The National Mental Health Services Survey (N-MHSS), conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), is an annual1 survey of all known public and private mental health treatment facilities in the United States. The survey is the only source of national and state-level data on the mental health services reported by both publicly and privately operated specialty mental health care facilities.
N-MHSS is used to collect basic data on the number, location, and characteristics of specialty mental health treatment facilities and the persons they serve throughout the 50 states, the District of Columbia, and other U.S. jurisdictions.2 This issue of The N-MHSS Report provides an overview of the survey methodology.
The following types of mental health treatment facilities were included in the 2010 N-MHSS: psychiatric hospitals; nonfederal general hospitals with a separate psychiatric unit; Department of Veterans Affairs medical centers; outpatient or day treatment or partial hospitalization mental health facilities; residential treatment centers (RTCs) for children; RTCs for adults; and multisetting (nonhospital) mental health facilities.3 The 2010 N-MHSS universe excluded Department of Defense military treatment facilities; facilities administered by the Indian Health Service; tribally operated facilities; private practitioners and small group practices not licensed as mental health clinics or centers; and jails or prisons.
The 2010 N-MHSS instrument collected information on specific facility characteristics and the number of clients in treatment on the survey reference date. It included questions on topics such as facility type, operation, primary treatment focus, management characteristics, and client demographics. The questionnaire contained 36 numbered questions, which Table 1 summarizes.
Three data collection modes were used during the data collection period: a Web-based questionnaire, a mailed paper questionnaire, and computer-assisted telephone interviewing (CATI). The data collection for the 2010 N-MHSS was conducted from June 2010 through January 2011, with a reference date of April 30, 2010. In June 2010, the data collection packets were mailed to each facility, and the Web-based survey also became available. Each facility had the option of completing the paper questionnaire and returning it by mail or completing the questionnaire via the secure survey Web site. During the data collection phase, contract personnel were available by telephone to answer facilities' questions concerning the survey. Web-based support was available for facilities completing the questionnaire on the Web. CATI was used to follow up with nonrespondents from late September 2010 to late December.
The final N-MHSS 2010 facility universe included 16,197 mental health treatment facilities, of which 12,186 were eligible for the survey.4 Of the 11,118 (91.2 percent) eligible facilities that responded to the 2010 N-MHSS, 10,374 were included in the N-MHSS main findings report and data files.5 The 10,374 facilities comprised 1,235 facilities that completed an abbreviated CATI follow-up questionnaire (basic facility information and client counts) and 9,139 facilities that completed all sections of the questionnaire, including basic facility information, services characteristics, and client counts.
In general, the N-MHSS data can be used to describe the nature and scope of mental health services provided in state-funded, state-operated, and other (e.g., federally funded, private for-profit, and nonprofit) mental health treatment facilities. The N-MHSS data can also be used to conduct comparative analyses and forecast future resource needs.
Additionally, the N-MHSS data are used to update SAMHSA's Inventory of Behavioral Health Services, an inventory of all known mental health and substance abuse treatment facilities in the United States, and to update the information in the mental health component of SAMHSA's online Behavioral Health Treatment Services Locator (http://findtreatment.samhsa.gov/), a searchable database of licensed and accredited public and private mental health treatment facilities.
Certain procedural considerations and data limitations must be taken into account when interpreting data from N-MHSS. In general, N-MHSS is a voluntary survey. Facilities are not required to respond. Although no penalty is associated with nonresponse, facilities that do not respond are not included in the Behavioral Health Treatment Services Locator.
N-MHSS is designed to collect data from each physical location where treatment services are provided. Because state administrative systems differ, there are some variations in how facilities with more than one geographic location report to N-MHSS.
N-MHSS is a point-prevalence survey. It provides a "snapshot" of mental health treatment facilities and clients on a typical day. Thus, the number of clients/patients in treatment reported for a single day does not represent an annual total, nor does it necessarily represent the full capacity of a facility to deliver mental health treatment services. For specific considerations and limitations, please refer to the National Mental Health Services Survey (N-MHSS): 2010. Data on Mental Health Treatment Facilities, which is available at http://www.samhsa.gov/data/DASIS/NMHSS2010_Web.pdf.
The Center for Behavioral Health Statistics and Quality (CBHSQ) has published an overall 2010 N-MHSS report that contains tables, graphs, charts, and a narrative discussing topics of special interest.6
In addition, reports focusing on specific topics using N-MHSS data are published periodically by CBHSQ. Some examples of these reports include
All reports are posted online on the SAMHSA Web site (http://www.samhsa.gov/data). The 2010 N-MHSS public use file is available through the Substance Abuse and Mental Health Data Archive and the archive's online data analysis system (http://www.icpsr.umich.edu/icpsrweb/SAMHDA/).7
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.
The National Mental Health Services Survey (N-MHSS) is an annual1 survey designed to collect information from all facilities in the United States, both public and private, that provide mental health treatment. N-MHSS provides the mechanism for quantifying the dynamic character and composition of the U.S. mental health treatment delivery system. The objectives of N-MHSS are to collect multipurpose data that can be used to assist SAMHSA and state and local governments in assessing the nature and extent of services provided and in forecasting treatment resource requirements, to update SAMHSA's Inventory of Behavioral Health Services (I-BHS), to analyze general treatment services trends, and to generate the Behavioral Health Treatment Services Locator (http://findtreatment.samhsa.gov/).
N-MHSS is one component of the Behavioral Health Services Information System (BHSIS), maintained by the Center for Behavioral Health Statistics and Quality (CBHSQ), SAMHSA. N-MHSS collects three types of information from facilities: (1) characteristics of individual facilities such as services offered and types of treatment provided, primary focus of the facility, and payment options; (2) client count information such as counts of clients served by service type and number of beds designated for treatment; and (3) general information such as licensure, certification, or accreditation and facility Web site availability. In 2010, N-MHSS collected information from 10,374 facilities from all 50 states, the District of Columbia, the territory of Guam, the Federated States of Micronesia, the Republic of Palau, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands. Information and data for this report are based on data reported to N-MHSS for the survey reference date April 30, 2010.
The N-MHSS Report is prepared by the Center for Behavioral Health Statistics and Quality, SAMHSA, and RTI International, Research Triangle Park, NC (RTI International is a trade name of Research Triangle Institute).
Latest N-MHSS public use files and variable definitions:
Other mental health reports: