Patterns of Mental Health Service Utilization and Substance Use Among Adults, 2000 and 2001

7. Perceived Unmet Need for Mental Health Treatment

Estimates of unmet need for mental health treatment can be used to identify disparities in access to mental health care. Although most measures of unmet need for mental health treatment indicate a perception that needed treatment has not been received, various studies have used different definitions and thereby produced diverse estimates. For example, a study of managed care using 1998 data from the Health Care for Communities (HCC) survey showed that a different picture of managed care is portrayed depending on the definition of unmet need that is used. In that study, unmet need for mental health treatment was defined among privately insured individuals who reported that they needed help for emotional or mental health problems as receipt of no care, less care than needed, or delayed care. When the definition of unmet need included only persons with no care, it appeared that there was no change in treatment quality under managed care. However, when the definition of unmet need also included less care or delayed care as well as no care, the quality of mental health treatment under managed care was considered to be lower. The study reported that among privately insured individuals who reported that they needed help for emotional, mental health, alcohol, or drug problems during the past 12 months, 12.0 percent reported receiving less care than needed (or delayed care) and 9.5 percent reported receiving no care (Sturm & Sherbourne, 2000).

The 2000 and 2001 National Household Survey on Drug Abuse (NHSDA) included a question to measure perceived unmet need for mental health treatment. Respondents were asked whether, during the past 12 months, there was a time when they needed mental health treatment or counseling for themselves but did not get it. For this report, persons were defined with perceived unmet need if they responded "yes" to this question. In addition, persons defined with unmet need who did not receive mental health treatment in the past year were considered to have received no care for their mental health problems, while those who received mental health treatment in the past year were considered to have had either less care than needed or delayed care for their mental health problems. Because this definition of unmet need is based on perceived need and does not include alcohol or drug abuse, it is not comparable with the definitions of unmet need from other studies.

From the combined 2000 and 2001 NHSDA, there were an estimated 8.3 million adults (4.1 percent of the total population) with a perceived unmet need for mental health treatment in the past year (Figure 7.1 and Table 7.1). These persons either received no care, less care than needed, or delayed care for their mental or emotional problems. More than half of adults with unmet need (52.1 percent) did not receive mental health treatment in the past year, and 47.9 percent did receive mental health treatment in the past year. Those who received treatment were almost 8 times more likely to report unmet need (less care than needed or delayed care) than those who received no mental health treatment (Table 7.1). For all individual characteristics examined, persons who received mental health treatment were far more likely to perceive unmet need than those who did not receive treatment. This may be because most of the people who did not receive treatment do not have a mental health disorder. Substance use, and especially substance dependence or abuse, also were strongly associated with unmet need for mental health treatment.

Figure 7.1 Adults with Perceived Unmet Need for Mental Health Treatment in the Past Year, 2000 and 2001

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

The remainder of this chapter examines the characteristics of persons with a perceived unmet need for mental health treatment separately among the treated and untreated populations. It also examines the percentages of adults with perceived unmet need by specific characteristics which include demographic and socioeconomic characteristics as well as substance use and abuse.

7.1 Perceived Unmet Need among Adults Who Did Not Receive Treatment (No Care)

7.1.1 Characteristics of Persons with Unmet Need

For the combined years of 2000 and 2001, data from the NHSDA indicated that among adults not receiving mental health treatment in the past year, 2.4 percent (4.3 million) had an unmet need for mental health treatment in that time period (Table 7.1). As shown in Table 7.2, most of these persons were aged 26 to 49 (59.4 percent of all persons reporting an unmet need) and 14.2 percent were aged 50 or older; 65.4 percent were female; 77.7 percent were white, 9.0 percent were black, and 8.5 percent were Hispanic; and 37.9 percent had never been married with 16.6 percent being divorced or separated. Among adults reporting an unmet need for mental health treatment, 25.2 percent had a family income of less than $20,000, 16.1 percent received government assistance, 22.3 percent had no health insurance, and 31.3 percent had used an illicit drug in the past year.

