Healthy People 2010 Focus Area 18

Mental Health and Mental Disorders

Progress ReviewNovember 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

Substancedisorders

30

20

10

0

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 leastone

2 3+

Number of disorders

1

Highlighted Objectives

* Percent of targeted progress achieved is between -10% and 10%, and/or not statistically significant.

Target Met18–3 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. 18–1

0

1999 2004

20

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

1510

White

American Indian/ Alaskan Native

0

4

8

12

16

20

1990 1992 1994 1996 1998 2000 2002 2004

Asian orPacific 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

15.7–34.5

13.1–15.7

11.5–13.1

9.9–11.5

4–9.9

Age Adjusted Rateper 100,000population

2010 Target:

4.8

Percent of Students

Obj. 18–2

0

1999 20055Decrease

desired

2010Targe

t: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 attentionSOURCE: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.

1

Serious Suicide Attempts Requiring Medical Attention

Among Adolescents

Male FemaleTotalGender

3

2

4

Percent of Students

Obj. 18–5

0

2001 200530Decrease

desired

2010Targe

t: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 inDisordered Eating

Black

Race/ethnicity

White Male FemaleTotalGender

Hispanic

20

10

25

15

Percent

Obj. 18–7

0

2001 200680

Increase desired

2010Targe

t: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

White Male FemaleTotal

Gender

Hispanic

60

40

Percent

Prevalence of Serious Mental Illness, Major Depressive Disorder, and Generalized

Anxiety Disorder in Adults, 2002 30

20

10

0

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 DepressiveDisorder

Generalized Anxiety Disorder

Obj. 18–4

Percent Employed

2010 Target: 54

Total

FemaleMale

Hispanic

Black

White

Less than high school

High school

At least some college

0 10 20 30 40 6050 70 80 90

Increase desired

Employment of Persons with Serious Mental Illness, 2002

52%

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

FemaleMale

Hispanic

Black

White

Less than high school

High school

At least some college

0 10 20 30 40 6050 70 80 90

Increase desired

Treatment for Adults with SeriousMental Illness, 2002

62%

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: 64

0 10 20 30 40 6050 70 80

90

Increase desired

Treatment for Adults withMajor Depressive Disorder, 2002

58%

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

0 10 20 30 40 6050 70 90

Increase

desired

Treatment for Adults withGeneralized Anxiety Disorder, 2002

60%

2010 Target:

79

*

Percent80

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 ServicesWho 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. 18-3

Increase desired

2010 Target: 30

Percent

Projects for Assistance in Transition from Homelessness (PATH)0

10

20

30

40

50

2000 2001 2002 2003 2004 2005

HRSA-Funded Primary Care Facilities thatProvide 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

0

20

40

60

80

2000 2001 2002 2003 2004 2005 2006

Counties with Jail Diversion Programs forAdults 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

10

15

0

5

2004 2005 2006

• 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 MentalDisorders Objectives

* Percent of targeted progress achieved is between -10% and 10%.

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 diversionprograms for adults with serious mental illness

Improving

18–8 Juvenile residential facilities that screen admissions for mental health problems

18–12 Consumer satisfaction with mental health services

Getting Worse

18–13 State mental health plans addressing cultural competence

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

18–14 State mental health plans addressing care of elderly

Baseline Only

18–4 Employment of persons with serious mental illness

18–9a–d Treatment for serious mental illness, major depressive disorder, schizophrenia, generalized anxiety disorder

18–10 Treatment for co-occurring substance abuse and mental disorders

Richard J. KleinChief - Health Promotion Statistics BranchCDC/National Center for Health Statisticsrklein@cdc.gov

Bruce S. JonasHealth Statistician CDC/National Center for Health Statisticsbjonas@cdc.gov

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:

http://www.cdc.gov/nchs/hphome.htmhttp://www.cdc.gov/nchs/hphome.htm