May is Mental Health Month again, so it’s also a good time to review the mental health statistics behind mental illness. Some of the statistics going around aren’t entirely accurate, because they’re based upon outdated web pages on the National Institute of Mental Health (NIMH) website. This misinformation is then propagated by well-meaning people and organizations, including NAMI and others. Sadly, the NIMH website is not as accurate or up-to-date as people like to think it is (I think that because it’s a government resource, people just assume it’s accurate and correct).
For instance, the NIMH Statistics page puts data into context of 2004 Census data. Well, it’s 2010, not 2004, and we have more up-to-date Census data. Also according to the more recent NCS-R data, it’s not really 1 in 4 Americans who could be diagnosed with a mental disorder in any given year — it’s 1 in 3!
According to the U.S. Census Bureau, in 2009 we had an estimated 307,006,550 people living in the U.S., approximately 75.5 percent of which are 18 or older. This translates to 231,789,945 adults. If we use the estimate of 26.2 percent of adults 18 or older who suffer from a diagnosable mental disorder in a given year, that translates into 60.7 million Americans. But I think the “26.2 percent of adults” number is also inaccurate and not up-to-date.
According to the most recent prevalence data we have (from the NCS-R, Kessler et al 2005, which is based upon 9,282 subjects), the 12 month prevalence rate for any mental disorder or substance disorder is 32.4 percent. Substance disorders — like alcoholism — are recognized in the rest of the world as a mental disorder, and indeed are included in the DSM-IV as such. So why the NIMH would leave those out of the estimate is beyond me.
So looking at these numbers with the latest data, we have nearly 1 in 3 Americans who are suffering from a mental disorder in any given year, or over 75 million people.
Behind the Numbers
Let’s break down the rates by category, as the NCS-R does:
| Women | Men | Both | |
| Any Anxiety Disorder | 23.4% | 14.3% | 19.1% |
| Any Mood Disorder | 11.6% | 7.7% | 9.7% |
| Any Impulse-Control Disorder | 9.3% | 11.7% | 10.5% |
| Any Substance Disorder | 11.6% | 15.4% | 13.4% |
| Any Disorder | 34.7% | 29.9% | 32.4% |
As we can see, women are at a significantly greater risk for any anxiety disorder (more than double the risk for a specific phobia, like a fear of spiders, for panic disorder, and for post-traumatic stress disorder). They are also at slightly more risk for a mood disorder — especially for depression, where their rate is nearly double that of men’s risk for depression.
Men are at greater risk for impulse-control disorders, but no disorder significantly stands out except conduct disorder (more than 4 times the risk). Men are at more risk for substance disorders across the board as well, with more than twice the risk for alcoholism and three times the risk for drug abuse.
Looking at lifetime prevalence rates is also interesting and quite eye-opening. For any mental disorder (including substance disorders), the lifetime prevalence rate is an astonishing 57.4 percent. That’s more than every 1 in 2 Americans. If you don’t think mental illness will impact your life, you’re sadly mistaken. If it doesn’t hit you, it’s going to hit someone you love or are close to.
References
Kessler, R.C., Chiu, W.T., Demler, O., Merikangas, K. R., Walters, E.E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 617-627.
Kessler, R.C., Berglund, P.A., Demler, O., Jin, R., Merikangas, K.R., Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 593-602.
34 comments
How about Mental Health Treatment Outcomes Awareness Month?
Question – does this number include the homeless, those who have never seen a doctor or been diagnosed or treated, prisoners who are not in mental health based facilities stuck in an ever lasting revolving door of arrests and release to the streets, younger people dumped in nursing homes instead of hospitals not receiving care, those living and working in the US illegally, those uninsured, without social aid?
Sadly the numbers are dated and accuracy cannot be assured. I would definitely agree the numbers are higher than estimated, just how much higher is the question. In 2008 New York & New Jersey were rated the most stressed cities in the nation (duh?). I’m sure with the collapse of banks and investment firms on Wall Street this has insured their standing.
