Behavioral Health Barometer. Oregon, 2015

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Behavioral Health Barometer Oregon, 2015

Acknowledgments This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by RTI International under contract No. 283 12 0605 with SAMHSA, U.S. Department of Health and Human Services (HHS). 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, HHS. Electronic Access and Printed Copies This publication may be downloaded or ordered at http://store.samhsa.gov. Or call SAMHSA at 1 877 SAMHSA 7 (1 877 726 4727) (English and Español). Recommended Citation Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: Oregon, 2015. HHS Publication No. SMA 16 Baro 2015 OR. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015. Originating Office Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857. i

CONTENTS FOREWORD...iii YOUTH SUBSTANCE USE... 1 Illicit Drug Use... 1 Cigarette Use... 2 Binge Alcohol Use... 3 Substance Use Initiation and Risk Perceptions... 4 Nonmedical Use of Pain Relievers... 6 YOUTH MENTAL HEALTH AND TREATMENT... 7 Depression... 7 Treatment for Depression... 8 MENTAL HEALTH AND TREATMENT... 9 Thoughts of Suicide... 9 Serious Mental Illness... 10 Treatment for Any Mental Illness...11 Mental Health Consumers... 12 SUBSTANCE USE... 13 Alcohol Dependence or Abuse... 13 Illicit Drug Dependence or Abuse...14 Heavy Alcohol Use... 15 SUBSTANCE USE TREATMENT... 16 Alcohol... 16 Illicit Drugs...17 FIGURE NOTES... 18 DEFINITIONS... 19 SOURCES... 20 ii

FOREWORD The Substance Abuse and Mental Health Services Administration (SAMHSA), an operating division within the U.S. Department of Health and Human Services (HHS), is charged with reducing the impact of substance abuse and mental illness on America s communities. SAMHSA is pursuing this mission at a time of significant change. Health care reform has been enacted, bringing sweeping changes to how the United States delivers, pays for, and monitors health care. Simultaneously, state budgets are shrinking, and fiscal restraint is a top priority. This is the third edition of the Behavioral Health Barometer: Oregon, one of a series of national and state reports that provide a snapshot of behavioral health in the United States. The reports present a set of substance use and mental health indicators as measured through data collection efforts sponsored by SAMHSA, including the National Survey on Drug Use and Health and the Uniform Reporting System. This array of indicators provides a unique overview of the nation s behavioral health at a point in time as well as a mechanism for tracking change and trends over time. As new data become available, indicators highlighted in these reports will be updated to reflect the current state of the science and incorporate new measures of interest. The Behavioral Health Barometers will provide critical information to a variety of audiences in support of SAMHSA s mission of reducing the impact of substance abuse and mental illness on America s communities. Behavioral Health Barometers for the nation and for all 50 states and the District of Columbia are published on a regular basis as part of SAMHSA s larger behavioral health quality improvement approach. Kana Enomoto, Acting Administrator Substance Abuse and Mental Health Services Administration iii

YOUTH SUBSTANCE USE ILLICIT DRUG USE Past Month Illicit Drug Use Among Adolescents Aged 12 17 in Oregon and the United States (2010 2011 to 2013 2014) 1 Oregon s percentage of illicit drug use among adolescents aged 12 17 was higher than the national percentage in 2013 2014. 2 Oregon United States 15% 12.7% 11.7% 12.3% 12.6% 1 10.1% 9.8% 9.2% 9.1% 5% 2010 2011 2011 2012 2012 2013 2013 2014 Years 12.6% In Oregon, about 37,000 adolescents aged 12 17 (12.6% of all adolescents) per year in 2013 2014 reported using illicit drugs within the month prior to being surveyed. The percentage did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 1

YOUTH SUBSTANCE USE CIGARETTE USE Past Month Cigarette Use Among Adolescents Aged 12 17 in Oregon and the United States (2010 2011 to 2013 2014) 1 Oregon s percentage of cigarette use among adolescents aged 12 17 was similar to the national percentage in 2013 2014. 2 Oregon United States 15% 1 5% 7.5% 8.1% 6.8% 7.2% 6.2% 6.1% 6.1% 5.2% 2010 2011 2011 2012 2012 2013 2013 2014 Years 6.1% In Oregon, about 18,000 adolescents aged 12 17 (6.1% of all adolescents) per year in 2013 2014 reported using cigarettes within the month prior to being surveyed. The percentage did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 2

