EXECUTIVE SUMMARY

Behavioral Health, United States, 2012 is the most recent edition of a publication issued biannually by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services since 1980. The scope of this volume has been expanded from previous editions to include information on substance use disorders, which frequently co-occur with mental health disorders. This larger perspective on behavioral health will help strengthen the series' utility as a key resource for decision making in a changing and challenging health care landscape.

The volume serves as a comprehensive resource for behavioral health statistics for the Nation, compiling information from a diverse set of data sources, journal articles, online tools, and other publications. It includes three analytic chapters, 13 figures, and 172 data tables. The volume presents national estimates on numerous aspects of behavioral health, including the prevalence of mental health and substance use disorders; the number of people treated for those disorders; the number of beds, providers, and facilities in which treatment is offered; and spending on treatment.

Behavioral Health, United States, 2012 provides behavioral health statistics using the most recent data available. This edition also includes several new tables that provide expanded information on some special populations of interest, such as children, the homeless, members of the military and their families, veterans, Medicaid beneficiaries, and the workforce providing behavioral health services.

This volume is organized into five sections. Section 1 provides an introduction to the report; summarizes the numerous changes from the previous volume, entitled Mental Health, United States, 2010; and explains the implications of health care reform under the Affordable Care Act. Sections 2 through 4 provide analytic text on three important behavioral health topics: the course and prevalence of behavioral health disorders over people's lives, the degree to which behavioral health conditions may affect an individual's daily functioning, and key issues regarding behavioral health treatment. Section 5 presents detailed reference tables.

The following are highlights of the estimates presented in Behavioral Health, United States, 2012:

Behavioral Health of the Population

  • In 2011, more than 41 million U.S. adults (18 percent) had any mental illness, and nearly 20 million (8 percent) had a substance use disorder.
  • In that same year, nearly 9 million U.S. adults (4 percent) had mental illness that greatly affected day-to-day living, or serious functional impairment.
  • Data collected between 2001 and 2004 indicate that nearly 14 percent of U.S. adolescent girls and 7 percent of adolescent boys aged 13 to 18 had the most prevalent kind of mental health disorder—a mood disorder—in the past year.
  • In 2012, approximately 24 percent of U.S. eighth graders and 64 percent of twelfth graders used alcohol in the past year.

Behavioral Health Service Utilization

  • In 2011, more than one in eight U.S. adults received some type of mental health treatment in the past year.
  • Data from 2009 through 2011 show that, on average per year, two-thirds of adults with serious functional impairment due to emotional and behavioral health problems received mental health treatment.
  • Data collected in 2010 and 2011 indicate that almost half of U.S. children aged 4 to 11 with emotional or behavioral difficulties used mental health services at least once during the past year.
  • From 1996 to 2010, the number of prescriptions filled increased considerably for mental health and/or substance use conditions. The most common types of these medications are antidepressant medications for adults and stimulant medications for children.

Behavioral Health Treatment Capacity

  • Between 1998 and 2007, the number of community health centers—an extensive network of clinics in underserved areas—increased by almost 50 percent. By 2007, nearly 80 percent of these clinics had some specialty mental health services on site, and more than 50 percent had specialty substance abuse services on site.
  • Across the United States in 2011, there were 2.1 child and adolescent psychiatrists per 100,000 people and 62 clinical social workers per 100,000 people.
  • In 2010, there were 10,374 specialty mental health treatment facilities and 13,339 specialty substance abuse treatment facilities in the United States.

Payers and Payment Mechanisms

  • Although mental health expenditures have increased in the past two decades (from $75 billion in 1990 to $155 billion in 2009), they have fallen as a share of all health expenditures.
  • In 2009, prescription medication accounted for 29 percent of mental health spending, but less than 4 percent of substance abuse spending.
  • Publicly funded sources account for approximately 60 percent of mental health spending and 69 percent of substance abuse spending.

The advent of health care reform will change the behavioral health landscape substantially in the next few years. Treatment decision making in the face of this change—and other changes yet to emerge—may place new demands on what data are needed and the presentation of those data. By evolving to meet the needs of data users, the Behavioral Health, United States series will continue to help support efforts to reduce the impact of mental illness and substance use on the Nation's communities.