Serious mental illness affects an estimated 19.6 million American adults,
or about 9.2 percent of the population, according to data from the 2003
National Survey on Drug Use and Health (NSDUH).
The number of people with serious mental illness has risen significantly
from 2002 NSDUH estimates (17.5 million), according to a report of the
survey's findings by the Substance Abuse and Mental Health Services
Administration. The results were extrapolated to U.S. population
The NSDUH is a national representative survey conducted among almost 70,000
people in their homes. It collects information on the prevalence of substance
use in the population, perceptions of risks related to substance use, patterns
of use, treatment, and mental illness (see
The findings were released in September.
According to the NSDUH, an estimated 4.2 million adults met criteria for
both serious mental illness and substance abuse or dependence during the
previous year. Serious mental illness was defined as experiencing a
diagnosable mental, behavioral, or emotional disorder that meets
DSM-IV criteria and results in functional impairment that
substantially interferes with or limits one or more major life activities.
For the purposes of the survey, substance abuse or dependence was
distinguished as a separate category from serious mental illness.
The study found a strong link between serious mental illness and drug and
Among adults with serious mental illness in 2003, 21.3 percent were also
dependent on or abused drugs or alcohol. The rate among people without serious
mental illness was just 7.9 percent.
About 21 percent of adults with substance abuse or dependence had a serious
mental illness, according to the NSDUH. This rate dropped to 8 percent among
adults without substance abuse or dependence.
The survey also measured the prevalence of mental health treatment in the
United States, defined as "the receipt of treatment or counseling for
any problem with emotions, `nerves,' or mental health" in an inpatient
or outpatient setting in the year prior to the interview.
In 2003 an estimated 28 million adults, or about 13.2 percent of the
population, receivedFIG1 treatment
for mental health problems. About 1.8 million adults were hospitalized for
mental health problems, according to the survey.
When researchers analyzed demographic information for those who received
treatment, they found the rates of treatments were highest for those reporting
that they belonged to two or more ethnic groups (17.5 percent) or who were
white (15.3 percent).
African Americans had lower rates of mental health treatment (8.5 percent)
than did whites; the same was true for Latinos (8 percent). Asian Americans
had the lowest treatment rates (4.9 percent).
Among the 19.6 million adults with serious mental illness in the United
States, 9.3 million, or 47.3 percent, received treatment.
As for the 5.9 million people with serious mental illness who perceived an
unmet treatment need, cost or insurance issues were cited most often for not
receiving professional help (see chart on page 6).
The survey also found that an estimated 21.6 million Americans had a
substance dependence or abuse problem in 2003, representing about 9 percent of
people aged 12 or older.
The majority were dependent on or abused alcohol (14.8 million), while 3.1
million were dependent on or abused both alcohol and drugs, and 3.8 million
were dependent on or abused drugs alone.
Only about 3.3 million people aged 12 or older received some kind of
treatment for a problem related to alcohol and/or drug use the previous year,
the survey found, yet an estimated 20.3 million people needed such treatment
but did not receive it.
Of the 20.3 million Americans who needed but did not receive treatment in
2003, only about 1 million said they felt they needed treatment for their
alcohol and/or drug problem at the time of the survey.
Need was determined by virtue of meeting DSM criteria for
substance abuse or dependence.
Of this latter group, 273,000 reported they had made an effort to get
treatment but did not get it for various reasons.
The majority of those who said they made an effort to get treatment felt
they were not ready to stop using the substance (41.2 percent), cited barriers
related to high costs of treatment or problems with insurance (33.2 percent),
said they were afraid of being stigmatized (19.6 percent), or reported that
they believed that they could handle the problem without treatment (17.2
More information about the 2003 National Survey on Drug Use and
Health is posted online at<www.oas.samhsa.gov/nhsda.htm#NHSDAinfo>.▪