National Mental Health Services Survey (N-MHSS) 2018

National Mental Health Services Survey (N-MHSS): 2018

Data on Mental Health Treatment Facilities

DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration

Acknowledgments

This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). Work was performed under Contract No. HHSS283201600001C. The Contracting Officer's Representative (COR) at SAMHSA/ CBHSQ was Nichele Waller. SAMHSA complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. SAMHSA cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.

Public Domain Notice

All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, U.S. Department of Health and Human Services.

Recommended Citation

Substance Abuse and Mental Health Services Administration, National Mental Health Services Survey (N-MHSS): 2018. Data on Mental Health Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2019.

Electronic Access of the Publication

This publication may be downloaded at .

Originating Office

Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration

5600 Fishers Lane, Room 15SEH03 Rockville, Maryland 20857

October 2019

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Table of Contents

List of Tables....................................................................................................................................v

List of Figures................................................................................................................................ xi

Highlights.........................................................................................................................................1

Chapter 1. Description of the National Mental Health Services Survey (N-MHSS)................3 Data Collection Procedures for the 2018 N-MHSS.....................................................................4 Content........................................................................................................................................6 Facility Reporting and Selection for the 2018 N-MHSS Report.................................................7 Quality Assurance.......................................................................................................................7 Response Rates...........................................................................................................................8 Data Considerations and Limitations..........................................................................................8 Organization of the Report.........................................................................................................8

Chapter 2. Facility Characteristics and Services.......................................................................11 Facility Type and Facility Operation.........................................................................................11 Service Settings Offered...........................................................................................................12 Facility Size...............................................................................................................................14 Facility Capacity and Utilization Rates....................................................................................16 Treatment Approaches..............................................................................................................18 Services and Practices...............................................................................................................19 Age Groups...............................................................................................................................19 Dedicated or Exclusively Designed Treatment Programs or Groups for Specific Client Types..............................................................................................................................20 Treatment Services Provided in Languages Other Than English and for the Deaf and Hard-of-Hearing........................................................................................................21 Crisis Intervention Teams.........................................................................................................22 Computerized Operational Functions.......................................................................................22 Quality Improvement Practices.................................................................................................22 Types of Payment or Insurance Accepted.................................................................................23 Smoking Policy.........................................................................................................................24 Seclusion and Restraint Practices.............................................................................................24 Facility Licensing, Certification, or Accreditation....................................................................25

Chapter 3. Client Characteristics................................................................................................27 Clients Who Received 24-Hour Mental Health Treatment Services in Inpatient Settings......................................................................................................................................27

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Table of Contents (continued)

Clients Who Received 24-Hour Mental Health Treatment Services in Residential Settings...................................................................................................................30 Clients Who Received Less-Than-24-Hour Mental Health Treatment Services in Outpatient Settings....................................................................................................................33 Clients With Co-occurring Mental Health and Substance Use Disorders................................34 Chapter 4. Selected Facility Characteristics at the Regional and State Levels.......................37 Facility Type.............................................................................................................................38 Facility Operation ....................................................................................................................40 Service Settings Offered...........................................................................................................41 Facility Size and Utilization......................................................................................................42 Treatment Approaches..............................................................................................................45 Services and Practices...............................................................................................................46 Age Groups...............................................................................................................................48 Dedicated or Exclusively Designed Treatment Programs or Groups for Specific Client Types..............................................................................................................................50 Treatment Services Provided in Languages Other Than English and for the Deaf and Hard-of-Hearing........................................................................................................50 Crisis Intervention Teams.........................................................................................................51 Quality Improvement Practices.................................................................................................52 Types of Payment or Insurance Accepted.................................................................................52 Facility Licensing, Certification, or Accreditation ...................................................................53 Computerized Operations.........................................................................................................54 Clients With Co-occurring Mental Health and Substance Use Disorders................................54 Military Veterans......................................................................................................................54 Tables..............................................................................................................................................55

Appendix A. 2018 N-MHSS Questionnaire..............................................................................175

Appendix B. Data Collection Procedures.................................................................................193

Appendix C. Methodology for Unrolling Client Counts to `Child' Facilities........................195

Appendix D. Response Rates.....................................................................................................197

Appendix E. List of Contributors..............................................................................................207

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List of Tables

Chapter 1 1.1 N-MHSS facilities, by status and mode of response: 2018..................................................7 Chapter 2 2.1 Mental health treatment facilities, by service setting and facility type:

Number and percent, 2018..................................................................................................56 2.2 Mental health treatment facilities, by facility operation and facility type:

Number and percent, 2018..................................................................................................57 2.3 Number of clients and beds in mental health treatment facilities that

provide 24-hour hospital inpatient care, by facility type: Number and percent, 2018.......................................................................................................................58 2.4 Facility size in terms of number of clients in 24-hour hospital inpatient care, by facility type: Number and percent distribution, April 30, 2018............................59 2.5 Number of clients and beds in mental health treatment facilities that provide 24-hour residential care, by facility type: Number and percent, April 30, 2018.....................................................................................................................60 2.6 Facility size in terms of number of clients in 24-hour residential care, by facility type: Number and percent distribution, April 30, 2018..........................................61 2.7 Number of clients in mental health treatment facilities that provide lessthan-24-hour outpatient or partial hospitalization/day treatment settings, by facility type: Number and percent, April 2018...................................................................62 2.8 Facility size in terms of number of clients in less-than-24-hour outpatient and partial hospitalization/day treatment settings, by facility type: Number and percent distribution, April 2018...................................................................................63 2.9 Median number of clients per facility, by facility type: Number, 2018..............................64 2.10 Number of beds and utilization rate of inpatient and residential care, by facility type: Number, utilization rate, and designated beds per facility, April 30, 2018.....................................................................................................................65 2.11a Mental health treatment facilities that offer various treatment approaches, by facility type: Number, 2018...........................................................................................66 2.11b Mental health treatment facilities that offer various treatment approaches, by facility type: Percent, 2018............................................................................................67

