drug Use and Health, nearly 2 million women aged 18 or older were estimated to have both serious mental illness (SMI) and a substance use disorder during the past year. Women with co-occurring SMI and a substance use disorder were more likely than men with co-occurring SMI and a substance use disorder to have received treatment for a mental disorder and/or specialty substance use treatment during the past year.
  • The NSDUH Report:  Adults with Co-Occurring Serious Mental Illness and a Substance Use Disorder    SAMHSA's 2002 National Survey on Drug Use and Health found that 17.5 million adults aged 18 or older (8%) were estimated to have a serious mental illness in the past year. About 4 million of the adults with a serious mental illness in 2002 also were dependent on or abused alcohol or an illicit drug; that is, they had a co-occurring substance abuse and mental disorder. More than half of the adults with co-occurring serious mental illness and a substance use disorder received neither specialty substance use treatment nor mental health treatment during the past year. Among adults with co-occurring disorders, 34% received mental health treatment only, 2% received specialty substance use treatment only, and 12% received both mental health and specialty substance use treatment during the past year.
  • The DASIS Report:  Admissions with Co-Occurring Disorders,  1995 and 2001   Between 1995 and 2001, the proportion of substance abuse treatment admissions with co-occurring substance abuse and psychiatric disorders reported to SAMHSA's Treatment Episode Data Set (TEDS) increased from 12% to 16%. The proportion of females among admissions with co-occurring disorders increased from 38% to 44%, while remaining stable at about 30% among all other admissions. The proportion of admissions reporting alcohol as the primary substance of abuse decreased for both admissions with co-occurring disorders (from 51% to 45%) and all other admissions (from 45% to 38%). However, primary use of opiates increased for admissions with co-occurring disorders (from 13% to 21%) while remaining stable for all other admissions at 25%.
  • The NSDUH Report:  Reasons for Not Receiving Treatment Among Adults with Serious Mental Illness   Although mental disorders account for 4 of the 10 leading causes of disability in the U.S., SAMHSA's Survey on Drug Use and Health found that less than half of adults (age 18 and older) with a serious mental illness received treatment or counseling for a mental health problem during the past year.  More than 2 million adults with a serious mental illness reported that they did not receive treatment.   Cost of treatment was the primary reason for not getting mental health treatment. Other reasons included concerns about stigma, not knowing where to go for treatment, fear of being committed or having to take medicine, and lack of time or transportation. 
  • The DASIS Report:  Services Provided by Substance Abuse Treatment Facilities   Based on SAMHSA's National Survey of Substance Abuse Treatment Services (N-SSATS), facilities with a specially designed treatment program were likely to offer related services.  For example, those with a specially designed treatment program or group for clients with co-occurring substance abuse and mental health disorders were likely to offer mental health assessment and pharmacotherapy; those  for pregnant women were likely to provide social services, child care assistance, and domestic violence education; and those for persons with HIV/AIDS to provide testing services, e.g., for HIV, TB, hepatitis, and STD. 
  • The DASIS Report:  Admissions of Persons with Co-Occurring Disorders,  2000  Co-occurring disorders admissions were less likely to be in the labor force than substance abuse only admissions (47 percent vs. 58 percent).   Co-occurring disorders admissions to substance abuse treatment were more likely to have been referred through alcohol, drug abuse, and other health care providers.  In contrast,  substance abuse only admissions  were more likely to have been referred to treatment by the criminal justice system. 
  • The DASIS Report: Primary Focus of Facilities Treating Substance Abuse    Nationally, 61 percent of substance abuse treatment facilities focused on substance abuse treatment services, 25 percent on a mix of mental health and substance abuse treatment services, and 9 percent on mental health services, and 5 percent on general health care or other services. 
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This page was last updated on May 10, 2008.


SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.

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