October 18, 2002

Serious Mental Illness

among Adults
M
ental disorders account for 4 of the
In Brief 10 leading causes of disability in the
United States.1 The 2001 National
● In 2001, approximately 15 Household Survey on Drug Abuse (NHSDA)
included questions for adults aged 18 or older to
million adults aged 18 or assess serious mental illness (SMI) during the
older were estimated to have year prior to the survey interview. For these
an SMI during the past year estimates, SMI is defined as having a
diagnosable mental, behavioral, or emotional
● Less than one half of adults disorder that met criteria in the 4th edition of the
with an SMI received Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV)2 and that resulted in
treatment or counseling functional impairment that substantially
during the past year interfered with or limited one or more major life
activities.3,4 Adults also were asked about their
● Adults with an SMI were experiences with mental health treatment.
more likely to smoke Treatment is defined as the receipt of treatment
cigarettes or use an illicit or counseling for any problem with emotions,
“nerves,” or mental health in the past year in
drug during the past year any inpatient or outpatient setting, or use of
compared with those without prescription medication for treatment of a
an SMI; however, there were mental or emotional condition. Respondents
aged 12 or older also were queried about their
no differences in past year
use of cigarettes, alcohol, and illicit drugs during
alcohol use by SMI status the past year. “Any illicit drug” refers to
marijuana/hashish, cocaine (including crack),
inhalants, hallucinogens, heroin, or prescription-
type drugs used nonmedically.

The NHSDA Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration
(SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA.
Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.DrugAbuseStatistics.samhsa.gov.
Citation of the source is appreciated.
NHSDA REPORT: SERIOUS MENTAL ILLNESS AMONG ADULTS
Figure 1. Percentages of Adults Aged 18 or Older
with Past Year Serious Mental Illness,** by Age
Group: 2001
15%
11.7
12%
9%
7.9
6%
3%
0%
18 to 25 26 to 49
Age Group
Prevalence of Serious
Mental Illness
In 2001, approximately 15 million
adults aged 18 or older (7 percent of
the U.S. population) were estimated
to have an SMI during the past
year. The rate of past year SMI was
higher among young adults aged 18
to 25 (12 percent) than among adults
aged 26 to 49 (8 percent) or 50 or
older (5 percent) (Figure 1). Females
(9 percent) were more likely than
males (6 percent) to have a past year
SMI. Rates of past year SMI were
higher among American Indians/
Alaska Natives (14 percent), and
lower among Asians (4 percent),
compared with other racial/ethnic
groups (Figure 2).
Treatment for Serious
Mental Illness
Past research has shown that in
many cases, SMI symptoms can be
ameliorated by mental health
treatment or counseling.5 However,
Figure 2. Percentages of Adults Aged 18 or Older
with Past Year Serious Mental Illness,** by Race/
Ethnicity: 2001
15% 14.4
12%
9%
6%
4.9
3%
0%
American
50 or Older
Indian/Alaska
Native
the 2001 NHSDA revealed that less
than one half (47 percent) of persons
with an SMI received treatment or
counseling during the past year.
Among those with an SMI, adults
aged 26 or older were more likely to
receive treatment or counseling in
the past year than those aged 18 to
25 (Figure 3). Females with an SMI
were more likely to receive past year
treatment or counseling (52 percent)
than males with an SMI (38 percent)
and whites with an SMI were more
likely to receive past year treatment
or counseling than blacks or
Hispanics with an SMI (Figure 4).
Serious Mental Illness and
Substance Use
Results from the NHSDA indicated
that adults with an SMI were more
likely to smoke cigarettes or use an
illicit drug during the past year
compared with those without an
SMI (Figure 5). The rate of
cigarette use during the past year
was 50 percent among adults with
an SMI and 29 percent among those
October 18, 2002
7.5 7.5
6.4
4.4
White Black Hispanic Asian
without an SMI. The rate of past
year illicit drug use was more than
twice as high among adults with an
SMI (27 percent) than it was among
adults without an SMI (11 percent).
Rates of past year alcohol use were
similar among adults with or
without an SMI.
End Notes
1. National Institute of Mental Health. (2001
January). The numbers count: Mental
disorders in America (NIMH Publication No. 01-
4584). Retrieved September 25, 2002, from
http://www.nimh.nih.gov/publicat/numbers.cfm.
2. American Psychiatric Association. (1994).
Diagnostic and statistical manual of mental
disorders (4th ed.). Washington, DC: Author.
3. Kessler, R.C., Barker, P.R., Colpe, L.J., Epstein,
J.F., Gfroerer, J.C., Hiripi, E., Howes, M.J.,
Normand, S.-L. T., Manderscheid, R.W., Walters,
E.E., & Zaslavsky, A.M. (in press). New scales to
screen for serious mental illness in the general
population. Archives of General Psychiatry.
4. A discussion of the methodology used to
generate SMI estimates can be found in
Appendix B of the following document:
Substance Abuse and Mental Health Services
Administration. (2002). Results from the 2001
National Household Survey on Drug Abuse:
Volume II. Technical appendices and selected
data tables (Office of Applied Studies, DHHS
Publication No. SMA 02-3759, NHSDA Series H-
18). Rockville, MD.
October 18, 2002 NHSDA REPORT: SERIOUS MENTAL ILLNESS AMONG ADULTS