YOUTH SUBSTANCE USE BINGE ALCOHOL USE Past Month Binge Alcohol Use Among Individuals Aged 12 20 in Oregon and the United States (2010 2011 to 2013 2014) 1 Oregon s percentage of binge alcohol use among individuals aged 12 20 was higher than the national percentage in 2013 2014. 2 Oregon United States 15% 15.5% 16.3% 16.4% 15.6% 16.9% 14.7% 16.5% 14. 1 5% 2010 2011 2011 2012 2012 2013 2013 2014 Years 16.5% In Oregon, about 75,000 individuals aged 12 20 (16.5% of all individuals in this age group) per year in 2013 2014 reported binge alcohol use within the month prior to being surveyed. The percentage did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 3

YOUTH SUBSTANCE USE SUBSTANCE USE INITIATION AND RISK PERCEPTIONS Past Year Initiation (First Use) of Selected Substances Among Adolescents Aged 12 17 in Oregon, by Substance Type (Annual Averages, 2010 2014) 2 Among adolescents aged 12 17 in Oregon from 2010 to 2014, an annual average of 9. initiated alcohol use (i.e., used it for the first time) within the year prior to being surveyed, and an annual average of 6.2% initiated marijuana use within the year prior to being surveyed. 2 15% 1 9. 5% 6.2% 5.4% 3.5% Alcohol Marijuana Cigarettes Nonmedical Use of Psychotherapeutics Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2014. Adolescents Aged 12 17 in Oregon and the United States Who Perceived No Great Risk from Smoking One or More Packs of Cigarettes a Day (2010 2011 to 2013 2014) 1,3 10 8 6 Oregon United States In Oregon, about 1 in 3 (35.8%) adolescents aged 12 17 in 2013 35.8% 2014 perceived no great risk from smoking one or more packs of cigarettes a day a percentage similar to the national percentage. 4 2 33.8% 34.3% 34.8% 34.1% 36.6% 35. 35.8% 34.7% 2010 2011 2011 2012 2012 2013 2013 2014 Years The percentage of adolescents aged 12 17 in Oregon who perceived no great risk from smoking one or more packs of cigarettes a day did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 4

YOUTH SUBSTANCE USE SUBSTANCE USE INITIATION AND RISK PERCEPTIONS Adolescents Aged 12 17 in Oregon and the United States Who Perceived No Great Risk from Having Five or More Drinks Once or Twice a Week (2010 2011 to 2013 2014) 1,3 10 8 6 Oregon United States 64.7% 64.9% 64.3% 66.7% 59.4% 59.8% 60.7% 60.9% 66.7% In Oregon, about 2 in 3 (66.7%) adolescents aged 12 17 in 2013 2014 perceived no great risk from having five or more drinks once or twice a week a percentage higher than the national percentage. 4 2 2010 2011 2011 2012 2012 2013 2013 2014 Years The percentage of adolescents aged 12 17 in Oregon who perceived no great risk from having five or more drinks once or twice a week did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. Adolescents Aged 12 17 in Oregon and the United States Who Perceived No Great Risk from Smoking Marijuana Once a Month (2010 2011 to 2013 2014) 1,3 10 8 6 Oregon United States 76.8% 78.2% 80. 82. 71.4% 73. 74.7% 76.5% 82. In Oregon, about 8 in 10 (82.) adolescents aged 12 17 in 2013 2014 perceived no great risk from smoking marijuana once a month a percentage higher than the national percentage. 4 2 2010 2011 2011 2012 2012 2013 2013 2014 Years The percentage of adolescents aged 12 17 in Oregon who perceived no great risk from smoking marijuana once a month increased from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 5

YOUTH SUBSTANCE USE NONMEDICAL USE OF PAIN RELIEVERS Past Year Nonmedical Use of Pain Relievers Among Adolescents Aged 12 17 in Oregon and the United States (2010 2011 to 2013 2014) 1 Oregon s percentage of nonmedical use of pain relievers among adolescents aged 12 17 was similar to the national percentage in 2013 2014. 12% Oregon United States 1 8% 6% 7.4% 6.1% 6.8% 5.6% 6.2% 5. 5.3% 4.7% 4% 2% 2010 2011 2011 2012 2012 2013 2013 2014 Years 5.3% In Oregon, about 15,000 adolescents aged 12 17 (5.3% of all adolescents) per year in 2013 2014 reported nonmedical use of pain relievers within the year prior to being surveyed. The percentage decreased from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 6

YOUTH MENTAL HEALTH AND TREATMENT DEPRESSION Past Year Major Depressive Episode (MDE) Among Adolescents Aged 12 17 in Oregon and the United States (2010 2011 to 2013 2014) 1,4 Oregon s percentage of major depressive episode (MDE) among adolescents aged 12 17 was higher than the national percentage in 2013 2014. 2 Oregon United States 15% 12.7% 14.6% 1 8.6% 8.1% 10.2% 8.7% 9.9% 11. 5% 2010 2011 2011 2012 2012 2013 2013 2014 Years 14.6% In Oregon, about 43,000 adolescents aged 12 17 (14.6% of all adolescents) per year in 2013 2014 had at least one MDE within the year prior to being surveyed. The percentage increased from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 7

