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Glossary 2023

Glossary

Indicator

Description of Measure

Source

Adults with Any Mental Illness (AMI)

 

Any mental illness (AMI) is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder, assessed by the Mental Health Surveillance Study (MHSS) Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders — Fourth Edition — Research Version Axis I Disorders (MHSS-SCID), which is based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). For details, see Section B of the "2019-2020 NSDUH: Guide to State Tables and Summary of Small Area Estimation Methodology" at www.samhsa.gov/data.

 

Data survey years: 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Adults with AMI Reporting Unmet Need

The variable, AMIYR_U is an indicator for any mental illness (AMI) based on the 2012 revised predicted probability of SMI (SMIPP_U). If SMIPP_U is greater than or equal to a specified cutoff point (0.0192519810) then AMIYR_U=1, and if SMIPP_U is less than the cutoff point then AMIYR_U=0. This indicator based on the 2012 model is not comparable with the indicator based on the 2008 model. AMI is defined as having serious, moderate, or mild mental illness. Specific details about this variable can be found in the Recoded Mental Health Appendix.

AMHTXND2 is defined as feeling a perceived need for mental health treatment/counseling that was not received. This is often referred to as "unmet need." Mental health treatment/counseling is defined as having received inpatient treatment/counseling or outpatient treatment/counseling or having used prescription medication for problems with emotions, nerves, or mental health. Respondents were not to include treatment for drug or alcohol use. Respondents with unknown treatment/counseling information were excluded.

 

Data survey years: 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health,

https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Adults with AMI Who Are Uninsured

 

For IRINSUR4, a respondent is classified as having any health insurance (IRINSUR4=1) if they satisfied ANY of the following conditions:

1. Covered by Medicare (IRMEDICR=1); 2. Covered by Medicaid/CHIP (IRMCDCHP=1); 3. Covered by Tricare, Champus, ChampVA, VA, or Military (IRCHMPUS=1); 4. Covered by private insurance (IRPRVHLT=1); 5. Covered by other health insurance (IROTHHLT=1).

A respondent is classified as NOT having any health insurance (IRINSUR4=2) if they meet EVERY one of the following conditions:

1. Not covered by Medicare (IRMEDICR=2); 2. Not covered by Medicaid/CHIP (IRMCDCHP=2); 3. Not covered by Tricare, Champus, ChampVA, VA, or Military (IRCHMPUS=2); 4. Not covered by private insurance (IRPRVHLT=2); 5. Not covered by other health insurance (IROTHHLT=2).

 

Data survey years: 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health,

https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Adults with Substance Use Disorder in the Past Year

NOTE: Substance use disorder data in 2020 are based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Substance use disorder is defined as meeting the criteria for illicit drug or alcohol use disorder. Substance use disorder estimates are based only on 2020 data because prior years’ substance use disorder data were based on DSM-IV criteria.

 

Data survey years: 2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Adults Reporting 14+ Mentally Unhealthy Days a Month Who Could Not See a Doctor Due to Costs

 

 

This indicator is derived from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System (BRFSS) core questionnaire. Mentally unhealthy days were determined using the calculated variable _MENT14D. _MENT14D is calculated from the following BRFSS question: “Now thinking about mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?” (MENTHLTH). The calculated variable, _MENT14D, contains four values: Zero days when mental health was not good, 1-13 days when mental health was not good, 14+ days when mental health was not good, and don’t know/refused/missing.

Respondents were also asked: “Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?” (MEDCOST). The measure was calculated based on individuals who answered “yes” to MEDCOST among those who answered “14+ days when mental health was not good” to _MENT14D.

 

Data survey year 2020.

Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System Survey Data 2020, https://www.cdc.gov/brfss/annual_data/annual_2020.html

 

Downloaded and calculated on 8/8/22.

 

Adults with Serious Thoughts of Suicide

Adults aged 18 or older were asked: “At any time in the past 12 months, did you seriously think about trying to kill yourself?” If they answered “Yes,” they were categorized as having serious thoughts of suicide in the past year.

 

Data survey year: 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Youth with Private Insurance That Did Not Cover Mental or Emotional

Problems

Youth with private insurance that did not cover mental or emotional problems is defined as any individual ages 12-17 responding “No” to HLTINMNT. HLTINMNT is defined as: “Does [SAMPLE MEMBER POSS] private health insurance include coverage for treatment for mental or emotional problems?”

