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Patterns of Mental Health Service Utilization and Substance Use Among Adults, 2000 and 2001

2. Demographic and Socioeconomic Characteristics of Adults Receiving Mental Health Treatment

Several studies have found that the receipt of mental health treatment varies with sociodemographic characteristics. For example, women are more likely than men to seek some type of treatment for a psychiatric problem (Kessler, 2000). Although racial and ethnic minority populations have traditionally been underrepresented in mental health care settings (Alvidrez, 1999), mental health service use has increased during the past decade, and the increase has been greatest among African Americans in general medical settings (Cooper-Patrick et al., 1999). The use of mental health services also has been shown to vary by type of household, with persons in female-headed families and persons living alone using the greatest number of services (Badawi, Kramer, & Eaton, 1996).

Using data from the 2000 and 2001 National Household Survey on Drug Abuse (NHSDA), this chapter provides detailed descriptions of the demographic and socioeconomic characteristics of adults receiving mental health treatment in the United States. Receipt of any mental health treatment is defined as self-reported receipt of inpatient or outpatient treatment or counseling or the use of prescription medication for mental or emotional problems during the 12 months prior to the interview. The chapter first presents the size and characteristics of the population of adults receiving treatment, followed by the prevalence of receipt of treatment among demographic and socioeconomic subgroups. A discussion of the logistic regression models used and their results also is presented.

2.1 Size of the Population Receiving Mental Health Treatment

Based on annual averages of combined data from the 2000 and 2001 NHSDA, an estimated 21.1 million adults aged 18 or older, or 10.5 percent of the adult population, received mental health treatment in the 12 months prior to the interview (see Tables 2.1 and 2.2). This total excludes the estimated 1.3 million adults, or 0.6 percent of the adult population, who received treatment only for substance abuse (see Table 6.3 in Chapter 6).

2.2 Characteristics of the Population Receiving Mental Health Treatment

As shown in Table 2.3, more than half of the 21.1 million adults in 2000 and 2001 who received mental health treatment in the past year were aged 26 to 49 (54.2 percent); 12.5 percent were aged 18 to 25, and 33 percent were aged 50 or older. Two thirds were women. The vast majority (83.5 percent) were non-Hispanic white. Over half were married (51.6 percent); almost one quarter (23.6 percent) had never been married; and 19.2 percent were divorced or separated. Slightly less than half (47.3 percent) had a high school education or less. Nearly half (49.2 percent) were employed full time, while only 2.9 percent were unemployed, and 34.3 percent were not in the labor force (e.g., students, housewives, and retired persons).

One fourth (25.1 percent) of adults receiving mental health treatment in the past year had family incomes of less than $20,000, while 21.3 percent had family incomes of $75,000 or more. The vast majority (72.6 percent) were covered by private health insurance: 14.7 percent by Medicaid or the Children's Health Insurance Program (CHIP), and 22.7 percent by some other type of insurance. An estimated 8.3 percent had no insurance coverage in the past year. Government assistance was received by 19.7 percent.

The highest proportion of adults receiving mental health treatment resided in the South (34.4 percent), followed by the Midwest (23.7 percent), the West (22.0 percent), and the Northeast (19.9 percent). Among adults receiving treatment, 47.0 percent were from large metropolitan areas, 32.8 percent were from small metropolitan areas, and 20.2 percent were from nonmetropolitan areas.

Almost half (49.4 percent) of all adults receiving mental health treatment perceived their overall health as very good or excellent; 26.6 percent perceived their health as good; and 23.9 percent perceived their overall health as fair or poor.

2.3 Prevalence of Mental Health Treatment among Demographic and Socioeconomic Subgroups

2.3.1 Age, Gender, and Race/Ethnicity

As shown in Table 2.2 and Figures 2.1 to 2.3, in 2000 and 2001, 11.8 percent of adults between the ages of 26 and 49 obtained treatment for a mental or emotional problem. This was a significantly greater proportion than the 9.1 percent of 18 to 25 year olds and the 9.4 percent of adults aged 50 or older who received treatment (Figure 2.1). Significantly more women (13.2 percent) than men (7.6 percent) received treatment for a mental or emotional problem in the previous year (Figure 2.2). Persons reporting more than one race and American Indians/Alaska Natives were more likely than persons in other racial/ethnic groups to receive mental health treatment in the past year (15.5 and 15.1 percent, respectively) (Figure 2.3). Whites (12.0 percent) were more likely to have received treatment than blacks (6.8 percent) or Hispanics (6.5 percent). Rates were lowest among Native Hawaiians and other Pacific Islanders (4.4 percent) and among Asians (3.1 percent).

