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Mental Health and Mental Disorders Data Details

MHMD-1 Reduce the suicide rate Leading Health Indicators

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Bridged-Race Population Estimates for Census 2000 and 2010; Centers for Disease Control and Prevention, National Center for Health Statistics and U.S. Census Bureau (CDC/NCHS and Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 (age adjusted—see Comments)
Baseline (Year)
11.3 (2007)
Target
10.2
Target-Setting Method
10 percent improvement
Numerator
Number of deaths due to suicide (ICD-10 codes *U03, X60-X84, Y87.0)
Denominator
Number of persons
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Leading Health Indicator
Mental Health
Methodology Notes

Suicide is an important public health problem. In the United States, decisions about whether deaths are listed as suicides on death certificates are usually made by a coroner or medical examiner. The definition of suicide is "death arising from an act inflicted upon oneself with the intent to kill oneself." ICD-9 codes: E950-E959. ICD-10 codes: *U03, X60-X84, Y87.0.

Suicides may be undercounted because of difficulty in the determination of suicidal intent by coroner or medical examiner.

Estimates based on fewer than 20 deaths are considered unreliable and are not displayed.

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

FOR MULTIPLE DATA YEARS: Death rates are calculated based on the sum of the resident populations for each of the data years involved (e.g. the denominator of a rate for 2008-2010 combined is the sum of the population estimates for 2008, 2009, and 2010). For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Age Adjustment

At the National level this Indicator uses Age-Adjustment Groups:

  • Race/Ethnicity: < 1, 1-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
  • Sex: < 1, 1-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
  • Marital Status: 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
  • Geographic Location: < 1, 1-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
  • Country of Birth: < 5, 5-17, 18-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75+
  • Total: < 1, 1-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
Caveats and Limitations
Suicide is not a recordable cause of death for persons less than five years old
Trend Issues
Mortality data by marital status were not available for 60% of Georgia’s records in 2008 and 94% of Georgia’s records in 2009. Therefore, 2008 and 2009 data by marital status should be interpreted with caution.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. However, the baseline estimate for the total population did not change.

References

Additional resources about the objective.

  1. Anderson, R.N.; Minino, A.M.; Hoyert, D.L.; Rosenberg, H.M.; Comparability of cause of death between ICD-9 and ICD-10: Preliminary estimates. National Vital Statistics Reports. Vol. 49 No.2. Hyattsville, MD: National Center for Health Statistics, 2001.
  2. CDC - Suicide Prevention
    http://www.cdc.gov/violenceprevention/suicide
  3. Klein, R.J.; Proctor, S.E.; Boudreault, M.A.; Turczyn, K.M. Healthy People 2010 Criteria for Data Suppression. Statistical Notes No. 24. Hyattsville, MD: National Center for Health Statistics. 2002.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Youth Risk Behavior Surveillance System (YRBSS); Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (CDC/NCHHSTP)
Changed Since the Healthy People 2020 Launch
No
Measure
per 100 
Baseline (Year)
1.9 (2009)
Target
1.7
Target-Setting Method
10 percent improvement
Numerator
Number of students in grades 9 through 12 who reported suicide attempts that required medical attention in the 12 months preceding the survey
Denominator
Number of students in grades 9 through 12
Questions Used to Obtain the National Baseline Data

From the Youth Risk Behavior Survey:

[NUMERATOR:]

If you attempted suicide during the past 12 months, did any attempt result in an injury, poisoning or overdose that had to be treated by a doctor or a nurse?

  1. I did not attempt suicide during the past 12 months
  2. Yes
  3. No
Data Collection Frequency
Biennial
Comparable Healthy People 2010 Objective
Retained from HP2010 objective

References

Additional resources about the objective.