YOUTH MENTAL HEALTH AND TREATMENT TREATMENT FOR DEPRESSION Past Year Treatment for Depression Among Adolescents Aged 12 17 with Major Depressive Episode (MDE) in Oregon (Annual Average, 2010 2014) 2,5 Oregon s annual average of treatment for depression among adolescents aged 12 17 with MDE was similar to the annual average for the nation (38.6%) from 2010 to 2014. 54.9% 45.1% Received Treatment for Depression Did Not Receive Treatment for Depression 45.1% In Oregon, about 16,000 adolescents aged 12 17 with MDE (45.1% of all adolescents with MDE) per year from 2010 to 2014 received treatment for their depression within the year prior to being surveyed. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2014. 8

MENTAL HEALTH AND TREATMENT THOUGHTS OF SUICIDE Past Year Serious Thoughts of Suicide Among Adults Aged 18 or Older in Oregon and the United States (2010 2011 to 2013 2014) 1,6 Oregon s percentage of adults aged 18 or older with suicidal thoughts was similar to the national percentage in 2013 2014. 12% Oregon United States 1 8% 6% 4% 4.4% 4.5% 4.1% 3.8% 3.9% 3.8% 3.9% 3.9% 2% 2010 2011 2011 2012 2012 2013 2013 2014 Years 4.5% In Oregon, about 138,000 adults aged 18 or older (4.5% of all adults) per year in 2013 2014 had serious thoughts of suicide within the year prior to being surveyed. The percentage did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 9

MENTAL HEALTH AND TREATMENT SERIOUS MENTAL ILLNESS Past Year Serious Mental Illness (SMI) Among Adults Aged 18 or Older in Oregon and the United States (2010 2011 to 2013 2014) 1,7 Oregon s percentage of serious mental illness (SMI) among adults aged 18 or older was similar to the national percentage in 2013 2014. 12% Oregon United States 1 8% 6% 4% 4.9% 4.6% 4.8% 4.7% 3.9% 4. 4.1% 4.2% 2% 2010 2011 2011 2012 2012 2013 2013 2014 Years 4.7% In Oregon, about 145,000 adults aged 18 or older (4.7% of all adults) per year in 2013 2014 had SMI within the year prior to being surveyed. The percentage did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 10

MENTAL HEALTH AND TREATMENT TREATMENT FOR ANY MENTAL ILLNESS Past Year Mental Health Treatment/Counseling Among Adults Aged 18 or Older with Any Mental Illness (AMI) in Oregon (Annual Average, 2010 2014) 2,8 Oregon s annual average of mental health treatment/counseling among adults aged 18 or older with any mental illness (AMI) was similar to the annual average for the nation (42.7%) from 2010 to 2014. 45.9% Received Mental Health Treatment/Counseling 54.1% Did Not Receive Mental Health Treatment/Counseling 45.9% In Oregon, about 318,000 adults aged 18 or older with AMI (45.9% of all adults with AMI) per year from 2010 to 2014 received mental health treatment/counseling within the year prior to being surveyed. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2014. 11

MENTAL HEALTH AND TREATMENT MENTAL HEALTH CONSUMERS Adult Mental Health Consumers Served in the Public Mental Health System in Oregon, by Age Group and Employment Status (2014) Among adults served in Oregon s public mental health system in 2014, 67.1% of those aged 18 20, 56.5% of those aged 21 64, and 85.8% of those aged 65 or older were not in the labor force. 10 Employed Unemployed Not in Labor Force 85.8% 8 6 59.5% 67.1% 56.5% 4 2 13.7% 26.9% 10.5% 22.4% 14.8% 28.8% 4.5% 9.6% Total 18 20 21 64 65 or Older Age Group Source: SAMHSA, Center for Mental Health Services, Uniform Reporting System, 2014. Mental Health Consumers in Oregon and the United States Reporting Improved Functioning from Treatment Received in the Public Mental Health System (2014) 10 8 6 4 2 62. Oregon Children and Adolescents (Aged 17 or Younger) United States 69.5% 70.9% 46.2% Adults (Aged 18 or Older) Source: SAMHSA, Center for Mental Health Services, Uniform Reporting System, 2014. In 2014, 41,192 children and adolescents (aged 17 or younger) were served in Oregon s public mental health system. The percentage of children and adolescents (aged 17 or younger) reporting improved functioning from treatment received in the public mental health system was lower in Oregon than in the nation as a whole. The percentage for adults (aged 18 or older) was lower in Oregon than in the nation as a whole. 12 F