7.1.2 Prevalence of Unmet Need, by Demographic and Socioeconomic Characteristics

The prevalence of perceived unmet need for mental health treatment among persons not receiving treatment in the past year varied by demographic characteristics. Prevalence was highest among persons aged 18 to 25 years (4.3 percent) and lowest among persons aged 50 or older (0.9 percent) (Table 7.1). Unmet need was higher among females than among males (3.1 vs. 1.7 percent, respectively). Among racial/ethnic groups, persons reporting more than one race had the highest unmet need (6.0 percent), and American Indians or Alaska Natives had the next highest (5.4 percent). Unmet need among blacks was the same as that among Hispanics (1.9 percent), but lower than that among whites (2.6 percent). Asians had the lowest (1.2 percent), and Native Hawaiians or other Pacific Islanders had the next lowest prevalence of unmet need (1.5 percent). Unmet need also varied by marital status; 4.1 percent of never married persons, 3.5 percent of divorced or separated persons, 1.8 percent of married persons, and 0.8 percent of widowed persons reported an unmet need for treatment.

Rates of perceived unmet need for mental health treatment among persons not receiving treatment in the past year were generally higher among those with characteristics associated with low socioeconomic status (SES). Unmet need was higher among those with lower total family income. Persons with a family income of $20,000 or less were significantly more likely to report unmet need (3.1 percent) than persons in any other income group. Unmet need also was associated with current employment. The rate of unmet need was 4.1 percent among unemployed persons, 3.6 percent among persons employed part time, and 2.4 percent among persons employed full time. Persons receiving government assistance had a higher rate of unmet need than those not receiving government assistance (3.4 vs. 2.3 percent). Although rates of unmet need were generally higher among persons with low SES, the rates of unmet need among persons with some college (2.8 percent) and among college graduates (2.6 percent) were significantly higher than the rates among persons with a high school diploma or less than a high school education (2.1 percent). Rates of unmet need among persons with no treatment in the past year also were higher for persons with poorer perceived health. Among persons with fair or poor health status, the percentage with unmet need was 3.1 percent. Rates of unmet need among persons with good, very good, and excellent health status were 2.7, 2.4, and 2.0 percent, respectively.

7.1.3 Prevalence of Unmet Need, by Use or Abuse of Substances

Unmet need for mental health treatment among adults not receiving treatment was associated with the use of substances, and it was highly correlated with dependence or abuse of substances. Among persons receiving no care, the prevalence of unmet need was highest for current daily smokers (4.2 percent) and lowest among persons who never smoked a cigarette (1.4 percent) (Table 7.3). The prevalence was 3.6 percent among those who smoked in the past year but not daily and 2.1 percent among those who ever smoked but not in the past year. Adults who had ever used alcohol had higher rates of unmet need for mental health treatment than adults who had not. However, heavy users of alcohol with no dependence or abuse were no more likely to have unmet need than those who used alcohol but were not heavy users or dependent or abusing. Prevalence of unmet need was 1.8 percent for alcohol use in the lifetime but not the past year, 2.4 percent for use in the past year but not heavy use or dependence or abuse, and 2.2 percent for heavy use but not dependence or abuse. Adults with past year alcohol dependence or abuse were 4 times as likely as adults with heavy use of alcohol but without dependence or abuse to have an unmet need for treatment (8.8 vs. 2.2 percent).

Unmet need among those not receiving treatment was positively associated with marijuana use or abuse. Rates of unmet need were lowest for adults who never used marijuana (1.4 percent) and highest for adults with marijuana dependence or abuse (12.4 percent). An estimated 3.4 percent of adults who had ever used marijuana, but not in the past year, reported unmet need. As with alcohol use, there were no significant differences in unmet need between the adults with past year use and with heavy use (6.6 vs. 6.4 percent, respectively). Unmet need for mental health treatment among those not receiving treatment also varied with the level of use or abuse of illicit drugs other than marijuana. Rates of unmet need ranged from 1.5 percent for those who never used other illicit drugs to 18.3 percent for those with past year dependence or abuse on other illicit drugs; the rate for lifetime, but no past year use, of other illicit drugs was 4.3 percent. As for marijuana use and alcohol use, unmet need among adults with past year use but not heavy use of other illicit drugs (7.8 percent) was not significantly different from unmet need among those with heavy use but without dependence or abuse (7.5 percent).

7.2 Perceived Unmet Need among Adults Who Received Mental Health Treatment (Delayed or Insufficient Care)

7.2.1 Characteristics of Persons with Unmet Need

Among persons receiving mental health treatment in the past year, 18.9 percent (4.0 million persons) had an unmet need for mental health treatment (Table 7.1). The majority (61.3 percent) of these persons were aged 26 to 49 years of age; most were female (70.7 percent); 80.7 percent were white; and 39.2 percent were married, 24.3 percent were divorced or separated, and 32.5 percent had never been married (Table 7.2). Among these adults with delayed care or insufficient care, 25.2 percent had a family income of less than $20,000; 16.1 percent received government assistance in the past year; and 66.1 percent had private health insurance, 9.3 percent received Medicaid/CHIP, and 22.3 percent had no coverage.