  1. Klein, R.J.; Proctor, S.E.; Boudreault, M.A.; Turczyn, K.M. Healthy People 2010 Criteria for Data Suppression. Statistical Notes No. 24. Hyattsville, MD: National Center for Health Statistics. 2002.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Youth Risk Behavior Surveillance System (YRBSS); Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (CDC/NCHHSTP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
14.3 (2009)
Target
12.9
Target-Setting Method
10 percent improvement
Numerator
One or more disordered eating behaviors based on three questions from the Youth Risk Behavior Survey
Denominator
Number of students in grades 9 through 12
Questions Used to Obtain the National Baseline Data
Persons are considered to have disordered eating they respond “yes” to any of the questions:
  • During the past 30 days, did you go without eating for 24 hours or more (also called fasting) to lose weight or to keep from gaining weight?
  • During the past 30 days, did you take any diet pills, powders, or liquids without a doctor’s advice to lose weight or to keep from gaining weight?
  • During the past 30 days, did you vomit or take laxatives to lose weight or to keep from gaining weight?
Data Collection Frequency
Biennial
Comparable Healthy People 2010 Objective
Retained from HP2010 objective

References

Additional resources about the objective.

  1. 1. Klein, R.J.; Proctor, S.E.; Boudreault, M.A.; Turczyn, K.M. Healthy People 2010 Criteria for Data Suppression. Statistical Notes No. 24. Hyattsville, MD: National Center for Health Statistics. 2002.
MHMD-4 Reduce the proportion of persons who experience major depressive episodes (MDEs)
MHMD-4.1 Reduce the proportion of adolescents aged 12 to 17 years who experience major depressive episodes (MDEs) Leading Health Indicators

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
8.3 (2008)
Target
7.5
Target-Setting Method
10 percent improvement
Numerator
Number of adolescents aged 12-17 with Major Depressive Episode (MDE)
Denominator
Number of adolescents aged 12-17
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Leading Health Indicator
Mental Health
Methodology Notes

The MDE statistics are annual (last twelve month) prevalence rates.

A modified version of the Composite International Diagnostic Interview is administered to assess criteria necessary for a diagnosis of Major Depressive Episode based on DSM IV for adolescents. A person was defined as having had a depressive episode (MDE) if he or she had a period of time in the past 12 months when he or she felt depressed or lost interest or pleasure in daily activities for 2 weeks or longer, and had at least five or more of the following nine symptoms in the same 2-week period, in which at least one of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day, nearly every day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day; (3) significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day; (4) insomnia or hypersomnia nearly every day; (5) psychomotor agitation or retardation nearly every day; (6) fatigue or loss of energy nearly every day; (7) feelings of worthlessness nearly every day; (8) diminished ability to think or concentrate or indecisiveness nearly every day; and (9) recurrent thoughts of death or recurrent suicide ideation. This definition is based on the definition found in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSMIV).

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
6.4 (2008)
Target
5.8
Target-Setting Method
10 percent improvement
Numerator
Number of adults aged 18 or older with Major Depressive Episode (MDE)
Denominator
Number of adults aged 18 or older
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The MDE statistics are annual (last twelve month) prevalence rates.

A modified version of the Composite International Diagnostic Interview is administered to assess criteria necessary for a diagnosis of Major Depressive Episode based on DSM IV for adults. A person was defined as having had a depressive episode (MDE) if he or she had a period of time in the past 12 months when he or she felt depressed or lost interest or pleasure in daily activities for 2 weeks or longer, and had at least five or more of the following nine symptoms in the same 2-week period, in which at least one of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day, nearly every day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day; (3) significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day; (4) insomnia or hypersomnia nearly every day; (5) psychomotor agitation or retardation nearly every day; (6) fatigue or loss of energy nearly every day; (7) feelings of worthlessness nearly every day; (8) diminished ability to think or concentrate or indecisiveness nearly every day; and (9) recurrent thoughts of death or recurrent suicide ideation.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