 

Data survey years: 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Adults with AMI Who Did Not Receive Mental Health Treatment

AMHTXRC-3 is a recoded variable with levels 1=Yes (received any mental health treatment in past year) and 2=No (did not receive any mental health treatment in past year). Recoded from variable AMHSVTYP, it classifies what type of mental health treatment/counseling was received in the past year. Respondents who reported receiving treatment for mental health were classified in one of seven mutually exclusive categories. A respondent was assigned to level one if they reported receiving inpatient treatment only (AMHINP2=1 and AMHOUTP3=2 and AMHRX2=2), to level two if they reported receiving outpatient treatment only (AMHINP2=2 and AMHOUTP3=1 and AMHRX2=2), to level three if they reported receiving prescription medication treatment only (AMHINP2=2 and AMHOUTP3=2 and AMHRX2=1), to level four if they reported receiving both inpatient and outpatient treatment only (AMHINP2=1 and AMHOUTP3=1 and AMHRX2=2), to level five if they reported receiving inpatient and prescription medication treatment only (AMHINP2=1 and AMHOUTP3=2 and AMHRX2=1), to level six if they reported receiving outpatient and prescription medication treatment only (AMHINP2=2 and AMHOUTP3=1 and AMHRX2=1), or to level seven if they reported receiving inpatient, outpatient, and prescription medication treatment (AMHINP2=1 and AMHOUTP3=1 and AMHRX2=1). Respondents who did not receive mental health treatment in the past year were assigned to level eight (AMHINP2=2 and AMHOUTP3=2 and AMHRX2=2). Respondents whose specific treatment was not distinguishable due to missing values in one or more of the three source variables (AMHINP2, AMHOUTP3, or AMHRX2) were assigned a system missing.

 

Adults with AMI who did not receive mental health treatment was calculated, where AMHTXRC-3= 2 (No treatment) and AMIYR_U indicates AMI.

 

Data survey years: 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Mental Health Workforce Availability

Mental health workforce availability is the ratio of the county population to the number of mental health providers, including psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, and advanced practice nurses specializing in mental health care. In 2015, marriage and family therapists and mental health providers that treat alcohol and other drug abuse were added to this measure.

These data come from the National Provider Identification data file, which has some limitations. Providers who transmit electronic health records are required to obtain an identification number, but very small providers may not obtain a number. While providers have the option of deactivating their identification number, some mental health professionals included in this list may no longer be practicing or accepting new patients. This may result in an overestimation of active mental health professionals in some communities. It is also true that mental health providers may be registered with an address in one county while practicing in another county.

 

Survey data year: 2021.

County Health Rankings and Roadmaps. http://www.countyhealthrankings.org/

 

 

 

 

 

Students Identified with Emotional Disturbance for an Individualized Education Program

This measure was calculated from data provided by IDEA Part B Child Count and Educational Environments, Common Core of Data. Under IDEA regulation, emotional disturbance is identified as a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which adversely affects a child’s educational performance: 1. an inability to learn, which cannot be explained by intellectual, sensory or health factors; 2. an inability to build or maintain satisfactory interpersonal relationships with peers and teachers; 3. inappropriate behavior or feelings under normal circumstances; 4. a general pervasive mood of unhappiness or depression; or 5. a tendency to develop physical symptoms or fears associated with personal or school problems. This term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined they have an emotional disturbance.

Percent of Students Identified with Emotional Disturbance for an Individualized Education Program was calculated as the percent of children identified as having an emotional disturbance among all enrolled students of “school age,” which includes kindergarten, grades 1-12, and “ungraded.”
 

Data years 2020-2021.

IDEA Data Center, 2020 – 2021 IDEA Section 618, State Level Data Files, Child Count and Educational Environments. https://data.ed.gov/dataset/idea-section-618-state-part-b-child-count-and-educational-environments/resources

 

U.S. Department of Education, National Center for Education Statistics, Common Core of Data. https://nces.ed.gov/ccd/files.asp

Downloaded and calculated on 8/4/2022.

Youth with at Least One Past Year Major Depressive Episode (MDE)

Among youth ages 12-17, major depressive episode (MDE) is defined in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which specifies a period of at least two weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. A subset of 2020 respondents who did not complete the questionnaire was excluded, and the analysis weights were adjusted for the reduced sample size. For details, see Section B of the “2019-2020 NSDUH: Guide to State Tables and Summary of

Small Area Estimation Methodology” at https://www.samhsa.gov/data/.

 

Data survey year 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

 

 

Youth with Substance Abuse Disorder in the Past Year

 

Among youth 12-17, substance use disorder data in 2020 are based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Substance use disorder is defined as meeting the criteria for illicit drug or alcohol use disorder. Substance use disorder estimates are based on only 2020 data because prior years’ substance use disorder data were based on DSM-IV criteria.

