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Impact of Mental Disorders

Healthy People 2010 Focus Area 18 Mental Health and Mental Disorders Progress Review November 15, 2007. Impact of Mental Disorders. A leading cause of: Disability Absenteeism and lost productivity in the workplace Affects approximately one of every four adults (2002)

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Impact of Mental Disorders

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  1. Healthy People 2010 Focus Area 18Mental Health and Mental Disorders Progress ReviewNovember 15, 2007

  2. Impact of Mental Disorders A leading cause of: • Disability • Absenteeism and lost productivity in the workplace • Affects approximately one of every four adults (2002) • $100 billion spent on treatment in 2003 • Depression is associated with the development of hypertension, heart disease, diabetes, and stroke.

  3. Prevalence of Mental Disorders in Adults, 2002 At least one 1 2 3+ Number of disorders NOTES: = 95% confidence interval. Except where noted, data are for adults aged 18+ years. *Data are for adults 18–44 years. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH. Percent 30 20 10 0 Anxiety disorders Mood disorders *Impulse-Control disorders Substance disorders

  4. Highlighted Objectives Target Met 18–3 PATH clients receiving social services who also receive mental health services 18–6 HRSA funded primary care facilities that provide mental health treatment 18–11 County with jail diversion programs for adults with serious mental illness Little or No Progress* 18–1 Suicide 18–2 Serious suicide attempts among adolescents 18–5 Adolescents engaging in disordered eating 18–7 Use of services by children with serious mental health problems Baseline Only 18–4 Employment of persons with serious mental illness 18–9a Treatment for serious mental illness 18–9b Treatment for major depressive disorder 18–9d Treatment for generalized anxiety disorder * Percent of targeted progress achieved is between -10% and 10%, and/or not statistically significant.

  5. Suicide Decrease desired Age Adjusted Rate per 100,000 Population Total 1999 2004 White American Indian/ Alaskan Native Asian or Pacific Islander Hispanic Black 2010 Target: 4.8 Female Male 0 5 20 15 10 NOTES: = 95% confidence interval.Based on ICD-10 codes U03, X60–X84, Y870. Data are age adjusted to the 2000 standard population. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: National Vital Statistics System - Mortality (NVSS-M), CDC, NCHS. Obj. 18–1

  6. Suicide, 2000–2004 2010 Target: 4.8 Age Adjusted Rate per 100,000 population 15.7–34.5 13.1–15.7 11.5–13.1 9.9–11.5 4–9.9 NOTES: Based on ICD-10 codes U03, X60–X84, Y870. Data are age adjusted to the 2000 standard population. Rates were calculated by health service area. Rates are per 100,000 population. Legend represents quintiles of the rates. SOURCE: National Vital Statistics System—Mortality (NVSS-M), CDC, NCHS. Obj. 18–1

  7. Decrease desired Serious Suicide Attempts Requiring Medical Attention Among Adolescents Percent of Students 1999 2005 5 4 3 2010 Target: 1.0 2 1 0 Total Male Female Gender NOTES: I= 95% confidence interval. Data are for students in grades 9 through 12. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select one or more races. The categories black and white include persons who reported only one racial group. Serious suicide attempts are those requiring medical attention SOURCE: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP. Obj. 18–2

  8. Decrease desired Adolescents Engaging in Disordered Eating Percent of Students 30 2001 2005 25 2010 Target: 16 20 15 10 5 0 Hispanic Black White Male Female Total Race/ethnicity Gender NOTES: I = 95% confidence interval. Data are for students in grades 9 through 12. Disordered eating includes any of the following behaviors to lose weight or to keep from gaining weight: (a) going without eating for 24 hours or more, (b) taking diet medication without a doctor’s advice, (c) or vomiting or taking laxatives. Persons were asked to select one or more races. The categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP. Obj. 18–5

  9. Increase desired Use of Services by Children with Serious Mental Health Problems Percent 80 2001 2006 60 2010 Target: 67 40 20 0 Total Hispanic Black White Male Female Race/ethnicity Gender NOTES: I= 95% confidence interval. The age group is 4-17 years. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Use of services include: seen or talked to a mental health professional, general doctor or receiving special educational or early intervention services. SOURCE: National Health Interview Survey (NHIS), CDC, NCHS. Obj. 18–7

  10. Prevalence of Serious Mental Illness, Major Depressive Disorder, and Generalized Anxiety Disorder in Adults, 2002 NOTES: = 95% confidence interval. Data are for adults aged 18+ years. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH. Percent 30 20 10 0 Serious Mental Illness (Role Impairment) Major Depressive Disorder Generalized Anxiety Disorder