The original baseline was revised from 6.8 to 6.4 due to a change in programming. The target was adjusted from 6.1 to 5.8 to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Uniform Data System (UDS); Health Resources and Services Administration, Bureau of Primary Health Care (HRSA/BPHC)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
79.0 (2006)
Target
87.0
Target-Setting Method
10 percent improvement
Numerator
Number of primary care facilities that provide mental health treatment on site or paid by referral
Denominator
Total number of primary care facilities
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

The Health Resources and Services Administration (HRSA) Uniform Data System (UDS) collects data covering 900 grantees at 3,500 sites. The data source provides the number of health center grantees that offer mental health treatment: 1) on-site, 2) by referral with the grantee paying, 3) by referral without payment.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
68.9 (2008)
Target
75.8
Target-Setting Method
10 percent improvement
Numerator
Persons aged 4 to 17 years with mental health problems receiving one or more forms of treatment
Denominator
Persons aged 4 to 17 years with mental health problems
Questions Used to Obtain the National Baseline Data

From the National Health Interview Survey:

[NUMERATOR]

DURING THE PAST 12 MONTHS, have you seen or talked to any of the following health care providers about [fill2: alias]'s health? A mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?

  1. Yes
  2. No

DURING THE PAST 12 MONTHS, that is since [fill1: 12 month reference date], have you seen or talked to the following about [fill2: alias]'s health? A general doctor who treats a variety of illnesses (a doctor in general practice, pediatrics, family medicine, or internal medicine)?

  1. Yes
  2. No

Did you see or talk to this general doctor because of an emotional or behavioral problem that [fill1: alias] may have?

  1. Yes
  2. No

Do any children under 18 in this family receive Special Educational or Early Intervention Service?

  1. Yes
  2. No

And Does the child receive these services because of an emotional or behavioral problem?

  1. Yes
  2. No

[DENOMINATOR]

Overall do you think that the child has difficulties in any of the following areas: emotions, concentration, behavior, or being able to get along with people? Yes, minor difficulties; Yes, definite difficulties; Yes, severe difficulties

  1. Yes
  2. No
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Children are considered to have received treatment based on the numerator questions if there is: 1) a “yes” response to the mental health specialist question, 2) a "yes" response to both the general doctor question and follow-up question regarding emotional or behavioral problems or 3) a "yes" response to both the Special Educational or Early Intervention Services question and follow-up question regarding emotional or behavioral problems. Children are considered to have had mental health problems if they answer Yes, definite difficulties or Yes, severe difficulties in the denominator question.

For all questions, the parent responds as a proxy for the child.

References

Additional resources about the objective.

  1. 1. Klein, R.J.; Proctor, S.E.; Boudreault, M.A.; Turczyn, K.M. Healthy People 2010 Criteria for Data Suppression. Statistical Notes No. 24. Hyattsville, MD: National Center for Health Statistics. 2002.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Juvenile Residential Facility Census (JRFC); Department of Justice, Office of Juvenile Justice and Delinquency Prevention (DOJ/OJJDP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
58.0 (2006)
Target
64.0
Target-Setting Method
10 percent improvement
Numerator
Number of facilities for which all young persons are evaluated or appraised by a mental health professional at a location inside the facility
Denominator
Number of facilities reporting in the JRFC
Data Collection Frequency
Biennial
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Facilities for which all young persons are evaluated or appraised by a mental health professional at a location inside the facility are reported in the JRFC.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
58.6 (2008)
Target
64.4
Target-Setting Method
10 percent improvement
Numerator
Persons with Serious Mental Illness (SMI) who are employed
Denominator
Persons with Serious Mental Illness
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

A modified version of the Composite International Diagnostic Interview is administered to assess criteria necessary for a diagnosis of Serious Mental Illness based on DSM IV for adults.

Now, think about the past 12 months, from [DATEFILL] through today. Did you work at a job or business at any time during the past 12 months?