7.2.2 Prevalence of Unmet Need, by Demographic and Socioeconomic Characteristics

Among persons 18 to 25 years of age who received treatment in the past year, 29.4 percent reported unmet need. The rate of unmet need among persons aged 50 or older who received treatment in the past year was 10.9 percent (Table 7.1). Rates were higher among females than males (20.3 vs. 16.1 percent). Blacks were more likely than whites to report unmet need (22.2 vs. 18.2 percent, respectively). By marital status, rates of unmet need were lowest among widowed persons (13.5 percent) and next lowest among married persons (14.3 percent); they were highest among persons who had never been married (26.1 percent) and next highest among persons who were divorced or separated (23.8 percent). Among adults who received mental health treatment in the past year, persons with no health insurance were twice as likely as persons with private health insurance to report delayed or insufficient care (33.4 vs. 16.4 percent). Among adults receiving treatment, the rates of unmet need were higher among persons with poorer health status. The rates ranged from 22.3 percent among those who reported fair to poor health to 14.4 percent among those who reported their health as excellent.

7.2.3 Prevalence of Unmet Need, by Use or Abuse of Substances

Unmet need among persons receiving treatment also was associated with the use or abuse of substances. Daily cigarette smokers were almost twice as likely to have delayed care or insufficient care than those who never smoked cigarettes (25.9 vs. 13.1 percent, respectively) (Table 7.4). However, the rate of unmet need among daily smokers of cigarettes was not significantly different from the rate among past year but not daily smokers (26.0 percent). The rate among lifetime but not past year smokers was 15.0 percent. For alcohol, the rate of unmet need among those with dependence or abuse (33.8 percent) was significantly higher than for any other measures of alcohol use. However, there were no significant differences in the rates of unmet need between those who never used alcohol (15.3 percent), those who had used in their lifetime but not in the past year (15.2 percent), those who used in the past year without heavy use or dependence or abuse (18.2 percent), and heavy users without dependence or abuse (17.6 percent). Among adults receiving treatment, those who had used marijuana in their lifetime but not in the past year were significantly more likely to have an unmet need than those who never used marijuana. The rate was 13.6 percent for those who never used marijuana and 20.6 percent for those who used marijuana in their lifetime but not the past year. Among persons receiving treatment, adults with dependence on or abuse of marijuana were more likely to have an unmet need than those with past year use without heavy use or dependence or abuse (47.1 vs. 28.7 percent, respectively).

7.3 Summary

Among persons receiving and not receiving treatment in the past year, the rates of perceived unmet need varied by demographic and socioeconomic characteristics. In addition, perceived unmet need was greater among persons with low socioeconomic status as well as poor perceived health. Among persons who did and who did not receive treatment in the past year, perceived unmet need also was associated with the use and abuse of cigarettes, alcohol, marijuana, and any illicit drug other than marijuana. Rates of perceived unmet need were highest for those with substance dependence or abuse compared with those who used but were not dependent or abusers and those who never used substances. For both alcohol and marijuana, there were no significant differences in the rates of perceived unmet need among those with any past year use and among those with heavy use without dependence or abuse in the past year.

Table 7.1 Estimated Numbers (in Thousands) and Percentages of Adults Perceiving Unmet Need for Mental Health Treatment, by Receipt of Mental Health Treatment and Selected Characteristics: 2000 and 2001