Although once again dated this report from 2007 states, “First of all consider this: “About 30 to 50% of adults will experience a mental illness at some point in their lives. More than 50% of them experience moderate to severe symptomsâ€, yet “only about 20% of those with mental illness receive professional help.†(Caroline Carney Doebbeling, MD, MSc – May 2007 Merck Manual)
On a lighter note, as Rita Brown (comedian) said, “One in four (let’s make that three)Americans are mentally ill. So look at two of your best friends. If they are normal, then it’s you!”
With 1 in 3 having such issues and almost 60% of the population likely to face mental health issues in their lifetimes, it seems quite obvious that the funding for mental health is woefully inadequate. Both in the US and in other countries, access to mental health services is expensive and this cost creates a barrier to adequate access by those who require it. This means that individuals may struggle their whole lives without any assistance.
I don’t think men are significantly less likely to have an anxiety or mood disorder, I think that they are more likely to cover up their symptoms with alcohol or drugs and thus develop a substance use disorder. Also, in reporting, women are probably more likely to report feeling depressed or anxious, I think. And they are certainly more willing to seek help for these problems.
Does this take into account the substantial overlap that exists among and between th anxiety, mood, impulse/control and substance disorders?? Those conditions are highly correlated, that is to say, many who have one condition suffer from one or more of the others. You’d be counting the same individuals two, three or four times.
This critical “detail” should be clarified. If those categories count unique individuals, how were the overlapping people separated into distinct categories? Surely there were individuals with two or more of the aforementioned conditions.
If they don’t count unique individuals, then the same people are being counted in two or more categories and someone has committed an egregious error in experimental design (or in the reporting of the results). Back to Statistics 101 for you.
Also, “any anxiety disorder” is inexcusably broad, and is the largest category.
Yes Mark’s comment is the same thing I was thinking about. The chart makes me worry that people may be getting counted multiple times. There’s so much co-morbidity.
I don’t know how a person could decide if I were in the anxiety disorder category or the mood disorder category.I have both. Putting me in only one or the other would be a huge over simplification.
Susan asks some really great questions – questions which are important to ask.
Her introductory paragraph covers many of the population which tend to get marginalized not only in society but also in the statistics when it comes to mental health (and even health in general). I wonder why this is….
Concerning the mental health statistics, my guess is the statistics are much higher than we think. Mental health and seeking services for mental health is still seen by many as seeking out “a crutch” – therapy and all things therapeutic continue to be stigmatized and to be avoided at all costs. According to someone I recently had lunch with, as a therapist I see “crazy people” and although this person is depressed and anxious, “therapy is not for me.”
Psychotherapy has be shrouded is negative language – “treatment”, “diagnosis”, “therapy” – implying there is something fundamentally wrong with individuals at the level of character. They are to be “fixed” or “repaired” and labeled in the process as having an illness.
Adoption of the medical model has been helpful in some ways but, not in others.
I don’t believe we will have accurate statistics until we as a professional community can begin to use language that consistently separates a person from the presenting problem without minimizing personal responsibility and agency.
Thank you for leading this article with “mental health” vs. “disorders”.
If these “disorders” are so prevalent, and we want to reduce the associated stigma, articles should avoid using nomenclatures that defines them as “not normal”?
These “challenges” affect our OVERALL health, our relationships, our performance, and need recognition, but less stigma.
Cancer gets more empathy, research and proper diagnosis/treatment than mental health (in my humble opinion), but affects much fewer statistically. It’s time mental health statistics and the realities about patient struggles are recognized by the general public. I hope John M. Grohol expands on his findings (as suggested in previous comments) and keeps publishing!
It is amazing to me that nobody gets this. We’ve known about this at the Citizens Commission on Human Rights since 1969. This is just a big propaganda campaign. Somebody says “we have nearly 1 in 3 Americans who are suffering from a mental disorder in any given year.â€
OK. How do you know you have a mental illness? They use something called “The Diagnosis and Statistical Manual.†In the introduction on page xxi it states, “… although this manual provides a classification of mental disorders, it must be admitted that no definition adequately specifies precise boundaries for the concept of ‘mental disorder’.†In other words they don’t really know exactly what a “mental disorder†is. And there is no physical test that can be done to prove or disprove that anybody has a “mental disorderâ€.
So why do they make such statements? Very simple. Money. They tell the government, “We need money to treat all these people with mental illness.†And they get it. Amazing.
Interesting questions Susan.
In many cases, statistics do not refer to individuals who are homeless or undiagnosed (or “undocumented” as having a mental health issue). Another problem includes individuals from different countries who do not seek mental health treatment in this country but are here suffering.
These things skew the statistical reports because these individuals are not statistically regarded. Therefore, this is something to consider when reading statistical reports about the prevalence of mental health problems.
However, I would like to remind everyone to be critical thinkers and challengers of every statistic they encounter because stats can be skewed, incorrect, inflated, and completely WRONG.
While I believe that 1 in 3 Americans face a mental health problem, I’m sure the picture of mental health problems in this country are way more severe in most cases.
Hello. I am bipolar. I have a problem that I can’t do anything about. It’s causing a very deep depression. I have the best psychiatrist in the world. What I’m experiencing is situational. I’ve had the worst mania episode you could imagine. I understand the depression end of bipolar, however, I’d never experienced mania. I’m concerned that my lack of sleep and crying will bring on a manic episode. Does anyone know how to deal with this?
physiatrist
It does not sound like a regular bipolar disorder to me–perhaps what is called bipolar depression. If you have never experienced a manic episode, but only severe depressive episodes, situational or otherwise, it cannot be general bipolar disorder (formally called manic.depressive disorder) or even Mood Disorder NOS. You say you have the “best” psychiatrist and I am glad you, obviously, like and trust your psychiatrist, however; I would get a second opinion from another psychiatrist and another psych evaluation.
Any idea how this compares to other countries/cultures? Even if it’s less official or clinically diagnosed, I’m curious if some cultures are more likely to lead to emotional problems than others. For instance, it’s been said that in the former Soviet Union, alcoholism was very high.
Your right. People trust the National Institute of Mental Health (NIMH) . According to whois.sc they get around 9,652,604 visits the there website site a month. They have over 500 scientists working for them according to the offices and divisions page of their site. So I would guess that they should have more than 250 data entry people. That is on the low end. 1 for every 2 scientists. This is not counting all other departments. This is just a guess based on work experience in the research field. They may only have 3. Haha. That would explain why they were showing 2004 info in 2010. Just backed up I guess.
I can see why they left alcoholism out of the results as a mental illness. It isn’t one. Not in my opinion anyway, but I i guess DSM-IV is more recognized then me. So lets give them that one. Perhaps in the statistics they where doing they wanted to leave out alcohol substance abuse and concentrate illegal substances. Alcohol is legal after all as are cigarettes, coffee, and food. I’m sure they had their reasons.
Thanks for this article John. Its important for people to be aware of misdated information online. Even from such trusted government resource sites like the NIMH.
I noticed that illnesses that involve psychosis, hallucinations, of an auditory or visual type, are not included. I am surprised to see that, since schizophrenia (as well as schizo-affective disorder)is prevalent in some social strata, that this illness was tallied. I suffer from schizo-affective disorder and, even though the lifetime prevalence is thought to be less than 1%, it is definitely mentioned in the DSM-IV, as well as DSM-V.
Mental health is not how you feel; it is according to your religion if you are labeled mentally ill.
Any takers? For example, a ”________” in DSM IV is conditional if they are ”__________” in DSM IV paired with a religion, or not.
For example: A set of identical twins- one is a Jehovahs Witness and does not play cards, bingo or et cetera activities that show or indicate ”mental illness” however the other identical twin does play cards, bingo, and so forth he/she has ”mental illness” from engaging in such activities. But, if they switch religions they, vice-versa, the other has mental illness and the other one does not. Even though they are identical twins, what?
Another demonmocker: one does not have ”bipolar disorder” in that sense but if it was to be an disorder it would be known as a disordered lifestyle, ”bipolar lifestyle”, and a change in lifestyle might alleviate the cycle of repetitions in such a described person.
”Bi-polar” refers to be under the influence of more that one magnetic field on one planet and subject to cosmic influences but since that cannot be proven it is conjecture up to a point or from a point onward. However, it can be shown a lifestyle is disordered if some standard is used to base a opinion on.
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