6. Serious Mental Illness

Serious mental illness (SMI) was first measured by the National Household Survey on Drug Abuse (NHSDA) in 2001 for all persons age 18 or older. SMI was present in 7.3 percent of the population age 18 or older (Office of Applied Studies [OAS], 2002c). At the individual level, SMI has been associated with use of illicit drugs and smoking cigarettes. Rates of SMI also have been associated with other characteristics, such as educational status, unemployment, and urbanicity (OAS, 2002c). Because the State estimates for SMI are only based on a single year of NHSDA data, the national model has a larger impact on State sample-based estimates that are either very high or very low relative to other States, especially for States based on samples of 600 persons or fewer.

Estimates of SMI were compared with estimates of various substance measures to determine the degree of correlation with those measures. Although SMI is somewhat correlated at the individual level with past month use of an illicit drug, the correlation at the State level was fairly small and negative (-0.18). The highest correlation at the State level was between SMI and past month use of cigarettes, 0.31. This finding is consistent with literature that shows a high correlation at the individual level between smoking cigarettes and SMI (Arday et al., 1995; Kessler et al., 2003; Romans, McNoe, Herbison, Walton, & Mullen, 1993; Woolf, Rothemich, Johnson, & Marsland, 1999). The State-level correlations between SMI and dependence on or abuse of drugs or need for treatment were generally quite low. The highest correlation between SMI and demographic information at the State level was with the 1999 per capita income obtained from the Bureau of Health Professions' 2002 Area Resource File, where the correlation was -0.53: the lower the income, the higher the percentage with SMI.

The States with the highest SMI for persons age 18 or older in 2001 were mostly in the South: Oklahoma, Kentucky, Georgia, West Virginia, Arkansas, and Louisiana (Figure 6.1; Table B.20). There also were three Western States (Utah, Washington, and Arizona) and one Midwestern State (Minnesota). States with the lowest SMI percentages included one Western State (Hawaii), three Northeastern States (Connecticut, New Jersey, and New Hampshire), three Southern States (Delaware, Maryland, and Florida), and three Midwestern States (Indiana, Iowa, and Illinois). Oklahoma had the highest rate (10.4 percent), and Hawaii had the lowest rate (5.1 percent).

Figure 6.1 Percentages Reporting Past Year Serious Mental Illness among Persons Aged 18 or Older, by State: 2001

Figure 6.1 D

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2001.

Figure 6.2 Percentages Reporting Past Year Serious Mental Illness among Persons Aged 18 to 25, by State: 2001

Figure 6.2 D

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2001.

Figure 6.3 Percentages Reporting Past Year Serious Mental Illness among Persons Aged 26 or Older, by State: 2001

Figure 6.3 D

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2001.