2.3.2 Marital Status, Education, and Employment

A significantly greater proportion of divorced or separated adults (16.6 percent) received treatment for a mental or emotional problem than those who had never married (11.1 percent), those who were married (9.3 percent), or those who were widowed (9.0 percent) (Figure 2.4). College graduates and adults with some college were more likely to have received mental health treatment (11.2 percent) than those with a high school education or less (10.0 and 9.7 percent, respectively) (Figure 2.5). Unemployed persons and those not in the labor force were more likely to have received mental health treatment (13.4 and 12.8 percent, respectively) than full-time employees (9.0 percent) (Figure 2.6).

 

Figure 2.1 Past Year Mental Health Treatment, by Age Group

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.2 Past Year Mental Health Treatment, by Gender

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.3 Past Year Mental Health Treatment, by Race/Ethnicity

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.4 Past Year Mental Health Treatment, by Marital Status

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.5 Past Year Mental Health Treatment, by Education

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.6 Past Year Mental Health Treatment, by Employment

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

2.3.3 Geographic Region and County Type

There were no significant differences in the rate of mental health treatment by geographic region (Figure 2.7). Individuals living in large metropolitan areas were significantly less likely to have received treatment for a mental or emotional problem (10.2 percent) than those living in small metropolitan areas (11.2 percent) (Figure 2.8).

2.3.4 Family Income, Government Assistance, and Health Insurance

Adults in the lowest family income category (less than $20,000 in the past year) were more likely to have received mental health services (13.1 percent) compared with those in all higher family income categories (approximately 10 percent) (Figure 2.9). Adults in families receiving government assistance (including supplemental security income, food stamps, cash or noncash assistance) were significantly more likely than those not in such families to have received mental health treatment in 2000 and 2001 (17.1 vs. 9.6 percent, respectively) (Figure 2.10). The rate of mental health treatment among adults covered by Medicaid/CHIP (19.3 percent) was significantly higher than the rate among adults covered by private insurance (10.1 percent) and other types of insurance (10.8 percent). The rate was lowest among persons with no coverage (7.5 percent) (Figure 2.11).

2.3.5 Perceived Health Status

Rates of mental health treatment were higher for adults with a more negative perception of their overall health. Adults who perceived their overall health as fair or poor were the most likely to receive mental health treatment in the past year (20.2 percent), while those who perceived their health as excellent were the least likely to receive treatment (7.2 percent) (Figure 2.12). The rate of mental health treatment was 9.4 percent among those who perceived their health as very good and 11 percent among those who perceived their health as good.

 

Figure 2.7 Past Year Mental Health Treatment, by Geographic Region

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.8 Past Year Mental Health Treatment, by County Type

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.9 Past Year Mental Health Treatment, by Family Income Category

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.10 Past Year Mental Health Treatment, by Receipt of Government Assistance

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.11 Past Year Mental Health Treatment, by Health Insurance

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Figure 2.12 Past Year Mental Health Treatment, by Perceived Health Status

     D

Note: Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

2.4 Logistic Regression Models

Simple logistic regression models were used to estimate the unadjusted odds of receiving any mental health treatment in the past year given an individual characteristic. To control for possible confounding variables, a multivariate logistic regression model also was estimated. In this model, the dependent variable was mental health treatment in the past year, and the independent variables included illicit drug dependence/abuse, alcohol dependence/abuse, daily smoking, and all the socioeconomic and demographic characteristics described above except region and county type (Table 2.4).

The results of these models indicate a strong association between past year mental health treatment and the demographic and socioeconomic variables in the model. All the unadjusted odds ratios for the variables in the models were significant for some level of the independent variable. The adjusted odds ratios corresponding to each of the unadjusted odds ratios also were significant except for family income, indicating that these variables were still associated with treatment receipt even when controlling for other confounding variables in the multivariate model.

