Patterns of Mental Health Service Utilization and Substance Use Among Adults, 2000 and 2001

5. Characteristics of Persons Receiving Inpatient Treatment

Although the role of inpatient mental health treatment has changed greatly over recent decades, resulting in a shift from institutionalization to more outpatient community-based approaches, inpatient treatment still plays an important role. These services emphasize safety measures, crisis intervention, acute medication and reevaluation of ongoing medications, and (re)establishing the client's links to other supports and services (Sederer & Dickey, 1995).

Using data from the 2000 and 2001 National Household Survey on Drug Abuse (NHSDA), this chapter presents selected characteristics of inpatient treatment stays for adults. Topics focus on the type of facility that respondents used for inpatient mental health treatment, the number of nights they spent in an inpatient facility, and the primary payer for their inpatient treatment (Table  5.1). Demographic differences by location of treatment and out-of-pocket costs also were analyzed, but due to low precision in the estimated numbers and percentages, these findings are not presented in this report.

5.1 Type of Facility

Among adults who received inpatient mental health treatment in 2000 and 2001, the vast majority (92.2 percent) received treatment in some type of hospital. Among adults who received inpatient treatment, 31.2 percent received inpatient treatment from a private/public psychiatric hospital and 31.5 percent from the psychiatric unit of a general hospital. A slightly smaller proportion of adults received inpatient care in the medical unit of a general hospital (24.8 percent), whereas only 4.7 percent of adults who received inpatient treatment stayed in another type of hospital. Only 6.4 percent of these adults received their inpatient treatment in a residential treatment center, and 7.3 percent specified "other" facility, which included a school/university facility, health clinic or center, crisis center, or another unspecified type of facility (Figure 5.1).

5.2 Number of Nights Spent in Facility

Of those who were hospitalized for mental health treatment, 43.6 percent spent 5 or more nights in such facilities. Almost one quarter of adults (24.8 percent) who received inpatient treatment spent 1 night in a facility, and 31.7 percent were hospitalized for 2 to 4 nights (Figure 5.2).

5.3 Primary Payer

Private health insurance (21.7 percent), self/family (20.9 percent), and Medicare (20.4 percent) were the most commonly reported primary payers for inpatient mental health treatment (Figure 5.3). Medicaid was the primary payer for 16.4 percent of adults, and 15.9 percent of adults who received inpatient treatment reported "some other type" of primary payer, which can include a rehabilitation program, employer, VA or military program, or other private or public sources. Approximately 65,000 adults (4.7 percent) received inpatient treatment for free.

Figure 5.1 Inpatient Treatment in the Past Year, by Type of Facility

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Figure 5.2 Number of Nights Spent in a Facility in the Past Year

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Figure 5.3 Inpatient Treatment in the Past Year, by Primary Payer

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5.4 Summary

Inpatient mental health treatment was most likely to be received in psychiatric and general hospitals, and to a lesser extent in residential treatment centers and other facility types in 2000 and 2001. Just under half (43.6 percent) of adults receiving inpatient mental health treatment spent 5 or more nights in a facility, and almost a quarter of adults (24.8 percent) spent only 1 night in a facility. Private health insurance (21.7 percent), self/family (20.9 percent), and Medicare (20.4 percent) were the most commonly reported primary payers for inpatient mental health treatment.

Table 5.1 Estimated Numbers (in Thousands) (with Standard Errors) and Percentages (with Standard Errors) of Adults Who Received Inpatient Mental Health Treatment in the Past Year, by Selected Characteristics Related to Their Treatment: 2000 and 2001

This page was last updated on June 16, 2008.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.