Healthy People 2010 Focus Area 18 Mental Health and Mental Disorders Progress Review November 15, 2007

Impact of Mental Disorders A leading cause of: –Disability –Absenteeism and lost productivity in the workplace Affects approximately one of every four adults (2002) $100 billion spent on treatment in 2003 Depression is associated with the development of hypertension, heart disease, diabetes, and stroke.

Percent Prevalence of Mental Disorders in Adults, 2002 Anxiety disorders Mood disorders *Impulse- Control disorders Substance disorders NOTES: = 95% confidence interval. Except where noted, data are for adults aged 18+ years. *Data are for adults 18–44 years. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH. At least one 23+ Number of disorders 1

Highlighted Objectives * Percent of targeted progress achieved is between -10% and 10%, and/or not statistically significant. Target Met 18–3 PATH clients receiving social services who also receive mental health services 18–6 HRSA funded primary care facilities that provide mental health treatment 18–11 County with jail diversion programs for adults with serious mental illness Little or No Progress* 18–1 Suicide 18–2 Serious suicide attempts among adolescents 18–5 Adolescents engaging in disordered eating 18–7 Use of services by children with serious mental health problems Baseline Only 18–4 Employment of persons with serious mental illness 18–9a Treatment for serious mental illness 18–9b Treatment for major depressive disorder 18–9d Treatment for generalized anxiety disorder

Age Adjusted Rate per 100,000 Population Obj. 18– Decrease desired 2010 Target: 4.8 NOTES: = 95% confidence interval. Based on ICD-10 codes U03, X60–X84, Y870. Data are age adjusted to the 2000 standard population. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: National Vital Statistics System - Mortality (NVSS-M), CDC, NCHS. 5 Suicide Hispanic Black Female Male Total White American Indian/ Alaskan Native Asian or Pacific Islander

NOTES: Based on ICD-10 codes U03, X60–X84, Y870. Data are age adjusted to the 2000 standard population. Rates were calculated by health service area. Rates are per 100,000 population. Legend represents quintiles of the rates. SOURCE: National Vital Statistics System—Mortality (NVSS-M), CDC, NCHS. Suicide, 2000–2004 Obj. 18–1 15.7– – – –11.5 4–9.9 Age Adjusted Rate per 100,000 population 2010 Target: 4.8

Percent of Students Obj. 18– Decrease desired 2010 Target: 1.0 NOTES: I= 95% confidence interval. Data are for students in grades 9 through 12. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select one or more races. The categories black and white include persons who reported only one racial group. Serious suicide attempts are those requiring medical attention SOURCE: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP. 1 Serious Suicide Attempts Requiring Medical Attention Among Adolescents MaleFemale Total Gender 3 2 4

Percent of Students Obj. 18– Decrease desired 2010 Target: 16 NOTES : I = 95% confidence interval. Data are for students in grades 9 through 12. Disordered eating includes any of the following behaviors to lose weight or to keep from gaining weight: (a) going without eating for 24 hours or more, (b) taking diet medication without a doctor’s advice, (c) or vomiting or taking laxatives. Persons were asked to select one or more races. The categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP. 5 Adolescents Engaging in Disordered Eating Black Race/ethnicity WhiteMaleFemale Total Gender Hispanic

Percent Obj. 18– Increase desired 2010 Target: 67 NOTES: I= 95% confidence interval. The age group is 4-17 years. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Use of services include: seen or talked to a mental health professional, general doctor or receiving special educational or early intervention services. SOURCE: National Health Interview Survey (NHIS), CDC, NCHS. 20 Use of Services by Children with Serious Mental Health Problems Black Race/ethnicity WhiteMaleFemale Total Gender Hispanic 60 40

Percent Prevalence of Serious Mental Illness, Major Depressive Disorder, and Generalized Anxiety Disorder in Adults, NOTES: = 95% confidence interval. Data are for adults aged 18+ years. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH. Serious Mental Illness (Role Impairment) Major Depressive Disorder Generalized Anxiety Disorder

Obj. 18–4 Percent Employed 2010 Target: 54 Total Female Male Hispanic Black White Less than high school High school At least some college Increase desired Employment of Persons with Serious Mental Illness, % NOTES: = 95% confidence interval. Data are for adults 18+ years. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH.

