Most Mental Illnesses, Substance Use Disorders Go Untreated

Megan Brooks

September 19, 2016

There continues to be a significant treatment gap for mental illness and substance use disorders in the United States, according to the Substance Abuse and Mental Health Services Administration's (SAMHSA's) latest National Survey on Drug Use and Health (NSDUH) report.

In 2015, 1 in 5 adults met diagnostic criteria for a mental illness or substance use disorder (SUD), yet only 39% of them received treatment, the report notes.

"In 2015, 33 million people went untreated," SAMHSA Principal Deputy Administrator Kana Enomoto said at a press briefing.

"Given what we know about the risks and harms of untreated behavioral health conditions, [these persons] are at higher risk for physical health comorbidities, suicide, accidents and injuries, accidental poisonings, and premature death. That's 33 million lives hanging in the balance," Enomoto said.

The data show that "too many people don't get the treatment they need for their substance use disorders," Michael Botticelli, director, White House Office of National Drug Control Policy, added in a news release. "That is why the president has repeatedly called for $1.1 billion in new funding for states to expand access to treatment. Every day that passes without Congressional action to provide these additional resources is a missed opportunity to save lives."

SAMHSA released the report on key substance use and mental health indicators as part of the 27th annual observance of National Recovery Month.

"Huge Numbers"

According to the report, in 2015, an estimated 21.7 million people aged 12 years or older, or about 1 in 12 people (8.1%), needed treatment for problems related to the use of alcohol or illicit drugs. However, only 10.8% of these people (2.3 million) received treatment at a specialty facility in the past year.

An estimated 43.4 million adults aged 18 years or older (17.9%) had any mental illness in the past year, with an estimated 9.8 million adults having a serious mental illness, representing 4.0% of all US adults in 2015. Among the 43.4 million adults with any mental illness, 18.6 million (43.1%) received mental health services.

An estimated 8.1 million adults had both an SUD and a mental illness in the past year, with fewer than half (48.0%) receiving either SUD treatment at a specialty facility or mental health care.

"These are huge numbers," Enomoto said. "And because behavioral health is a public health issue, with impact across the lifespan in almost every aspect of human endeavor, these conditions have a major ripple effect in the lives of individuals, families, and communities."

Overall, the report finds that levels of mental illness among adults aged 26 years and older generally remained steady, but there has been a slight rise in the levels of major depressive disorder (MDD) among adolescents and young adults.

In 2015, 3.0 million adolescents aged 12 to 17 had an MDE in the past year, yet only 1.2 million received treatment for depression. An estimated 350,000 adolescents in 2015 had an SUD and an MDE in the past year. Among adolescents who had co-occurring MDD and SUD in the past year, only about two thirds (63.1%) received either substance use treatment at a specialty facility or mental health services in the past year.

Over the past few years, some forms of substance use, such as adolescent underage drinking and alcohol use among young adults aged 18 to 25, continued to drop, while levels of the use of other substances among youth and young adults, including marijuana, remained relatively stable, the report notes.

Bright Spots

In terms of heroin use, the new report hints at a trend "in the right direction," Enomoto said, with a slight reduction in heroin users, from 914,000 users in 2014 to 828,000 in 2015. Rates of death from heroin, fentanyl, and prescription pain medication remain "alarmingly high," she noted.

"These findings offer hope that marijuana and heroin use may be slowing down," Enomoto said in a news release. "And more American youth are rejecting alcohol and tobacco. This is great progress. But our nation still faces a public health crisis of untreated mental and substance use disorders."

A separate NSDUH report released September 8 includes comprehensive information on the use and misuse of prescription psychotherapeutic medications, including tranquilizers, stimulants, sedatives, and pain relievers (including those containing opioids).

The report estimates that 119 million Americans aged 12 years or older used prescription psychotherapeutic drugs in the past year, representing 44.5% of the population. About 97.5 million people used pain relievers (36.4%), 39.3 million used tranquilizers (14.7%), 17.2 million used stimulants (6.4%), and 18.6 million used sedatives (6.9%).

In 2015, 18.9 million people aged 12 years or older (7.1%) misused prescription psychotherapeutic drugs in the past year, including 12.5 million who misused pain relievers (4.7%), 6.1 million who misused tranquilizers (2.3%), 5.3 million who misused stimulants (2.0%), and 1.5 million who misused sedatives (0.6%). However, most people (84.1%) who used prescription drugs in the past year did not misuse them, the report notes.

NSDUH Report: Key Substance Use and Mental Health Indicators in the United States. Published September 8, 2016. Full text

NSDUH Report: Prescription Drug Use and Misuse in the United States. Published September 8, 2016. Full text

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