Background: People across the United States experience mental disorders and substance use disorders (SUDs), but only a subset of these individuals actually receive services. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports information from the National Survey on Drug Use and Health (NSDUH) on substance use treatment (i.e., treatment for problems related to the use of alcohol or illicit drugs) and mental health service use in the United States to help evaluate access to and use of substance use treatment and mental health services.
Methods: This report presents data from the 2016 NSDUH for substance use treatment and data from the 2002 through 2016 NSDUHs for mental health service use among adults aged 18 years old or older. Estimates for the receipt of substance use treatment are presented for young adults aged 18 to 25 and for adults aged 26 or older. The substance use treatment estimates are presented only for 2016 because the substance use questions were changed as part of the partial redesign of the 2015 NSDUH. Estimates for mental health service use are presented for young adults aged 18 to 25, adults aged 26 to 49, and those aged 50 or older. Where trends for mental health service use are presented, the report focuses on long-term trends by comparing estimates from the 2016 NSDUH with comparable estimates from 2002 to 2015 (or from 2008 to 2015 for selected estimates). Statistically significant differences are noted between estimates in 2016 and those in prior years.
Results: An estimated 1.5 percent of adults aged 18 or older in 2016 (3.6 million adults) received any substance use treatment in the past year, and 0.9 percent (2.1 million adults) received treatment at a specialty facility. In 2016, about 19.9 million adults needed substance use treatment in the past year, representing 8.1 percent of adults. Of the 19.9 million adults needing substance use treatment, 10.8 percent received specialty treatment (2.1 million). An estimated 17.7 million adults needed substance use treatment but did not receive specialty treatment, of whom only 4.5 percent (806,000) felt that they needed substance use treatment. Included in the 806,000 adults who needed substance use treatment and had a perceived need for substance use treatment but did not receive treatment were 351,000 adults who made an effort to get treatment and 455,000 adults who did not report making an effort to get treatment. Common reasons for not receiving substance use treatment among adults who needed but did not receive treatment at a specialty facility despite perceiving a need for treatment included not being ready to stop using alcohol or illicit drugs (38.1 percent) or having no health care coverage and not being able to afford the cost of treatment (26.9 percent).
In 2016, about 35.0 million adults aged 18 or older (14.4 percent) received mental health services in the past year. The estimate of 14.4 percent of adults in 2016 who received mental health services in the past year was similar to the estimates in years from 2012 to 2015, but it was higher than the estimates in most years between 2002 and 2011. Among the 44.7 million adults with any mental illness (AMI) in the past year, about 19.2 million (43.1 percent) received mental health services in the past year. The percentage of adults with AMI who received mental health care in 2016 was similar to the percentages in most years from 2008 to 2015. Included in the 44.7 million adults with past year AMI were 10.4 million adults with serious mental illness (SMI). Of the 10.4 million adults in 2016 with past year SMI, 64.8 percent received mental health services in the past year. The 2016 estimate of adults with past year SMI who received mental health services in the past year was similar to the estimates in all years between 2008 and 2015. Among the 8.2 million adults in 2016 with both AMI and an SUD in the past year, less than half (48.1 percent) received either mental health services or substance use treatment at a specialty facility in the past year. About two thirds (65.6 percent) of the 2.6 million adults in 2016 with co-occurring SMI and an SUD received either mental health services or specialty substance use treatment in the past year. Among adults with AMI or SMI who perceived a need for mental health services but did not receive services in the past year, inability to afford the cost of care was the most commonly reported reason for not receiving services.
Conclusions: This report provides the most current findings from NSDUH on the receipt of substance use treatment and trends in mental health service use among adults aged 18 or older in the United States. Findings presented in the report can be useful for monitoring the use of substance use treatment and mental health services and assessing whether adults are receiving the services they need.