Obj. 18–9a Percent 2010 Target: 68 Total Female Male Hispanic Black White Less than high school High school At least some college Increase desired Treatment for Adults with Serious Mental Illness, % NOTES: = 95% confidence interval. Data are for adults 18+ years. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Treatment was based on therapeutic intervention and/or the prescription of psychotropic medications. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH.

Obj. 18–9b 2010 Target: Increase desired Treatment for Adults with Major Depressive Disorder, % Percent Total Female Male Hispanic Black White Less than high school High school At least some college NOTES: = 95% confidence interval. Data are for adults 18+ years. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Treatment was based on therapeutic intervention and/or the prescription of psychotropic medications. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH.

Obj. 18–9d Total Female Male Hispanic Black White Less than high school High school At least some college Increase desired Treatment for Adults with Generalized Anxiety Disorder, % 2010 Target: 79 * Percent 80 NOTES: = 95% confidence interval. Data are for adults 18+ years. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. *Data are statistically unreliable. Treatment was based on therapeutic intervention and/or the prescription of psychotropic medications. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH.

PATH Clients Receiving Social Services Who Also Receive Mental Health Services NOTE: Homeless adults 18 years and older in social services who may or may not be diagnosed with mental health problems. SOURCE: Projects for Assistance in Transition from Homelessness (PATH), SAMHSA, CMHS. Obj Increase desired 2010 Target: 30 Percent Projects for Assistance in Transition from Homelessness (PATH)

HRSA-Funded Primary Care Facilities that Provide Mental Health Treatment NOTE: Includes primary care facilities that provide mental health treatment on site or paid by referral. SOURCE: Uniform Data System (UDS), HRSA. Obj. 18–6 Increase desired 2010 Target: 68 Percent

Counties with Jail Diversion Programs for Adults with Serious Mental Illness NOTE: Includes programs such as specialized police responses to situations involving individuals with mental health problems, pre-booking programs, mental health courts and post-booking programs. SOURCE: Mental Health Courts Survey (MHCS), SAMHSA, CMHS, DSSI. Obj. 18–11 Increase desired 2010 Target: 7.6 Percent

Little or no progress for: –Suicide –Adolescent suicide attempts –Adolescent disordered eating –Use of services by children Target met: HRSA, SAMHSA treatment programs Treatment rates for serious mental illness, major depressive disorder, and generalized anxiety disorder: –Lower for Hispanics and blacks compared to whites –Lower for males compared to females Adolescents–girls have significantly higher disordered eating compared to boys Summary

Status of Mental Health and Mental Disorders Objectives * Percent of targeted progress achieved is between -10% and 10%. Target met 18–3PATH clients receiving social services who also receive mental health services 18–6HRSA funded primary care facilities that provide mental health treatment 18–11County with jail diversion programs for adults with serious mental illness Improving 18–8Juvenile residential facilities that screen admissions for mental health problems 18–12Consumer satisfaction with mental health services Getting Worse 18–13State mental health plans addressing cultural competence Little or No Progress* 18–1Suicide 18–2Serious suicide attempts among adolescents 18–5Adolescents engaging in disordered eating 18–7Use of services by children with serious mental health problems 18–14State mental health plans addressing care of elderly Baseline Only 18–4Employment of persons with serious mental illness 18–9a–d Treatment for serious mental illness, major depressive disorder, schizophrenia, generalized anxiety disorder 18–10Treatment for co-occurring substance abuse and mental disorders

Richard J. Klein Chief - Health Promotion Statistics Branch CDC/National Center for Health Statistics Bruce S. Jonas Health Statistician CDC/National Center for Health Statistics Acknowledgments: Nancy Brady Patricia Pastor Leda Gurley Carter Roeber Elizabeth Jackson Shelagh Smith Robert Heinssen

Progress review data and slides are available on the web at: