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18. Mental Health and Mental Disorders

Goal: Improve mental health and ensure access to appropriate, quality mental health services.

Mental Health Status Improvement

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)
18-1. Reduce the suicide rate.
Target: 4.81 suicides per 100,000 population.
Baseline: 10.52 suicides per 100,000 population occurred in 19992 (age adjusted to the year 2000 standard population).
Target setting method: Better than the best.
Data source : National Vital Statistics System (NVSS), CDC, NCHS.
1 (Target revised from 5.0 because of baseline revision after November 2000 publication)
2 (Baseline and baseline year revised from 11.3 and 1998 after November 2000 publication)


NO CHANGE IN OBJECTIVE
18-2. Reduce the rate of suicide attempts by adolescents.
Target: 12-month average of 1.0 percent.
Baseline: 12-month average of 2.6 percent of adolescents in grades 9 through 12 attempted suicide in 1999.
Target setting method: Better than the best.
Data source : Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.


ORIGINAL OBJECTIVE
18-3. Reduce the proportion of homeless adults who have serious mental illness (SMI).
Target: 19 percent.
Baseline: 25 percent of homeless adults aged 18 years and older had SMI in 1996.
Target setting method: 24 percent improvement. (Better than the best will be used when data are available.)
Data source : Projects for Assistance in Transition from Homelessness (PATH) Annual Application, SAMHSA, CMHS.
OBJECTIVE WITH REVISIONS
18-3. ReduceIncrease the proportion of homeless adults who have with mental health illness (SMI).problems who receive mental health services. 
Target: 19 30 percent. 
Baseline: 25 27 percent of homeless adults aged 18 years and older with mental health problems received mental health serviceshad SMI in 19962000. 
Target setting method: 24 10 percent improvement. (Better than the best will be used when data are available.) 
Data source : Projects for Assistance in Transition from Homelessness (PATH) Annual Application, SAMHSA, CMHS.
REVISED OBJECTIVE
18-3. Increase the proportion of homeless adults with mental health problems who receive mental health services.
Target: 30 percent.
Baseline: 27 percent of homeless adults aged 18 years and older with mental health problems received mental health services in 2000.
Target setting method: 10 percent improvement. (Better than the best will be used when data are available.)
Data source : Projects for Assistance in Transition from Homelessness (PATH) Annual Application, SAMHSA, CMHS.


ORIGINAL OBJECTIVE
18-4. Increase the proportion of persons with serious mental illness (SMI) who are employed.
Target: 51 percent.
Baseline: 43 percent of persons aged 18 years and older with SMI were employed in 1994.
Target setting method: 19 percent improvement. (Better than the best will be used when data are available.)
Data source : National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
18-4. Increase the proportion of persons with serious mental illness (SMI) who are employed.
Target: 54 51 percent. 
Baseline: 52 43 percent of persons aged 18 years and older with SMI were employed in 19942002. 
Target setting method: 19 percent improvement. (Better than the best will be used when data are available.) 
Data source : National Comorbidity Survey–Replication (NCS–R), NIH, NIMHHealth Interview Survey (NHIS), CDC, NCHS. 
REVISED OBJECTIVE
18-4. Increase the proportion of persons with serious mental illness (SMI) who are employed.
Target: 54 percent.
Baseline: 52 percent of persons aged 18 years and older with SMI were employed in 2002.
Target setting method: Better than the best.
Data source : National Comorbidity Survey–Replication (NCS–R), NIH, NIMH.