For example, after controlling for possible confounding variables, adults who perceived their overall health as poor or fair were almost 4 times as likely as those who perceived their health as excellent to receive mental health treatment. Women were almost twice as likely to receive treatment as men, while whites were 2.4 times as likely to receive mental health treatment as blacks. Those who were divorced or separated were twice as likely to receive mental health treatment as those who were widowed. Those receiving Medicaid/CHIP were more than twice as likely to receive mental health treatment as those who had no health insurance coverage. Adults with drug dependence/abuse were 2.8 times as likely to receive mental health treatment as those who did not meet criteria for drug dependence or abuse. Further findings on the association between mental health treatment and substance use and abuse are discussed in Chapter 6.

2.5 Summary

The receipt of mental health treatment varies significantly by demographic and socioeconomic characteristics. This was demonstrated by both the rates of mental health treatment and the logistic regression models. Rates of mental health treatment were highest among adults aged 26 to 49; women; American Indians or Alaska Natives, persons reporting more than one race, and, to a lesser extent, whites; divorced or separated persons; persons with some college or college graduates; unemployed persons and persons not in the labor force; those living in small metropolitan areas; persons with less than $20,000 family income; and those in families receiving government assistance. The results of the logistic regression models indicated that persons with the levels of the characteristics described above were significantly more likely to receive mental health treatment even after controlling for confounding variables, except for those with a family income of less than $20,000.

 

Table 2.1 Estimated Numbers (in Thousands) of Adults Who Received Specific Types of Mental Health Treatment and No Treatment in the Past Year, by Type of Treatment and Selected Characteristics: 2000 and 2001

Demographic/Socioeconomic Characteristic Received Mental
Health Treatment/
Counseling1		 Type of Mental Health Treatment Did Not Receive
Mental Health
Treatment/Counseling
Any Inpatient Any Outpatient Any Prescription Medication
Total 21,092 1,477 11,924 16,567 178,997
Age in Years          
   18–25 2,643 261 1,623 1,828 26,456
   26–49 11,433 725 6,909 8,749 85,132
   50 or older 7,015 491 3,393 5,989 67,410
Gender          
   Male 7,258 630 4,067 5,386 88,198
   Female 13,833 848 7,857 11,180 90,799
Hispanic Origin and Race          
   Not Hispanic 19,741 1,284 11,140 15,574 159,557
      White only 17,619 937 9,902 14,048 129,809
      Black only 1,505 272 827 1,148 20,470
      American Indian or Alaska Native only 146 25 107 85 820
      Native Hawaiian or other Pacific Islander only 24 1 11 16 512
      Asian only 216 24 135 115 6,684
      More than one race 231 26 158 161 1,263
   Hispanic 1,351 193 784 993 19,440
Education          
   Less than high school 3,340 574 1,538 2,671 31,256
   High school graduate 6,639 524 3,231 5,583 59,434
   Some college 5,475 272 3,223 4,449 43,609
   College graduate 5,638 107 3,931 3,863 44,699
