2002 State Estimates of Substance Use

6. Serious Mental Illness among Adults

Serious mental illness (SMI) was first measured by the National Household Survey on Drug Abuse (NHSDA) in 2001 for all persons aged 18 or older. For this 2002 National Survey on Drug Use and Health (NSDUH) report, SMI is defined as having at some time during the past year a diagnosable mental, behavioral, or emotional disorder that met the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4^th edition (DSM-IV) (American Psychiatric Association [APA], 1994) and resulted in functional impairment that substantially interfered with or limited one of more major life activities.

In 2002, SMI was present in 8.3 percent of the population aged 18 or older (Table A.20). The States with the highest rates of SMI in 2002 were mostly in the South (Alabama, Arkansas, Kentucky, Oklahoma, and West Virginia) or in the West (Idaho, Montana, Utah, and Washington). Oklahoma reported the highest rate in the Nation for SMI in 2002 (11.4 percent), and New Jersey had the lowest rate in the Nation in 2002 (6.5 percent) (Table A.20, Figure 6.1).

At the individual level, SMI has been associated with the use of illicit drugs and smoking cigarettes, as well as with other characteristics, such as educational status, unemployment, and urbanicity (Office of Applied Studies [OAS], 2003b). At the State level, estimates of SMI were compared with estimates of various substance use 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 among persons aged 18 or older was fairly low (0.08). The correlation at the State level between SMI and past month use of cigarettes was slightly higher (0.36). 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 correlation at the State level between SMI and the 2000 per capita income was negative and quite high (-0.51); the lower the income, the higher the percentage with SMI.

Figure 6.1 Percentages Reporting Past Year Serious Mental Illness among Persons Aged 18 or Older, by State: 2002

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Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002.

Figure 6.2 Percentages Reporting Past Year Serious Mental Illness among Persons Aged 18 to 25, by State: 2002

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Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002.

Figure 6.3 Percentages Reporting Past Year Serious Mental Illness among Persons Aged 26 or Older, by State: 2002

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Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002.

This page was last updated on June 03, 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.