Erin Bagalman, Angela Napili; (2015)
Summary
Determining how many people have a mental illness can be difficult, and prevalence estimates
vary. While numerous surveys include questions related to mental illness, few provide prevalence
estimates of diagnosable mental illness (e.g., major depressive disorder as opposed to feeling
depressed, or generalized anxiety disorder as opposed to feeling anxious), and fewer still provide
national prevalence estimates of diagnosable mental illness. This report briefly describes the
methodology and results of three large surveys (funded in whole or in part by the U.S.
Department of Health and Human Services) that provide national prevalence estimates of
diagnosable mental illness: the National Comorbidity Survey Replication (NCS-R), the National
Comorbidity Survey Replication Adolescent Supplement (NCS-A), and the National Survey on
Drug Use and Health (NSDUH). The NCS-R and the NCS-A have the advantage of identifying
specific mental illnesses, but they are more than a decade old. The NSDUH does not identify
specific mental illnesses, but it has the advantage of being conducted annually.
Between February 2001 and April 2003, NCS-R staff interviewed more than 9,000 adults aged 18
or older. Analyses of NCS-R data have yielded different prevalence estimates. One analysis of
NCS-R data estimated that 26.2% of adults had a mental illness within a 12-month period
(hereinafter called 12-month prevalence). Another analysis of NCS-R data estimated the 12-
month prevalence of mental illness to be 32.4% among adults. A third analysis of NCS-R data
estimated the 12-month prevalence of mental illness excluding substance use disorders to be
24.8% among adults. The 12-month prevalence of serious mental illness was estimated to be
5.8% among adults, based on NCS-R data.
Between February 2001 and January 2004, NCS-A staff interviewed more than 10,000
adolescents aged 13 to 17. Using NCS-A data, researchers estimated the 12-month prevalence of
mental illness to be 40.3% among adolescents. Some have suggested that the current approach to
diagnosing mental illness identifies people who should not be considered mentally ill. The 12-
month prevalence of serious mental illness was estimated to be 8.0% among adolescents, based
on NCS-A data.
The NSDUH is an annual survey of approximately 70,000 adults and adolescents aged 12 years
or older in the United States. According to the 2013 NSDUH, the estimated 12-month prevalence
of mental illness excluding substance use disorders was 18.5% among adults aged 18 or older.
The estimated 12-month prevalence of serious mental illness (excluding substance use disorders)
was 4.2% among adults. Although the NSDUH collects information related to mental illness (e.g.,
symptoms of depression) from adolescents aged 12 to 17, it does not produce estimates of mental
illness for that population.
The prevalence estimates discussed in this report may raise questions for Congress. Should
federal mental health policy focus on adults or adolescents with any mental illness (including
some whose mental illnesses may be mild and even transient) or on those with serious mental
illness? Should substance use disorders be addressed through the same policies as other mental
illnesses? Members of Congress may approach mental health policy differently depending in part
on how they answer such questions.
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