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National Expenditures for Mental Health Services and Substance Abuse Treatment 1991–2001
An estimated 28 to 30 percent of the adult U.S. population will suffer from a mental or substance use disorder during the course of a year. In any given year, about five to seven percent of adults have a serious mental illness (Kessler et al., 2001). A similar percentage of children—about five to nine percent—has a serious emotional disturbance (Friedman et al., 1996). Of the ten leading causes of disability worldwide in 2000 among individuals age 15 to 44, five were psychiatric disorders including alcohol abuse (WHO, 2004). Given the prevalence of morbidity and mortality related to mental and substance use disorders and their wider societal impacts, it is important to know how much the United States is investing in treatment of mental and substance use disorders. Moreover, because of the rapid changes occurring in treatment technologies, philosophy, organization, and financing, the extent and character of this investment should be tracked over time.
The report addresses the following key questions:
These MHSA spending estimates use data and methods that are used by the Centers for Medicare and Medicaid Services (CMS) to estimate national health expenditures, also called the National Health Accounts (NHA). This work is based primarily on nationally representative databases with multiple years of data, which generally cover the period of 1991 to 2001. The estimates are presented for mental health (MH), substance abuse (SA), and MHSA combined, and are compared with all health care expenditures.
Because the estimates focus on expenditures for treatment and not disease burden, figures include only expenditures for the direct treatment of MHSA disorders. The estimates exclude the other substantial comorbid health costs that can result from MHSA (for example, trauma and cirrhosis of the liver) and other direct costs of caring for these clients (for example, job training and subsidized housing). Other indirect costs, such as lost wages and productivity, also are excluded from these MHSA expenditure estimates.
Total Mental Health Services and Substance Abuse Treatment (MHSA) Spending
Mental Health (MH) Spending
Substance Abuse (SA) Spending
Substance Abuse & Mental Health Services Administration • 1 Choke Cherry Road • Rockville, MD 20857