ORIGINAL OBJECTIVE
18-5. (Developmental) Reduce the relapse rates for persons with eating disorders including anorexia nervosa and bulimia nervosa.
Potential data source: Prospective studies of patients with anorexia or bulimia nervosa, NIH, NIMH.
OBJECTIVE WITH REVISIONS
18-5. (Developmental) Reduce the proportion of adolescents who engage in disordered eating behaviors in an attempt to control their weightrelapse rates for persons with eating disorders including anorexia nervosa and bulimia nervosa. 
Target: 16 percent. 
Baseline: 19 percent of adolescents grades 9 through 12 engaged in disordered eating behaviors in an attempt to control their weight in 2001. 
Target setting method: Better than the best. 
Potential dData source : Prospective studies of patients with anorexia or bulimia nervosa, NIH, NIMHYouth Risk Behavior Surveillance Survey (YRBSS), CDC, NCHS. 
REVISED OBJECTIVE
18-5. Reduce the proportion of adolescents who engage in disordered eating behaviors in an attempt to control their weight.
Target: 16 percent.
Baseline: 19 percent of adolescents grades 9 through 12 engaged in disordered eating behaviors in an attempt to control their weight in 2001.
Target setting method: Better than the best.
Data source : Youth Risk Behavior Surveillance Survey (YRBSS), CDC, NCHS.


Treatment Expansion

ORIGINAL OBJECTIVE
18-6. (Developmental) Increase the number of persons seen in primary health care who receive mental health screening and assessment.
Potential data source: Primary Care Data System/Federally Qualified Health Centers, HRSA.
OBJECTIVE WITH REVISIONS
18-6. (Developmental) Increase the number proportion of primary care facilities that provide mental health treatment on site or paid by referral. of persons seen in primary health care who receive mental health screening and assessment. 
Target: 68 percent of HRSA-funded primary care facilities. 
Baseline: 62 percent of HRSA-funded primary care facilities provided mental health treatment on site or paid by referral in 2000. 
Target setting method: 10 percent improvement. 
Potential dData source : Primary Care Data System/Federally Qualified Health CentersUniform Data System (UDS), HRSA. 
REVISED OBJECTIVE
18-6. Increase the proportion of primary care facilities that provide mental health treatment on site or paid by referral.
Target: 68 percent of HRSA-funded primary care facilities.
Baseline: 62 percent of HRSA-funded primary care facilities provided mental health treatment on site or paid by referral in 2000.
Target setting method: 10 percent improvement.
Data source : Uniform Data System (UDS), HRSA.


ORIGINAL OBJECTIVE
18-7. (Developmental) Increase the proportion of children with mental health problems who receive treatment.
Potential data source: National Household Survey on Drug Abuse (NHSDA), SAMHSA, OAS.
OBJECTIVE WITH REVISIONS
18-7. (Developmental) Increase the proportion of children with mental health problems who receive treatment. 
Target: 66 percent. 
Baseline: 59 percent of children with mental health problems received treatment in 2001. 
Target setting method: Better than the best. 
Potential data source : National Health Interview Survey (NHIS), CDC, NCHS.Household Survey on Drug Abuse (NHSDA), SAMHSA, OAS. 
REVISED OBJECTIVE
18-7. Increase the proportion of children with mental health problems who receive treatment.
Target: 66 percent.
Baseline: 59 percent of children with mental health problems received treatment in 2001.
Target setting method: Better than the best.
Data source : National Health Interview Survey (NHIS), CDC, NCHS.


ORIGINAL OBJECTIVE
18-8. (Developmental) Increase the proportion of juvenile justice facilities that screen new admissions for mental health problems.
Potential data source: Inventory of Mental Health Services in Juvenile Justice Facilities, SAMHSA.
OBJECTIVE WITH REVISIONS
18-8. (Developmental) Increase the proportion of juvenile justice residential facilities that screen new admissions for mental health problems. 
Target: 55 percent. 
Baseline: 50 percent of juvenile residential facilities screened admissions for mental health problems in 2000. 
Target setting method: 10 percent improvement. 
Potential dData source : Inventory of Mental Health Services in Juvenile Justice Facilities, SAMHSAJuveniles in Residential Facilities Census (JRFC), National Center for Juvenile Justice. 
REVISED OBJECTIVE
18-8. Increase the proportion of juvenile residential facilities that screen admissions for mental health problems.
Target: 55 percent.
Baseline: 50 percent of juvenile residential facilities screened admissions for mental health problems in 2000.
Target setting method: 10 percent improvement.
Data source : Juveniles in Residential Facilities Census (JRFC), National Center for Juvenile Justice.