Current Employment          
   Full-time 10,369 352 6,115 7,687 104,399
   Part-time 2,867 193 1,852 2,133 21,336
   Unemployed 614 57 357 466 3,973
   Not in the labor force2 7,242 875 3,601 6,281 49,288
Marital Status          
   Married 10,879 508 5,812 8,842 106,700
   Widowed 1,191 107 407 1,049 12,037
   Divorced or separated 4,049 365 2,494 3,184 20,329
   Never married 4,972 497 3,211 3,492 39,931
Geographic Division          
   Northeast 4,196 260 2,628 3,131 34,387
      New England 1,437 68 934 1,104 8,684
      Middle Atlantic 2,759 192 1,694 2,027 25,703
   Midwest 5,001 336 2,920 4,000 41,311
      East North Central 3,502 227 2,077 2,809 29,018
      West North Central 1,499 110 843 1,191 12,292
   South 7,249 615 3,680 5,929 63,785
      South Atlantic 3,851 350 2,050 3,133 33,176
      East South Central 1,381 112 596 1,185 10,934
      West South Central 2,017 154 1,035 1,610 19,675
   West 4,646 266 2,696 3,506 39,514
      Mountain 1,533 82 857 1,181 11,052
      Pacific 3,113 184 1,839 2,325 28,462
County Type          
   Large metropolitan 9,923 673 6,025 7,417 87,320
   Small metropolitan 6,916 478 3,803 5,615 54,906
      250,000 to 1,000,000 5,163 367 2,743 4,200 40,704
      <250,000 1,754 111 1,060 1,415 14,202
   Nonmetropolitan 4,252 326 2,095 3,535 36,772
      Urbanized 1,341 92 671 1,054 10,610
      Less urbanized 2,451 201 1,170 2,083 22,134
      Completely rural 460 32 254 399 4,028
Family Income          
   Less than $20,000 5,299 685 2,706 4,315 35,079
   $20,000 to $49,999 7,707 574 4,170 6,248 70,847
   $50,000 to $74,999 3,601 141 2,139 2,698 33,442
   $75,000 or more 4,484 78 2,910 3,306 39,630
Government Assistance3          
   Yes 4,164 706 2,336 3,428 20,168
   No 16,928 772 9,589 13,139 158,829
Health Insurance          
   Private 15,317 584 8,824 11,890 136,511
   Medicaid/CHIP4 3,101 532 1,652 2,628 12,939
   Other5 4,793 501 2,376 4,136 39,703
   No coverage 1,756 224 870 1,291 21,729
Past Year Any Illicit Drug Use6          
   Yes 3,815 346 2,353 2,830 17,930
   No 17,277 1,131 9,571 13,737 161,067
Overall Health          
   Excellent 4,034 165 2,612 2,720 52,179
   Very good 6,388 250 3,734 4,878 61,271
   Good 5,611 426 3,117 4,567 45,466
   Fair/poor 5,051 637 2,456 4,397 19,932
*Low precision; no estimate reported.
Note: The types of mental health treatment do not add to the totals because they are not mutually exclusive.
1 Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.
2 Retired, disabled, homemaker, student, or other.
3 Government assistance includes the following programs: supplemental security income, food stamps, cash assistance, and noncash assistance.
4 Children's Health Insurance Program. Individuals aged 20 or older are not eligible for this plan.
5 Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other program that provides or pays for medical care (not including Medicaid/CHIP or private health insurance).
6 Any illicit drug indicates use at least once of marijuana/hashish, cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type psychotherapeutic used nonmedically.
Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Table 2.2 Percentages of Adults Who Received Specific Types of Mental Health Treatment and No Treatment in the Past Year, by Selected Characteristics: 2000 and 2001