Illicit drug use includes the misuse of prescription psychotherapeutics or the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Misuse of prescription psychotherapeutics is defined as use in any way not directed by a doctor, including use without a prescription of one’s own; use in greater amounts, more often, or longer than told; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs.

 

Data survey years: 2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

 

 

Youth with MDE Who Did Not Receive Mental Health Services

Youth with Past Year MDE Who Did Not Receive Treatment is defined as those who apply to having past year MDE as defined above (“Youth With At Least One Past Year Major Depressive Episode,” YMDEYR) and respond “No” to ANYSMH2.

ANYSMH2 indicates whether a youth reported receiving specialty mental health services in the past year from any of six specific inpatient/residential or outpatient specialty sources for problems with behavior or emotions that were not caused by alcohol or drugs. This variable was created based on the following six source of treatment variables: stayed overnight in a hospital (YHOSP), stayed in a residential treatment facility (YRESID), spent time in a day treatment facility (YDAYTRT), received treatment from a mental health clinic (YCLIN), from a private therapist (YTHER), and from an in-home therapist (YHOME). Youths who reported a positive response (source variable=1) to one or more of the six questions were included in the “Yes” category regardless of how many of the six questions they answered. Youths who did not report a positive response but answered all six of the questions were included in the “No” category. Youths who did not report a positive response and did not answer all the questions, and respondents over age 18 were included in the unknown/18+ category.

 

Data survey year 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health,

https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Youth with Severe MDE

 

 

Youth with Severe MDE is defined as the following variable MDEIMPY. MDEIMPY is derived from the maximum severity level of MDE role impairment (YSDSOVRL) and is restricted to adolescents with past year MDE (YMDEYR). Youth met criteria for MDEIMPY if they answered “Yes” to YSDSOVRL and “Yes” to YMDEYR.

Youth who answer “Yes” to YMDEYR are asked questions from the Sheehan Disability Scale (SDS) to measure the level of functional impairment in major life activities reported to be caused by the MDE in the past 12 months (Leon, Olfson, Portera, Farber, & Sheehan, 1997). The SDS measures mental health-related impairment in four major life activities or role domains. The following variable, YSDSOVRL, is assigned the maximum level of interference over the four role domains of SDS: chores at home (YSDSHOME), school or work (YSDSWRK), family relationships (YSDSREL), and social life (YSDSSOC). Each module consists of four questions that are assessed on a 0 to 10 visual analog scale with categories of "none" (0), "mild" (1-3), "moderate" (4-6), "severe" (7-9), and "very severe" (10). The four SDS role domain variables were recoded so that no interference=1, mild=2, moderate=3, severe=4, and very severe=5. A maximum level of interference over all four domains was then defined as YSDSOVRL. A maximum impairment score (YSDSOVRL) is defined as the single highest severity level of role impairment across all four SDS role domains. Ratings greater than or equal to seven on the scale YSDSOVRL=4, 5 were considered severe impairment.

 

Data survey years 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health,

https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020

Youth with Severe MDE Who Received Some Consistent Treatment

 

The following variable was calculated as how many youths who answered “Yes” to MDEIMPY from “Youth with Severe MDE” defined above received consistent treatment, which is determined by the variable SPOUTVST.

The variable SPOUTVST indicates how many times a specialty outpatient mental health service was visited in the past year. The number of visits is calculated by adding the number of visits to a day treatment facility (YUDYTXNM), mental health clinic (YUMHCRNM), private therapist (YUTPSTNM), and an in-home therapist (YUIHTPNM). A value of 6 (No Visits) was assigned whenever a respondent said they had used none of the services (YUDYTXYR, YUMHCRYR, YUTPSTYR, YUIHTPYR all equal 2 or 4). A value of missing was assigned when the response to whether received treatment or number of visits was unknown for any of the 4 locations (any of YUDYTXYR, YUMHCRYR, YUTPSTYR, YUIHTPYR=85, 94, 97, 98 or any of YUDYTXNM, YUMHCRNM, YUTPSTNM, YUIHTPNM=985, 994, 997, 998), unless the sum of the visits for services with non-missing information was greater than or equal to 25, in which case a value of 5 (25 or more visits) was assigned. A missing value was also assigned for respondents aged 18 or older.

The variable SPOUTVST was recoded for visit distribution as 0-6 visits, and 7-25+ visits. Some consistent treatment was considered 7-25+ visits in a year. 

 

Data survey years 2019-2020.

SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, https://www.samhsa.gov/data/nsduh/state-reports-NSDUH-2020