ORIGINAL OBJECTIVE
18-9. Increase the proportion of adults with mental disorders who receive treatment.
Target and baseline:
Objective Increase in Adults With Mental Disorders Receiving Treatment 1997
Baseline
(unless noted) 		2010
Target
Percent
18-9a. Adults aged 18 to 54 years with serious mental illness 47 (1991) 55
18-9b. Adults aged 18 years and older with recognized depression 23 50
18-9c. Adults aged 18 years and older with schizophrenia 60 (1984) 75
18-9d. Adults aged 18 years and older with generalized anxiety disorder 38 50
Target setting method: 17 percent improvement for 18-9a. (Better than the best will be used when data are available.) Better than the best for 18-9b, 18-9c, and 18-9d.
Data source s: Epidemiologic Catchment Area (ECA) Program, NIH, NIMH; National Household Survey on Drug Abuse (NHSDA), SAMHSA, OAS; National Comorbidity Survey, SAMHSA, CMHS; NIH, NIMH.
OBJECTIVE WITH REVISIONS
18-9. Increase the proportion of adults with mental disorders who receive treatment.
Target and baseline:
Objective Increase in Adults With Mental Disorders Receiving Treatment 19972002
Baseline
(unless noted) 		2010
Target
Percent
18-9a. Adults aged 18 to 54 years and older with serious mental illness  47 (1991)62 5568 
18-9b. Adults aged 18 years and older with recognized depression 2358 (2001-02)  5064 
18-9c. Adults aged 18 years and older with schizophrenia 60 (1984) 75
18-9d. Adults aged 18 years and older with generalized anxiety disorder 3860 5079
Target setting method: Better than the best.17 percent improvement for 18-9a. (Better than the best will be used when data are available. 
Data source s: Epidemiologic Catchment Area (ECA) Program, NIH, NIMH; Household Survey on Drug Abuse (NHSDA), SAMHSA, OAS; National Comorbidity Survey–Replication (NCS–R), NIH, NIMH.  
REVISED OBJECTIVE
18-9. Increase the proportion of adults with mental disorders who receive treatment.
Target and baseline:
Objective Increase in Adults With Mental Disorders Receiving Treatment 2002
Baseline
(unless noted) 		2010
Target
Percent
18-9a. Adults aged 18 years and older with serious mental illness 62 68
18-9b. Adults aged 18 years and older with recognized depression 58 (2001-02) 64
18-9c. Adults aged 18 years and older with schizophrenia 60 (1984) 75
18-9d. Adults aged 18 years and older with generalized anxiety disorder 60 79
Target setting method: Better than the best.
Data source s: Epidemiologic Catchment Area (ECA) Program, NIH, NIMH; National Comorbidity Survey–Replication (NCS–R), NIH, NIMH.  


ORIGINAL OBJECTIVE
18-10. (Developmental) Increase the proportion of persons with co-occurring substance abuse and mental disorders who receive treatment for both disorders.
Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Household Survey on Drug Abuse (NHSDA), SAMHSA, OAS; Replication of National Comorbidity Survey, NIH, NIMH.
OBJECTIVE WITH REVISIONS
18-10. (Developmental) Increase the proportion of persons with co-occurring substance abuse and mental disorders who receive treatment for both disorders. 
Target: 57 percent. 
Baseline: 51 percent of persons with co-occurring substance abuse and mental disorders received treatment for both disorders in 2002. 
Target setting method: 10 percent improvement. (Better than the best will be used when population data are available.) 
Potential dData source s: National Health Interview Survey (NHIS), CDC, NCHS; National Household Survey on Drug Abuse (NHSDA) Replication of National Comorbidity Survey–Replication (NCS–R), NIH, NIMH.
REVISED OBJECTIVE
18-10. Increase the proportion of persons with co-occurring substance abuse and mental disorders who receive treatment for both disorders.
Target: 57 percent.
Baseline: 51 percent of persons with co-occurring substance abuse and mental disorders received treatment for both disorders in 2002.
Target setting method: 10 percent improvement. (Better than the best will be used when population data are available.)
Data source : National Comorbidity Survey–Replication (NCS–R), NIH, NIMH.