MHMD-9 Increase the proportion of adults with mental health disorders who receive treatment

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
58.7 (2008)
Target
64.6
Target-Setting Method
10 percent improvement
Numerator
Number of adults aged 18 or older with serious mental illness who received treatment
Denominator
Number of adults aged 18 or older with serious mental illness
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

A modified version of the Composite International Diagnostic Interview is administered to assess criteria necessary for a diagnosis of Serious Mental Illness based on DSM IV for adults

Persons answering affirmatively to any of the battery of questions in the mental health service utilization module were considered to have received treatment.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
71.1 (2008)
Target
78.2
Target-Setting Method
10 percent improvement
Numerator
Number of adults aged 18 or older with major depressive episode within the past 12 month who received treatment
Denominator
Number of adults aged 18 or older with major depressive episode in the past 12 months
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

A modified version of the Composite International Diagnostic Interview is administered to assess criteria necessary for a diagnosis of Major Depressive Episode based on DSM IV for adults

Persons answering affirmatively to any of the battery of questions in the mental health service utilization module were considered to have received treatment.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

The original baseline was revised from 68.3 to 71.1 due to a change in programming. The target was adjusted from 75.1 to 78.2 to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
2.7 (2008)
Target
3.0
Target-Setting Method
10 percent improvement
Numerator
Number of adults aged 18 or older with co-occurring substance abuse and mental disorders who receive treatment for both disorders
Denominator
Number of adults aged 18 or older with co-occurring substance abuse and mental disorders
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Persons answering affirmatively to any of the battery of questions in the mental health service utilization module were considered to have received treatment.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

The original baseline was revised from 3.0 to 2.7 due to a change in programming. The target was adjusted from 3.3 to 3.0 to reflect the revised baseline using the original target-setting method.

MHMD-11 Increase depression screening by primary care providers

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Ambulatory Medical Care Survey (NAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
2.2 (2007)
Target
2.4
Target-Setting Method
10 percent improvement
Numerator
Primary care visits that included depression screening
Denominator
All primary care physician visits by patients 19+ years Primary care was defined by specialty: general/family practice, internal medicine, pediatrics, & obstetrics/gynecology
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The survey questionnaire for NAMCS (the Patient Record Form) includes an item called Diagnostic/Screening Services. This item comprises a series of checkboxes and several open-ended response fields, and respondents are instructed to mark all services ordered or provided at the sampled visit.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Ambulatory Medical Care Survey (NAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
2.1 (2005-2007)
Target
2.3
Target-Setting Method
10 percent improvement
Numerator
Primary care visits that included depression screening
Denominator
All primary care physician visits by patients 12-18 years Primary care was defined by specialty: general/family practice, internal medicine, pediatrics, & obstetrics/gynecology
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Single year rates of screening for adolescents were too low to be statistically valid. Measures will be aggregated over multiple years when necessary.

The survey questionnaire for NAMCS (the Patient Record Form) includes an item called Diagnostic/Screening Services. This item comprises a series of checkboxes and several open-ended response fields, and respondents are instructed to mark all services ordered or provided at the sampled visit.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Projects for Assistance in Transition from Homelessness (PATH); Substance Abuse and Mental Health Services Administration, Center for Mental Health Services (SAMHSA/CMHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
37.0 (2006)
Target
41.0
Target-Setting Method
10 percent improvement
Numerator
Number of homeless persons aged 18 years and older with mental health problems who receive mental health services
Denominator
Number of homeless persons aged 18 years and older contacted by PATH mental health outreach workers
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

PATH tracks the number of homeless adults in social services who may or may not be diagnosed with mental health problems. Clients are eligible for PATH mental health services if they are homeless and diagnosed with one of a variety of mental health disorders or have co-occurring disorders.

References

Additional resources about the objective.

  1. Klein, R.J.; Proctor, S.E.; Boudreault, M.A.; Turczyn, K.M. Healthy People 2010 Criteria for Data Suppression. Statistical Notes No. 24. Hyattsville, MD: National Center for Health Statistics. 2002.