Demographic/Socioeconomic Characteristic Received Mental Health Treatment/Counseling1 Type of Mental Health Treatment Did Not Receive
Mental Health
Treatment/Counseling
Any Inpatient Any Outpatient Any Prescription Medication
Total 10.5 0.7 6.0 8.3 89.5
Age in Years          
   18–25 9.1 0.9 5.6 6.3 90.9
   26–49 11.8 0.8 7.2 9.1 88.2
   50 or older 9.4 0.7 4.6 8.1 90.6
Gender          
   Male 7.6 0.7 4.3 5.6 92.4
   Female 13.2 0.8 7.5 10.7 86.8
Hispanic Origin and Race          
   Not Hispanic 11.0 0.7 6.2 8.7 89.0
      White only 12.0 0.6 6.7 9.5 88.0
      Black only 6.8 1.2 3.8 5.2 93.2
      American Indian or Alaska Native only 15.1 2.5 11.1 8.8 84.9
      Native Hawaiian or other Pacific Islander only 4.4 0.2 2.0 2.9 95.6
      Asian only 3.1 0.4 2.0 1.7 96.9
      More than one race 15.5 1.7 10.5 10.8 84.5
   Hispanic 6.5 0.9 3.8 4.8 93.5
Education          
   Less than high school 9.7 1.7 4.4 7.7 90.3
   High school graduate 10.0 0.8 4.9 8.5 90.0
   Some college 11.2 0.6 6.6 9.1 88.8
   College graduate 11.2 0.2 7.8 7.7 88.8
Current Employment          
   Full-time 9.0 0.3 5.3 6.7 91.0
   Part-time 11.8 0.8 7.7 8.8 88.2
   Unemployed 13.4 1.2 7.8 10.1 86.6
   Not in the labor force2 12.8 1.5 6.4 11.1 87.2
Marital Status          
   Married 9.3 0.4 4.9 7.5 90.7
   Widowed 9.0 0.8 3.1 7.9 91.0
   Divorced or separated 16.6 1.5 10.2 13.1 83.4
   Never married 11.1 1.1 7.2 7.8 88.9
Geographic Division          
   Northeast 10.9 0.7 6.8 8.1 89.1
      New England 14.2 0.7 9.2 10.9 85.8
      Middle Atlantic 9.7 0.7 6.0 7.1 90.3
   Midwest 10.8 0.7 6.3 8.6 89.2
      East North Central 10.8 0.7 6.4 8.6 89.2
      West North Central 10.9 0.8 6.1 8.6 89.1
   South 10.2 0.9 5.2 8.3 89.8
      South Atlantic 10.4 0.9 5.5 8.5 89.6
      East South Central 11.2 0.9 4.8 9.6 88.8
      West South Central 9.3 0.7 4.8 7.4 90.7
   West 10.5 0.6 6.1 7.9 89.5
      Mountain 12.2 0.7 6.8 9.4 87.8
      Pacific 9.9 0.6 5.8 7.4 90.1
County Type          
   Large metropolitan 10.2 0.7 6.2 7.6 89.8
   Small metropolitan 11.2 0.8 6.2 9.1 88.8
      250,000 to 1,000,000 11.3 0.8 6.0 9.2 88.7
      <250,000 11.0 0.7 6.6 8.9 89.0
   Nonmetropolitan 10.4 0.8 5.1 8.6 89.6
      Urbanized 11.2 0.8 5.6 8.8 88.8
      Less urbanized 10.0 0.8 4.8 8.5 90.0
      Completely rural 10.3 0.7 5.7 8.9 89.7
Family Income          
   Less than $20,000 13.1 1.7 6.7 10.7 86.9
   $20,000 to $49,999 9.8 0.7 5.3 8.0 90.2
   $50,000 to $74,999 9.7 0.4 5.8 7.3 90.3
   $75,000 or more 10.2 0.2 6.6 7.5 89.8
Government Assistance3          
   Yes 17.1 2.9 9.6 14.1 82.9
   No 9.6 0.4 5.5 7.5 90.4
Health Insurance          
   Private 10.1 0.4 5.8 7.8 89.9
   Medicaid/CHIP4 19.3 3.3 10.3 16.4 80.7
   Other5 10.8 1.1 5.3 9.3 89.2
   No coverage 7.5 1.0 3.7 5.5 92.5
Past Year Any Illicit Drug Use6          
   Yes 17.5 1.6 10.8 13.0 82.5
   No 9.7 0.6 5.4 7.7 90.3
Overall Health          
   Excellent 7.2 0.3 4.6 4.8 92.8
   Very good 9.4 0.4 5.5 7.2 90.6
   Good 11.0 0.8 6.1 8.9 89.0
   Fair/poor 20.2 2.5 9.8 17.6 79.8
*Low precision; no estimate reported.
Note: The types of mental health treatment do not add to the totals because they are not mutually exclusive.
1 Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.
2 Retired, disabled, homemaker, student, or other.
3 Government assistance includes the following programs: supplemental security income, food stamps, cash assistance, and noncash assistance.
4 Children's Health Insurance Program. Individuals aged 20 or older are not eligible for this plan.
5 Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other program that provides or pays for medical care (not including Medicaid/CHIP or private health insurance).
6 Any illicit drug indicates use at least once of marijuana/hashish, cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type psychotherapeutic used nonmedically.
Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Table 2.3 Percent Distributions of Selected Characteristics among Adults Who Received Specific Types of Mental Health Treatment and No Treatment in the Past Year: 2000 and 2001