Demographic/Socioeconomic Characteristic	Estimated Number with Unmet Need¹			Percent with Unmet Need
Demographic/Socioeconomic Characteristic	Total	Received Treatment	Did Not Receive Treatment	Total	Received Treatment	Did Not Receive Treatment
Total	8,270	3,962	4,308	4.1	18.9	2.4
Age in Years
18–25	1,912	775	1,137	6.6	29.4	4.3
26–49	4,985	2,428	2,557	5.2	21.3	3.0
50 or older	1,373	759	613	1.8	10.9	0.9
Gender
Male	2,651	1,160	1,491	2.8	16.1	1.7
Female	5,619	2,803	2,816	5.4	20.3	3.1
Hispanic Origin and Race
Not Hispanic	7,617	3,673	3,944	4.3	18.7	2.5
White only	6,546	3,199	3,348	4.4	18.2	2.6
Black only	722	333	389	3.3	22.2	1.9
American Indian or Alaska Native only	111	*	44	11.5	*	5.4
Native Hawaiian or other Pacific Islander only	11	*	7	2.1	*	1.5
Asian only	96	*	80	1.4	*	1.2
More than one race	131	*	75	8.7	*	6.0
Hispanic	653	289	364	3.1	21.5	1.9
Education
Less than high school	1,346	692	655	3.9	20.8	2.1
High school graduate	2,474	1,198	1,277	3.7	18.1	2.1
Some college	2,387	1,160	1,226	4.9	21.3	2.8
College graduate	2,063	913	1,150	4.1	16.2	2.6
Current Employment
Full-time	4,452	1,976	2,476	3.9	19.1	2.4
Part-time	1,363	595	768	5.6	20.8	3.6
Unemployed	313	152	162	6.9	24.7	4.1
Other²	2,142	1,240	902	3.8	17.2	1.8
Marital Status
Married	3,422	1,553	1,869	2.9	14.3	1.8
Widowed	253	160	93	1.9	13.5	0.8
Divorced or separated	1,678	963	715	6.9	23.8	3.5
Never married	2,917	1,286	1,631	6.5	26.1	4.1
Geographic Division
Northeast	1,490	716	774	3.9	17.2	2.3
New England	528	276	252	5.2	19.2	2.9
Middle Atlantic	963	441	522	3.4	16.1	2.0
Midwest	1,747	879	869	3.8	17.6	2.1
East North Central	1,216	610	607	3.7	17.5	2.1
West North Central	531	269	262	3.9	18.0	2.1
South	2,935	1,356	1,579	4.1	18.7	2.5
South Atlantic	1,445	671	773	3.9	17.5	2.3
East South Central	483	233	250	3.9	16.9	2.3
West South Central	1,006	451	555	4.6	22.4	2.8
West	2,098	1,012	1,086	4.8	21.9	2.8
Mountain	676	298	378	5.4	19.5	3.4
Pacific	1,422	713	709	4.5	23.1	2.5
County Type
Large metropolitan	4,037	1,828	2,209	4.2	18.5	2.5
Small metropolitan	2,737	1,356	1,381	4.4	19.6	2.5
250,000 to 1,000,000	1,973	992	981	4.3	19.2	2.4
<250,000	764	364	400	4.8	20.8	2.8
Nonmetropolitan	1,497	778	719	3.7	18.3	2.0
Urbanized	505	246	259	4.2	18.3	2.4
Less urbanized	817	429	388	3.3	17.5	1.8
Completely rural	175	104	71	3.9	22.6	1.8
Family Income
Less than $20,000	2,346	1,259	1,086	5.8	23.9	3.1
$20,000 to $49,999	3,279	1,569	1,710	4.2	20.4	2.4
$50,000 to $74,999	1,359	628	732	3.7	17.5	2.2
$75,000 or more	1,287	507	780	2.9	11.3	2.0
Government Assistance³
Yes	1,683	991	692	6.9	24.1	3.4
No	6,587	2,971	3,616	3.8	17.6	2.3
Health Insurance
Private	5,364	2,515	2,849	3.5	16.4	2.1
Medicaid/CHIP⁴	1,065	665	399	6.7	21.7	3.1
Other⁵	1,167	709	458	2.6	14.9	1.2
No coverage	1,548	586	961	6.6	33.4	4.4
Past Year Any Illicit Drug Use⁶
Yes	2,570	1,221	1,349	11.8	32.3	7.5
No	5,700	2,741	2,959	3.2	15.9	1.8
Overall Health
Excellent	1,604	581	1,023	2.9	14.4	2.0
Very good	2,517	1,073	1,444	3.7	16.8	2.4
Good	2,402	1,190	1,212	4.7	21.2	2.7
Fair/poor	1,736	1,115	621	7.0	22.3	3.1

*Low precision; no estimate reported.