  11. Employment of Persons with Serious Mental Illness, 2002 Increase desired NOTES: = 95% confidence interval. Data are for adults 18+ years. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH. 52% Total Hispanic Black White Male Female 2010 Target: 54 Less than high school High school At least some college 0 10 20 30 40 50 60 70 80 90 Percent Employed Obj. 18–4

  12. Treatment for Adults with Serious Mental Illness, 2002 Increase desired NOTES: = 95% confidence interval. Data are for adults 18+ years. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Treatment was based on therapeutic intervention and/or the prescription of psychotropic medications. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH. 62% Total Hispanic Black White Male Female Less than high school High school At least some college 2010 Target: 68 0 10 20 30 40 50 60 70 80 90 Percent Obj. 18–9a

  13. Treatment for Adults with Major Depressive Disorder, 2002 Increase desired NOTES: = 95% confidence interval. Data are for adults 18+ years. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Treatment was based on therapeutic intervention and/or the prescription of psychotropic medications. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH. 58% Total Hispanic Black White Male Female Less than high school High school 2010 Target: 64 At least some college 0 10 20 30 40 50 60 70 80 90 Percent Obj. 18–9b

  14. Treatment for Adults with Generalized Anxiety Disorder, 2002 NOTES: = 95% confidence interval. Data are for adults 18+ years. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. *Data are statistically unreliable. Treatment was based on therapeutic intervention and/or the prescription of psychotropic medications. SOURCE: National Comorbidity Survey - Replication (NCS-R), NIH, NIMH. 60% Increase desired Total Hispanic * Black White Male Female Less than high school 2010 Target: 79 High school At least some college 0 10 20 30 40 50 60 70 80 90 Percent Obj. 18–9d

  15. PATH Clients Receiving Social Services Who Also Receive Mental Health Services Increase desired Percent 50 40 2010 Target: 30 30 20 10 Projects for Assistance in Transition from Homelessness (PATH) 0 2000 2001 2002 2003 2004 2005 NOTE: Homeless adults 18 years and older in social services who may or may not be diagnosed with mental health problems. SOURCE: Projects for Assistance in Transition from Homelessness (PATH), SAMHSA, CMHS. Obj. 18-3

  16. HRSA-Funded Primary Care Facilities that Provide Mental Health Treatment Increase desired Percent 80 2010 Target: 68 60 40 20 0 2000 2001 2002 2003 2004 2005 2006 NOTE: Includes primary care facilities that provide mental health treatment on site or paid by referral. SOURCE: Uniform Data System (UDS), HRSA. Obj. 18–6

  17. Counties with Jail Diversion Programs for Adults with Serious Mental Illness Increase desired Percent 15 10 2010 Target: 7.6 5 0 2004 2005 2006 NOTE: Includes programs such as specialized police responses to situations involving individuals with mental health problems, pre-booking programs, mental health courts and post-booking programs. SOURCE: Mental Health Courts Survey (MHCS), SAMHSA, CMHS, DSSI. Obj. 18–11

  18. Summary • Little or no progress for: • Suicide • Adolescent suicide attempts • Adolescent disordered eating • Use of services by children • Target met: HRSA, SAMHSA treatment programs • Treatment rates for serious mental illness, major depressive disorder, and generalized anxiety disorder: • Lower for Hispanics and blacks compared to whites • Lower for males compared to females • Adolescents–girls have significantly higher disordered eating compared to boys

  19. Status of Mental Health and Mental Disorders Objectives Target met 18–3 PATH clients receiving social services who also receive mental health services 18–6 HRSA funded primary care facilities that provide mental health treatment 18–11 County with jail diversion programs for adults with serious mental illness Improving 18–8 Juvenile residential facilities that screen admissions for mental health problems 18–12 Consumer satisfaction with mental health services Getting Worse 18–13 State mental health plans addressing cultural competence Little or No Progress* 18–1 Suicide 18–2 Serious suicide attempts among adolescents 18–5 Adolescents engaging in disordered eating 18–7 Use of services by children with serious mental health problems 18–14 State mental health plans addressing care of elderly Baseline Only 18–4 Employment of persons with serious mental illness 18–9a–d Treatment for serious mental illness, major depressive disorder, schizophrenia, generalized anxiety disorder 18–10 Treatment for co-occurring substance abuse and mental disorders * Percent of targeted progress achieved is between -10% and 10%.

  20. Richard J. Klein • Chief - Health Promotion Statistics Branch • CDC/National Center for Health Statistics • rklein@cdc.gov • Bruce S. Jonas • Health Statistician • CDC/National Center for Health Statistics • bjonas@cdc.gov • Acknowledgments: • Nancy Brady Patricia Pastor • Leda Gurley Carter Roeber • Elizabeth Jackson Shelagh Smith • Robert Heinssen

  21. Progress review data and slides are available on the web at: http://www.cdc.gov/nchs/hphome.htm

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