Demographic/Socioeconomic Characteristic Received Mental Health Treatment/Counseling1 Type of Mental Health Treatment Did Not Receive
Mental Health
Treatment/Counseling
Any Inpatient Any Outpatient Any Prescription Medication
Total 100.0 100.0 100.0 100.0 100.0
Age in Years          
   18–25 12.5 17.7 13.6 11.0 14.8
   26–49 54.2 49.1 57.9 52.8 47.6
   50 or older 33.3 33.2 28.5 36.2 37.7
Gender          
   Male 34.4 42.6 34.1 32.5 49.3
   Female 65.6 57.4 65.9 67.5 50.7
Hispanic Origin and Race          
   Not Hispanic 93.6 86.9 93.4 94.0 89.1
      White only 83.5 63.4 83.0 84.8 72.5
      Black only 7.1 18.4 6.9 6.9 11.4
      American Indian or Alaska Native only 0.7 1.7 0.9 0.5 0.5
      Native Hawaiian or other Pacific Islander only 0.1 0.1 0.1 0.1 0.3
      Asian only 1.0 1.7 1.1 0.7 3.7
      More than one race 1.1 1.8 1.3 1.0 0.7
   Hispanic 6.4 13.1 6.6 6.0 10.9
Education          
   Less than high school 15.8 38.9 12.9 16.1 17.5
   High school graduate 31.5 35.5 27.1 33.7 33.2
   Some college 26.0 18.4 27.0 26.9 24.4
   College graduate 26.7 7.2 33.0 23.3 25.0
Current Employment          
   Full-time 49.2 23.8 51.3 46.4 58.3
   Part-time 13.6 13.1 15.5 12.9 11.9
   Unemployed 2.9 3.9 3.0 2.8 2.2
   Not in the labor force2 34.3 59.2 30.2 37.9 27.5
Marital Status          
   Married 51.6 34.4 48.7 53.4 59.6
   Widowed 5.6 7.3 3.4 6.3 6.7
   Divorced or separated 19.2 24.7 20.9 19.2 11.4
   Never married 23.6 33.6 26.9 21.1 22.3
Geographic Division          
   Northeast 19.9 17.6 22.0 18.9 19.2
      New England 6.8 4.6 7.8 6.7 4.9
      Middle Atlantic 13.1 13.0 14.2 12.2 14.4
   Midwest 23.7 22.8 24.5 24.1 23.1
      East North Central 16.6 15.3 17.4 17.0 16.2
      West North Central 7.1 7.4 7.1 7.2 6.9
   South 34.4 41.6 30.9 35.8 35.6
      South Atlantic 18.3 23.7 17.2 18.9 18.5
      East South Central 6.5 7.6 5.0 7.2 6.1
      West South Central 9.6 10.4 8.7 9.7 11.0
   West 22.0 18.0 22.6 21.2 22.1
      Mountain 7.3 5.5 7.2 7.1 6.2
      Pacific 14.8 12.4 15.4 14.0 15.9
County Type          
   Large metropolitan 47.0 45.6 50.5 44.8 48.8
   Small metropolitan 32.8 32.4 31.9 33.9 30.7
      250,000 to 1,000,000 24.5 24.9 23.0 25.4 22.7
      <250,000 8.3 7.5 8.9 8.5 7.9
   Nonmetropolitan 20.2 22.1 17.6 21.3 20.5
      Urbanized 6.4 6.2 5.6 6.4 5.9
      Less urbanized 11.6 13.6 9.8 12.6 12.4
      Completely rural 2.2 2.2 2.1 2.4 2.3
Family Income          
   Less than $20,000 25.1 46.4 22.7 26.0 19.6
   $20,000 to $49,999 36.5 38.8 35.0 37.7 39.6
   $50,000 to $74,999 17.1 9.5 17.9 16.3 18.7
   $75,000 or more 21.3 5.3 24.4 20.0 22.1
Government Assistance3          
   Yes 19.7 47.8 19.6 20.7 11.3
   No 80.3 52.2 80.4 79.3 88.7
Health Insurance          
   Private 72.6 39.5 74.0 71.8 76.3
   Medicaid/CHIP4 14.7 36.0 13.9 15.9 7.2
   Other5 22.7 33.9 19.9 25.0 22.2
   No coverage 8.3 15.2 7.3 7.8 12.1
Past Year Any Illicit Drug Use6          
   Yes 18.1 23.5 19.7 17.1 10.0
   No 81.9 76.5 80.3 82.9 90.0
Overall Health          
   Excellent 19.1 11.1 21.9 16.4 29.2
   Very good 30.3 17.0 31.3 29.4 34.2
   Good 26.6 28.8 26.1 27.6 25.4
   Fair/poor 23.9 43.1 20.6 26.5 11.1
*Low precision; no estimate reported.
Note: The types of mental health treatment do not add to the totals because they are not mutually exclusive.
1 Mental health treatment or counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.
2 Retired, disabled, homemaker, student, or other.
3 Government assistance includes the following programs: supplemental security income, food stamps, cash assistance, and noncash assistance.
4 Children's Health Insurance Program. Individuals aged 20 or older are not eligible for this plan.
5 Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other program that provides or pays for medical care (not including Medicaid/CHIP or private health insurance).
6 Any illicit drug indicates use at least once of marijuana/hashish, cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type psychotherapeutic used nonmedically.
Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

