Annual SAMHSA Survey Highlights Pandemic’s Toll on Nation’s Mental Health

The Substance Abuse and Mental Health Services Administration this week released its annual National Survey on Drug Use and Health, and while changes were made to certain questions and the ways in which responses were collected for much of 2020 because of COVID-19, the survey’s results paint a vivid picture of how the pandemic has impacted the nation’s mental health and substance use patterns.

Traditionally conducted in person, data collection for the NSDUH was halted by COVID-19 from mid-March 2020 through September 2020. The following month, data collection resumed mostly online with limited in-person surveying. Questionnaire changes were made starting in October 2020, with questions about the use of telehealth-based services and substance cravings among the new queries, and criteria used to categorize substance use disorders was revised in accordance with the publishing of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

>> READ the full 2020 National Survey on Drug Use and Health Report

Among the report’s major findings:

• About 25.9 million past-year alcohol users and 10.9 million past-year users of drugs surveyed between October and December 2020 said they were using these substances “a little more to much more” compared to before the onset of the pandemic.
• The pandemic has taken a particular toll on adults 18 and over who had any mental illness or serious mental illness, with both groups more likely to report that their mental health was negatively impacted by the pandemic “quite a bit or a lot.”
• Similarly, adolescents between the ages of 12 and 17 who had a past-year major depressive episode (MDE) were more likely to say the pandemic affected their mental health “quite a bit or a lot” than those who had not had a past-year MDE.
• The percentage of adults with a past-year MDE or past-year MDE with severe impairment who received treatment for depression increased with age; adults over the age of 50 reported the highest such rates, followed by those 26 to 49, and then adults 18 to 25. However, adults over the age of 50 were less likely than young adults to have received inpatient or outpatient mental health treatment or counseling or taken a prescription medication "for any problem with emotions, 'nerves,' or mental health."
• About 4.9% of adults ages 18 and over had serious thoughts of suicide, 1.3% made a suicide plan, and 0.5% attempted suicide within the past year. Rates were significantly higher for individuals of mixed ethnicity, with 11% reporting thoughts of suicide, as well as youths between the ages of 12 and 17 (12% reporting serious thoughts of suicide).
• Among 138.5 million current alcohol users, 61.6 million were classified as binge drinkers and 17.7 million were classified as heavy drinkers. Meanwhile, more than 59.3 million over the age of 12 reported past-year illicit drug use—a figure that includes 49.6 million who used marijuana.

Cost of care was the most commonly cited reason by adults ages 18 and over who had mental illness within the past year and a perceived unmet need for mental health services but did not receive any form of care. Not knowing where to go for treatment, belief that they could handle their illness without treatment, and concerns over the potential of being committed to a psychiatric hospital or having to take medication were other reasons individuals with mental illness did not receive care.

“These data show the urgent need to intervene at every opportunity to reduce substance use disorder and meet people where they are,” Acting Director of National Drug Control Policy Regina LaBelle said in a SAMHSA news release. “The Biden-Harris Administration is taking steps to quickly reduce barriers to evidence-based prevention, harm reduction, treatment and recovery services. Over the long term, we must build an addiction infrastructure that can prevent addiction, link people to quality treatment, and support long-term recovery.”

SAMHSA noted in its release that over the past year, the Biden administration has re-established the Behavioral Health Coordinating Council and announced plans to use American Rescue Plan funding to distribute $3 billion through SAMHSA block grants. SAMHSA, which is on pace to distribute $8 billion in COVID-related funding to states, has also awarded $250 million in grants to 100 Certified Community Behavioral Health Clinics, and is distributing $825 million to Community Mental Health Centers. Those 231 facilities, which provide prevention, treatment and rehabilitation services, will be required to address behavioral health disparities among communities that historically have been under-resourced.