ORIGINAL OBJECTIVE
18-11. (Developmental) Increase the proportion of local governments with community-based jail diversion programs for adults with serious mental illness (SMI).
Potential data source: National Survey of Jail Mental Health Diversion Programs, SAMHSA.
OBJECTIVE WITH REVISIONS
18-11. (Developmental) Increase the proportion of local governments with counties served by community-based jail diversion programs and/or mental health courts for adults with serious mental illness (SMI) health problems. 
Target: 7.6 percent. 
Baseline: 6.9 percent of counties were served by community-based jail diversion programs and/or mental health courts for adults with mental health problems in 2004. 
Target setting method: 10 percent improvement. 
Potential dData source : National Survey of Jail Mental Health Diversion Programs Database, SAMHSA. 
REVISED OBJECTIVE
18-11. Increase the proportion of counties served by community-based jail diversion programs and/or mental health courts for adults with mental health problems.
Target: 7.6 percent.
Baseline: 6.9 percent of counties were served by community-based jail diversion programs and/or mental health courts for adults with mental health problems in 2004.
Target setting method: 10 percent improvement.
Data source : Jail Diversion Program Database, SAMHSA.


State Activities

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)
18-12. Increase the number of States and the District of Columbia that track consumers’ satisfaction with the mental health services they receive.
Target: All States and the District of Columbia.
Baseline: 401 States tracked consumers’ satisfaction with the mental health services they received in 2002.1
Target setting method: Total coverage.
Data source : Uniform Reporting System (URS), SAMHSA.
1 (Baseline and baseline year revised from 36 and 1999 after November 2000 publication)


NO CHANGE IN OBJECTIVE
18-13. (Developmental) Increase the number of States, Territories, and the District of Columbia with an operational mental health plan that addresses cultural competence.
Potential data source: State Mental Health Agency Profiling System, National Association of State Mental Health Program Directors, National Research Institute.


ORIGINAL OBJECTIVE
18-14. Increase the number of States, Territories, and the District of Columbia with an operational mental health plan that addresses mental health crisis interventions, ongoing screening, and treatment services for elderly persons.
Target: 50 States and the District of Columbia.
Baseline: 24 States had an operational mental health plan that addressed mental health crisis interventions, ongoing screening, and treatment services for elderly persons in 1997.
Target setting method: Total coverage.
Data source : National Technical Assistance Center for State Mental Health Systems, National Association of State Mental Health Program Directors, National Research Institute; SAMHSA, CMHS.
OBJECTIVE WITH REVISIONS
18-14. Increase the number of States, Territories, and the District of Columbia with an operational mental health plan that addresses specialized mental health crisis interventionsservices ongoing screening, and treatment services for elderly persons. 
Target: All States and the District of Columbia.
Baseline: 2418 States had an operational mental health plan that addressed specialized mental health crisis interventions, ongoing screening, and treatment services for elderly persons in 19972000–01. 
Target setting method: Total coverage.
Data source : State Mental Health Agency Profiling System, National Association of State Mental Health Program Directors, National Research Institute. National Technical Assistance Center for State Mental Health Systems, National Association of State Mental Health Program Directors, National Research Institute; SAMHSA, CMHS. 
REVISED OBJECTIVE
18-14. Increase the number of States, Territories, and the District of Columbia with an operational mental health plan that addresses specialized mental health services for elderly persons.
Target: All States and the District of Columbia.
Baseline: 18 States had an operational mental health plan that addressed specialized mental health services for elderly persons in 2000–01.
Target setting method: Total coverage.
Data source : State Mental Health Agency Profiling System, National Association of State Mental Health Program Directors, National Research Institute.

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