Figure 3. Percentages of Adults Aged 18 or Older Figure 4. Percentages of Adults Aged 18 or Older
Reporting Receipt of Past Year Mental Health Reporting Receipt of Past Year Mental Health
Treatment* among Those with Past Year Serious Treatment/Counseling* among Those with Serious
Mental Illness**, by Age Group: 2001 Mental Illness,** by Race/Ethnicity:*** 2001

60%
60%
53.3 51.4
50.0
50% 50%

40% 40% 38.4

32.7
30%
30% 26.6

20%
20%
10%
10%
0%
18 to 25 26 to 49 50 or Older
0%
Age Group White Black Hispanic

The National Household Survey on Drug Abuse (NHSDA) is an annual Figure 5. Percentages of Adults Aged 18 or Older
survey sponsored by the Substance Abuse and Mental Health Services
Administration (SAMHSA). The 2001 data are based on information
Reporting Past Year Substance Use, by Past Year
obtained from 69,000 persons aged 12 or older each year, including adults Serious Mental Illness:** 2001
aged 18 or older who were asked the SMI questions. The survey collects
data by administering questionnaires to a representative sample of the
population through face-to-face interviews at their place of residence. 80% SMI
The NHSDA Report is prepared by the Office of Applied Studies (OAS), 69.3 No SMI
SAMHSA, and by RTI in Research Triangle Park, North Carolina. 67.0
Information and data for this issue are based on the following publication
and statistics: 60%
Office of Applied Studies. (2002). Results from the 2001 National 50.1
Household Survey on Drug Abuse: Volume 1. Summary of national findings
(DHHS Publication No. SMA 02-3758. NHSDA Series H-17). Rockville, MD:
Substance Abuse and Mental Health Services Administration. 40%
Also available on-line: www.DrugAbuseStatistics.samhsa.gov. 28.5 26.5
Additional tables available upon request.
U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES 20%
Substance Abuse & Mental Health Services Administration
Office of Applied Studies 10.5
www.samhsa.gov

0%
Cigarettes Alcohol Any Illicit
Drug****

5. U.S. Department of Health and Human
Services. (1999). Mental health: A report of
the Surgeon General. Retrieved September 25,
2002, from http://www.surgeongeneral.gov/
library/mentalhealth/home.html.
** Serious mental illness (SMI) is defined as
Figure Notes
* Treatment is defined as the receipt of treatment
or counseling for any problem with emotions,
“nerves,” or mental health in the past year in
any inpatient or outpatient setting, or use of
prescription medication for treatment of a
mental or emotional condition.
having a diagnosable mental, behavioral, or
emotional disorder that met criteria in the 4th
edition of the Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV) and that resulted
in functional impairment that substantially
interfered with or limited one or more major life
activities.
*** Small sample sizes prevented analyses of
American Indians/Alaska Natives and Asians.
**** “Any illicit drug” refers to marijuana/hashish,
cocaine (including crack), inhalants,
hallucinogens, heroin, or prescription-type
drugs used nonmedically.
Source (all figures): SAMHSA, 2001 NHSDA.