 

Table 2.4 Results of Logistic Regression of Demographic and Socioeconomic Characteristics and Substance Abuse on Receipt of Past Year Mental Health Treatment: 2000 and 2001

Covariate Unadjusted Adjusted
Odds
Ratio		 95% Limit Odds
Ratio		 95% Limit
Age Group        
Age 26–49 vs. Age 18–25 1.34 (1.26 – 1.43) 1.52 (1.39 – 1.67)
Age 50 or Older vs. Age 18–25 1.04 (0.96 – 1.13) 0.91 (0.80 – 1.04)
Gender        
Female vs. Male 1.85 (1.73 – 1.98) 1.93 (1.80 – 2.08)
Race/Ethnicity        
Non-Hispanic White vs. Non-Hispanic Black 1.82 (1.59 – 2.09) 2.44 (2.11 – 2.82)
Hispanic vs. Non-Hispanic Black 0.93 (0.77 – 1.13) 1.20 (0.98 – 1.46)
Other1 vs. Non-Hispanic Black 0.69 (0.53 – 0.90) 0.82 (0.63 – 1.07)
Adult Education        
High School Graduate vs. Less Than High School 1.05 (0.93 – 1.17) 1.19 (1.06 – 1.34)
Some College vs. Less Than High School 1.17 (1.05 – 1.32) 1.49 (1.31 – 1.68)
College Graduate vs. Less Than High School 1.18 (1.05 – 1.32) 1.80 (1.57 – 2.07)
Current Employment        
Part-Time vs. Full-Time 1.35 (1.22 – 1.49) 1.21 (1.08 – 1.34)
Unemployed vs. Full-Time 1.56 (1.28 – 1.89) 1.45 (1.18 – 1.79)
Not in the Labor Force2 vs. Full-Time 1.48 (1.36 – 1.61) 1.27 (1.14 – 1.41)
Marital Status        
Married vs. Widowed 1.03 (0.86 – 1.24) 1.33 (1.09 – 1.63)
Divorced/Separated vs. Widowed 2.01 (1.67 – 2.43) 2.26 (1.84 – 2.78)
Never Married vs. Widowed 1.26 (1.05 – 1.50) 1.76 (1.43 – 2.18)
Family Income        
$20,000-Lower Than $50,000 vs. Less Than $20,000 0.72 (0.65 – 0.79) 0.91 (0.82 – 1.02)
$50,000-Lower Than $75,000 vs. Less Than $20,000 0.71 (0.64 – 0.80) 0.95 (0.84 – 1.08)
$75,000 or More vs. Less Than $20,000 0.75 (0.66 – 0.84) 1.05 (0.91 – 1.21)
Government Assistance3        
Yes vs. No 1.94 (1.76 – 2.13) 1.51 (1.35 – 1.69)
Health Insurance        
Medicaid/CHIP4 vs. No Coverage 2.97 (2.57 – 3.43) 2.22 (1.89 – 2.60)
Other5 vs. No Coverage 1.39 (1.24 – 1.56) 1.61 (1.41 – 1.84)

Overall Health

        
Very Good vs. Excellent 1.35 (1.23 – 1.48) 1.40 (1.27 – 1.54)
Good vs. Excellent 1.60 (1.45 – 1.76) 1.84 (1.66 – 2.04)
Fair/Poor vs. Excellent 3.28 (2.94 – 3.66) 3.90 (3.44 – 4.43)
Illicit Drug Dependence/Abuse6        
Yes vs. No 3.52 (3.04 – 4.07) 2.80 (2.37 – 3.31)
Alcohol Dependence/Abuse        
Yes vs. No 2.04 (1.84 – 2.28) 1.86 (1.65 – 2.11)
Daily Smoking7        
Yes vs. No 1.50 (1.38 – 1.63) 1.16 (1.05 – 1.27)
1 American Indian or Alaska Native, Asian, or Pacific Islander.
2 Retired, disabled, homemaker, student, or other.
3 Government assistance includes the following programs: supplemental security income, food stamps, cash assistance, and noncash assistance.
4 Children's Health Insurance Program. Individuals aged 20 or older are not eligible for this plan.
5 Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other government-sponsored program that provides or pays for medical care.
6 Illicit drug dependence or abuse indicates dependence on or abuse of at least one of the following drugs: marijuana/hashish, cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type psychotherapeutic used nonmedically. Dependence or abuse is based on the definition found in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
7 Daily cigarette use is defined as using cigarettes daily in the past 30 days.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

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This page was last updated on August 08, 2007.


SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.

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