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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 [email protected]
Bruce S. JonasHealth Statistician CDC/National Center for Health [email protected]
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