News coverage of the school shooting that occurred at Marjory Stoneman Douglas High School in Parkland, FL, one week ago on Wednesday, February 14, 2018 has been steady. Since the shootings, one 19-year-old male, Nikolas Cruz, has been charged with 17 counts of premeditated murder, and accused of injuring more than a dozen others at the high school that he formerly attended. Cruz was defined by his classmates as a loner with a temper. He also has a history of behavioral problems and some speculated that he was suffering from a mental illness.
The debate regarding gun control or restrictions has revved up over the past week, and the question of mental illness and its role in the shooting incident continue to be discussed. Student survivors in Parkland, FL and students across America are demanding that law makers in their states, Congressional representatives in Washington, DC and the president do more. While some would like to make you think otherwise, guns are not responsible for every act of violence in this country, and neither is mental illness. However, they both fit under an umbrella called “Violence in America”.
This most recent mass shooting poked me to ask two questions: Who are the mentally ill in American? and How many Americans are characterized as mentally ill? These two questions are the focus of this blog post.
Before I attempt to answer these two questions, here are some mental health stats for the United States [Source, USA Today] (Ref 1):
- 1 in 5 adults experience mental illness in the United States.
- Nearly 1 in 25 adults live with a serious mental illness.
- 8 million adults 18 or older thought about trying to kill themselves in 2015, according the Centers for Disease Control and Prevention (CDC) Data & Statistics Fatal Injury Report for 2015. Of those, 2.7 million made suicide plans and 1.4 million made a nonfatal suicide attempt.
- 1% of U.S. adults have experienced an anxiety disorder in the past year, according to the National Institute of Mental Health.
- Suicide is the 10th leading cause of death in the U.S., according to CDC.
- 4% of adults experienced serious psychological distress during the past 30 days, according to CDC’s National Health Interview Survey for January–March 2016.
- Mental illness affects people of all races.
According to the National Institute of Mental Health (Ref 2), mental illnesses are common in the United States. One in [five] U.S. adults lives with a mental illness (44.7 million in 2016). Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe. Two broad categories can be used to describe these conditions: any mental illness and serious mental illness.
- Any mental illness (AMI) is defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment (e.g., see serious mental illness as defined below).
- Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.
Data presented in this post are provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). Before moving further into this discussion, I should caution my readers that the above definitions include mental illnesses that have been diagnosed in Calendar Year 2016. The definition and data exclude developmental and substance use disorders.
Any Mental Illness (AMI)
Figure 1 shows the prevalence of AMI among U.S. adults for Calendar Year 2016:
- There were an estimated 44.7 million adults aged 18 or older in the United States with AMI. This number represented 18.3% of all U.S. adults.
- The prevalence of AMI was higher among women (21.7%) than men (14.5%).
- Young adults aged 18-25 years had the highest prevalence of AMI (22.1%) compared to adults aged 26-49 years (21.1%) and aged 50 and older (14.5%).
- The prevalence of AMI was highest among the adults reporting two or more races (26.5%), followed by the American Indian/Alaska Native group (22.8%). The prevalence of AMI was lowest among the Asian group (12.1%).
The prevalence of AMI would be incomplete without discussing mental health treatment. National Survey on Drug Use and Health (NSDUH) defines mental health treatment as having received inpatient treatment/counseling or outpatient treatment/counseling, or having used prescription medication for problems with emotions, nerves, or mental health.
NSDUH data on mental health treatment received in Calendar Year 2016 by U.S. adults aged 18 or older with any mental illness (AMI) show:
- Among the 44.7 million adults with AMI, 19.2 million (43.1%) received mental health treatment in the past year.
- More women with AMI (48.8%) received mental health treatment than men with AMI (33.9%).
- The percentage of young adults aged 18-25 years with AMI who received mental health treatment (35.1%) was lower than adults with AMI aged 26-49 years (43.1%) and aged 50 and older (46.8%).
Serious Mental Illness (SMI)
Figure 2 shows the past year prevalence of SMI among U.S. adults for Calendar Year 2016:
- There were an estimated 10.4 million adults aged 18 or older in the United States with SMI. This number represented 4.2% of all U.S. adults.
- The prevalence of SMI was higher among women (5.3%) than men (3.0%).
- Young adults aged 18-25 years had the highest prevalence of SMI (5.9%) compared to adults aged 26-49 years (5.3%) and aged 50 and older (2.7%).
- The prevalence of SMI was highest among the adults reporting two or more races (7.5%), followed by the American Indian/Alaska Native group (4.9%). The prevalence of SMI was lowest among the Asian group (1.6%).
Similarly for AMI, data on mental health treatment received within Calendar 2016 by U.S. adults 18 or older with serious mental illness (SMI) show:
- In 2016, among the 10.4 million adults with SMI, 6.7 million (64.8%) received mental health treatment in the past year.
- More women with SMI (68.8%) received mental health treatment than men with AMI (57.4%).
- The percentage of young adults aged 18-25 years with AMI who received mental health treatment (51.5%) was lower than adults with AMI aged 26-49 years (66.1%) and aged 50 and older (71.5%).
Once again, I am thankful to SAMHSA for the above data that sheds light on those suffering from mental illness, and the challenges that they and those who may be tasked to care or assist them face. One of my biggest take-aways from the above information is recognizing that only those diagnosed with a mental illness or disorder are counted in this data set.
Some critics of the SAMHSA study argue that the above numbers for the total numbers of mentally ill in the U.S. is higher and is limited by those illnesses that were studies. A 2011 report published by CDC considers the mental illness issue to be as high as 25 % for adults. Some estimate that up to 30 percent of adults in the U.S. suffer from some form of mental illness.
Either way, there is significant disparity between those who have a mental illness and those who are being treated for the illness. Roughly half of adults diagnosed with mental illness are receiving some form of treatment. Those numbers should sound an alarm to everyone in these United States.
- #MentalHealthMonth: Mental health in America, by the numbers, by Mary Bowerman for USA Today Network, May 3, 2017, https://www.usatoday.com/story/news/nation-now/2017/05/03/mental-health-month-united-states-stats-on-mental-illness/101238906/
- Health and Education: Mental Illness, National Institute of Mental Health, https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#part_154910