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List of Tables (continued)

2.12a Mental health treatment facilities that offer specific services and practices, by facility type: Number, 2018...........................................................................................68

2.12b Mental health treatment facilities that offer specific services and practices, by facility type: Percent, 2018............................................................................................70

2.13 Mental health treatment facilities that accept specific age groups for treatment, by facility type: Number and percent, 2018......................................................72

2.14a Mental health treatment facilities that offer treatment programs or groups designed exclusively for specific client groups, by facility type: Number, 2018....................................................................................................................................73

2.14b Mental health treatment facilities that offer treatment programs or groups dedicated or exclusively designed for specific client categories, by facility type: Percent, 2018..............................................................................................................75

2.15 Mental health treatment facilities that offer treatment services in a language other than English and in sign language for the deaf and hard-of-hearing, by facility type: Number and percent, 2018........................................................................77

2.16 Mental health treatment facilities that employ a crisis intervention team, by facility type: Number and percent distribution, 2018.........................................................78

2.17a Mental health treatment facilities with specific computerized operational functions, by facility type: Number, 2018..........................................................................79

2.17b Mental health treatment facilities with specific computerized operational functions, by facility type: Percent, 2018...........................................................................80

2.18 Mental health treatment facilities with specific quality improvement practices as part of the standard operating procedures, by facility type: Number and percent, 2018..................................................................................................81

2.19a Mental health treatment facilities that accept a specific type of payment or funding source, by facility type: Number, 2018 ................................................................82

2.19b Mental health treatment facilities that accept a specific type of payment or funding source, by facility type: Percent, 2018..................................................................83

2.20 Mental health treatment facilities, by smoking policy and facility type: Number and percent, 2018..................................................................................................84

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List of Tables (continued)

2.21 Mental health treatment facilities that use seclusion or restraint practices and adoption of initiatives to reduce use, by facility type: Number and percent, 2018.......................................................................................................................85

2.22a Mental health treatment facility licensing, certification, or accreditation, by facility type: Number, 2018................................................................................................86

2.22b Mental health treatment facility licensing, certification, or accreditation, by facility type: Percent, 2018.................................................................................................87

Chapter 3 3.1a Clients in 24-hour hospital inpatient treatment settings, by client

characteristics and facility type: Number, 2018..................................................................88 3.1b Clients in 24-hour hospital inpatient treatment settings, by client

characteristics and facility type: Percent distribution, 2018...............................................90 3.2a Clients in 24-hour residential treatment settings, by client characteristics

and facility type: Number, 2018.........................................................................................92 3.2b Clients in 24-hour residential treatment settings, by client characteristics

and facility type: Percent distribution, 2018.......................................................................94 3.3a Clients in less-than-24-hour outpatient or partial hospitalization/day

treatment settings, by client characteristics and facility type: Number, April 2018...........................................................................................................................96 3.3b Clients in less-than-24-hour outpatient or partial hospitalization/day treatment settings, by client characteristics and facility type: Percent distribution, April 2018.......................................................................................................98 3.4 Clients diagnosed with co-occurring mental health and substance use disorders, by facility type and service setting: Estimated number and percent, April 30, 2018......................................................................................................100 Chapter 4 4.1a Mental health treatment facilities, by facility type, Census region, and state or jurisdiction: Number, 2018...........................................................................................101 4.1b Mental health treatment facilities, by facility type, Census region, and state or jurisdiction: Percent, 2018............................................................................................103 4.2a Mental health treatment facilities, by facility operation, Census region, and state or jurisdiction: Number, 2018...................................................................................105

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List of Tables (continued)

4.2b Mental health treatment facilities, by facility operation, Census region, and state or jurisdiction: Percent, 2018....................................................................................107

4.3a Mental health treatment facilities that provide 24-hour hospital inpatient treatment settings, by facility type, Census region, and state or jurisdiction: Number, 2018....................................................................................................................109

4.3b Mental health treatment facilities that provide 24-hour hospital inpatient treatment settings, by facility type, Census region, and state or jurisdiction: Percent, 2018.....................................................................................................................111

4.4a Mental health treatment facilities that provide 24-hour residential treatment settings, by facility type, Census region, and state or jurisdiction: Number, 2018....................................................................................................................113

4.4b Mental health treatment facilities that provide 24-hour residential treatment settings, by facility type, Census region, and state or jurisdiction: Percent, 2018.....................................................................................................................115

4.5a Mental health treatment facilities that provide less-than-24-hour partial hospitalization/day treatment settings, by facility type, Census region, and state or jurisdiction: Number, 2018...................................................................................117

4.5b Mental health treatment facilities that provide less-than-24-hour partial hospitalization/day treatment settings, by facility type, Census region, and state or jurisdiction: Percent, 2018....................................................................................119

4.6a Mental health treatment facilities that provide less-than-24-hour outpatient treatment settings, by facility type, Census region, and state or jurisdiction: Number, 2018....................................................................................................................121

4.6b Mental health treatment facilities that provide less-than-24-hour outpatient treatment settings, by facility type, Census region, and state or jurisdiction: Percent, 2018.....................................................................................................................123

4.7 Total number of clients and beds in all applicable treatment settings, and number of clients and beds in 24-hour hospital inpatient treatment settings, by Census region and state or jurisdiction: Number and percent, April 30, 2018..................................................................................................................................125

4.8 Total number of clients and beds in all applicable treatment settings, and number of clients and beds in 24-hour residential treatment settings, by Census region and state or jurisdiction: Number and percent, April 30, 2018..................................................................................................................................127

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