¹ Unmet need is defined as a perceived need for mental health treatment or counseling that was not received. Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.
² Retired, disabled, homemaker, student, or other.
³ Government assistance includes the following programs: supplemental security income, food stamps, cash assistance, and noncash assistance.
⁴ Children's Health Insurance Program. Individuals aged 20 or older are not eligible for this plan.
⁵ Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other program that provides or pays for medical care (not including Medicaid/CHIP or private health insurance).
⁶ Any illicit drug indicates use at least once of marijuana/hashish, cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type psychotherapeutic used nonmedically.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

Table 7.2 Percent Distributions of Selected Characteristics among Adults with Perceived Unmet Need for Mental Health Treatment in the Treated and Untreated Population: 2000 and 2001

Demographic/Socioeconomic Characteristic	Total in Treated Population	Total in Untreated Population
Total	100.0	100.0
Age in Years
18–25	19.6	26.4
26–49	61.3	59.4
50 or older	19.2	14.2
Gender
Male	29.3	34.6
Female	70.7	65.4
Hispanic Origin and Race
Not Hispanic	92.7	91.5
White only	80.7	77.7
Black only	8.4	9.0
American Indian or Alaska Native only	*	*
Native Hawaiian or other Pacific Islander only	*	*
Asian only	*	*
More than one race	*	*
Hispanic	7.3	8.5
Education
Less than high school	17.5	15.2
High school graduate	30.2	29.6
Some college	29.3	28.5
College graduate	23.0	26.7
Current Employment
Full-time	49.9	57.5
Part-time	15.0	17.8
Unemployed	3.8	3.8
Not in the labor force¹	31.3	20.9
Marital Status
Married	39.2	43.4
Widowed	*	*
Divorced or separated	24.3	16.6
Never married	32.5	37.9
Geographic Division
Northeast	18.1	18.0
New England	7.0	5.9
Middle Atlantic	11.1	12.1
Midwest	22.2	20.2
East North Central	15.4	14.1
West North Central	6.8	6.1
South	34.2	36.6
South Atlantic	16.9	18.0
East South Central	5.9	5.8
West South Central	11.4	12.9
West	25.5	25.2
Mountain	7.5	8.8
Pacific	18.0	16.4
County Type
Large metropolitan	46.1	51.3
Small metropolitan	34.2	32.0
250,000 to 1,000,000	25.0	22.8
<250,000	9.2	9.3
Nonmetropolitan	19.6	16.7
Urbanized	6.2	6.0
Less urbanized	10.8	9.0
Completely rural	2.6	1.7
Family Income
Less than $20,000	31.8	25.2
$20,000 to $49,999	39.6	39.7
$50,000 to $74,999	15.8	17.0
$75,000 or more	12.8	18.1
Government Assistance²
Yes	25.0	16.1
No	75.0	83.9
Health Insurance
Private	63.5	66.1
Medicaid/CHIP³	16.8	9.3
Other⁴	17.9	10.6
No coverage	14.8	22.3
Past Year Any Illicit Drug Use⁵
Yes	30.8	31.3
No	69.2	68.7
Overall Health
Excellent	14.7	23.8
Very good	27.1	33.5
Good	30.0	28.1
Fair/poor	28.1	14.4

*Low precision; no estimate reported.

Note: The categories of health insurance are not mutually exclusive, so the sum of all categories is not 100 percent. Overall health status is not an imputed variable, so the percentage of all levels for this variable does not sum to 100 percent.
Unmet need is defined as a perceived need for mental health treatment or counseling that was not received.
Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

¹ Retired, disabled, homemaker, student, or other.
² Government assistance includes the following programs: supplemental security income, food stamps, cash assistance, and noncash assistance.
³ Children's Health Insurance Program. Individuals aged 20 or older are not eligible for this plan.
⁴ Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other program that provides or pays for medical care (not including Medicaid/CHIP or private health insurance).
⁵ Any illicit drug indicates use at least once of marijuana/hashish, cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type psychotherapeutic used nonmedically.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

Table 7.3 Estimated Numbers (in Thousands) (with Standard Errors) and Percentages (with Standard Errors) of Adults with Perceived Need for Mental Health Treatment among Those Not Receiving Treatment, by Categories of Substance Use and Abuse: 2000 and 2001

Category of Substance Use/Abuse	Estimated Number in Thousands (Standard Error)	Percent (Standard Error)
Category of Substance Use/Abuse	Unmet Need¹	Unmet Need¹
Cigarettes
Never smoked in lifetime	749 (55)	1.4 (0.10)
Smoked in lifetime but not in the past year	1,505 (86)	2.1 (0.12)
Smoked in past year but not daily²	800 (52)	3.6 (0.23)
Smoked daily	1,253 (81)	4.2 (0.27)
Alcohol
Never used in lifetime	277 (34)	1.1 (0.13)
Used in lifetime but not in the past year	633 (60)	1.8 (0.17)
Used in past year but neither heavy use³ nor dependence/abuse⁴	2,417 (105)	2.4 (0.10)
Heavy use but not dependence or abuse	154 (22)	2.2 (0.31)
Past year dependence/abuse	828 (58)	8.8 (0.59)
Marijuana
Never used in lifetime	1,572 (86)	1.4 (0.08)
Used in lifetime but not in the past year	1,728 (93)	3.4 (0.18)
Used in past year but neither heavy use⁵ nor dependence/abuse⁶	707 (54)	6.6 (0.48)
Heavy use but not dependence or abuse	77 (17)	6.4 (1.34)
Past year dependence/abuse	223 (28)	12.4 (1.46)
Other illicit drugs
Never used in lifetime	2,036 (101)	1.5 (0.07)
Used in lifetime but not in the past year	1,408 (84)	4.3 (0.25)
Used in past year but neither heavy use⁷ nor dependence/abuse⁸	490 (39)	7.8 (0.59)
Heavy use but not dependence or abuse	134 (27)	7.5 (1.42)
Past year dependence/abuse	240 (29)	18.3 (2.01)

* Low precision; no estimate reported.

¹ Unmet need is defined as a perceived need for treatment that was not received. Mental health treatment is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.
² Daily cigarette use is defined as using cigarettes daily in the past 30 days.
³ Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days.
⁴ Dependence or abuse is based on the definition found in the text revision of the 4^th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).
⁵ Heavy marijuana use refers to using marijuana on 300 or more days in the past year.
⁶ Other illicit drug indicates use at least once of cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type psychotherapeutic used nonmedically.
⁷ Heavy use of other illicit drugs refers to using cocaine, hallucinogens, inhalants, heroin, or any prescription-type psychotherapeutic used nonmedically (i.e., pain relievers, tranquilizers, stimulants, or sedatives) for at least 50 days in the past year.
⁸ Other illicit drug dependence or abuse indicates meeting the dependence or abuse criteria of at least one of the following drugs: cocaine, hallucinogens, inhalants, heroin, pain relievers, tranquilizers, stimulants, or sedatives.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

Table 7.4 Estimated Numbers (in Thousands) (with Standard Errors) and Percentages (with Standard Errors) of Adults with Perceived Need for Mental Health Treatment among Those Receiving Treatment, by Categories of Substance Use and Abuse: 2000 and 2001

Category of Substance Use/Abuse	Estimated Number in Thousands (Standard Error)	Percent (Standard Error)
Category of Substance Use/Abuse	Unmet Need¹	Unmet Need¹
Cigarettes
Never smoked in lifetime	581 (48)	13.1 (1.04)
Smoked in lifetime but not in the past year	1,265 (90)	15.0 (0.98)
Smoked in past year but not daily²	868 (70)	26.0 (1.83)
Smoked daily	1,249 (83)	25.9 (1.50)
Alcohol
Never used in lifetime	321 (45)	15.3 (1.89)
Used in lifetime but not in the past year	701 (65)	15.2 (1.34)
Used in past year but neither heavy use³ nor dependence/abuse⁴	2,127 (109)	18.2 (0.84)
Heavy use but not dependence or abuse	91 (22)	17.6 (3.76)
Past year dependence/abuse	723 (60)	33.8 (2.23)
Marijuana
Never used in lifetime	1,326 (84)	13.6 (0.84)
Used in lifetime but not in the past year	1,765 (104)	20.6 (1.05)
Used in past year but neither heavy use³ nor dependence/abuse⁴	565 (52)	28.7 (2.11)
Heavy use but not dependence or abuse	()	()
Past year dependence/abuse	251 (34)	47.1 (4.11)
Other illicit drugs
Never used in lifetime	1,720 (93)	14.0 (0.72)
Used in lifetime but not in the past year	1,425 (90)	21.9 (1.25)
Used in past year but neither heavy use³ nor dependence/abuse⁴	400 (42)	34.0 (2.81)
Heavy use but not dependence or abuse	()	()
Past year dependence/abuse	310 (41)	45.9 (4.36)

This page was last updated on June 16, 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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