SUBSTANCE USE ALCOHOL DEPENDENCE OR ABUSE Past Year Alcohol Dependence or Abuse Among Individuals Aged 12 or Older in Oregon and the United States (2010 2011 to 2013 2014) 1 Oregon s percentage of alcohol dependence or abuse among individuals aged 12 or older was similar to the national percentage in 2013 2014. 12% Oregon United States 1 8% 6% 7.8% 7.5% 7.1% 6.8% 7. 6.6% 6.7% 6.5% 4% 2% 2010 2011 2011 2012 2012 2013 2013 2014 Years 7. In Oregon, about 233,000 individuals aged 12 or older (7. of all individuals in this age group) per year in 2013 2014 were dependent on or abused alcohol within the year prior to being surveyed. The percentage did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 13

SUBSTANCE USE ILLICIT DRUG DEPENDENCE OR ABUSE Past Year Illicit Drug Dependence or Abuse Among Individuals Aged 12 or Older in Oregon and the United States (2010 2011 to 2013 2014) 1 Oregon s percentage of illicit drug dependence or abuse among individuals aged 12 or older was similar to the national percentage in 2013 2014. 12% Oregon United States 1 8% 6% 4% 3. 3. 3.2% 2.7% 2.7% 2.7% 2.9% 2.6% 2% 2010 2011 2011 2012 2012 2013 2013 2014 Years 2.9% In Oregon, about 99,000 individuals aged 12 or older (2.9% of all individuals in this age group) per year in 2013 2014 were dependent on or abused illicit drugs within the year prior to being surveyed. The percentage did not change significantly from 2010 2011 to 2013 2014. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2011 to 2013 2014. 14

SUBSTANCE USE HEAVY ALCOHOL USE Past Month Heavy Alcohol Use Among Adults Aged 21 or Older in Oregon and the United States (Annual Averages, 2010 2014) 2 Oregon s annual average of heavy alcohol use among adults aged 21 or older was similar to the annual average for the nation from 2010 to 2014. 12% 1 8% 6% 6.2% 6.7% 4% 2% Oregon United States 6.2% In Oregon, about 177,000 adults aged 21 or older (6.2% of all adults in this age group) per year from 2010 to 2014 reported heavy alcohol use within the month prior to being surveyed. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2014. 15

SUBSTANCE USE TREATMENT ALCOHOL Past Year Treatment for Alcohol Use Among Individuals Aged 12 or Older with Alcohol Dependence or Abuse in Oregon (Annual Average, 2010 2014) 2 Oregon s annual average of treatment for alcohol use among individuals aged 12 or older with alcohol dependence or abuse was similar to the annual average for the nation (7.3%) from 2010 to 2014. 8. Received Treatment for Alcohol Use Did Not Receive Treatment for Alcohol Use 92. 8. In Oregon, among individuals aged 12 or older with alcohol dependence or abuse, about 21,000 individuals (8.) per year from 2010 to 2014 received treatment for their alcohol use within the year prior to being surveyed. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2014. 16

SUBSTANCE USE TREATMENT ILLICIT DRUGS Past Year Treatment for Illicit Drug Use Among Individuals Aged 12 or Older with Illicit Drug Dependence or Abuse in Oregon (Annual Average, 2010 2014) 2 Oregon s annual average of treatment for illicit drug use among individuals aged 12 or older with drug dependence or abuse was similar to the annual average for the nation (14.1%) from 2010 to 2014. 10.9% Received Treatment for Illicit Drug Use Did Not Receive Treatment for Illicit Drug Use 89.1% 10.9% In Oregon, among individuals aged 12 or older with illicit drug dependence or abuse, about 13,000 individuals (10.9%) per year from 2010 to 2014 received treatment for their illicit drug use within the year prior to being surveyed. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 2014. 17

FIGURE NOTES 1 State estimates are based on a small area estimation procedure in which state-level National Survey on Drug Use and Health (NSDUH) data from 2 consecutive survey years are combined with local-area county and census block group/tract-level data from the state. This model-based methodology provides more precise estimates at the state level than those based solely on the sample, particularly for states with smaller sample sizes. 2 Estimates are annual averages based on combined 2010 2014 NSDUH data or combined 2007 2014 NSDUH data where indicated. These estimates are based solely on the sample, unlike estimates based on the small area estimation procedure as stated above. 3 Risk perceptions were measured by asking respondents to assess the extent to which people risk harming themselves physically and in other ways when they use various illicit drugs, alcohol, and cigarettes, with various levels of frequency. Response options were (1) no risk, (2) slight risk, (3) moderate risk, and (4) great risk. Respondents with unknown risk perception data were excluded. 4 Respondents with unknown past year major depressive episode (MDE) data were excluded. 5 Respondents with unknown past year MDE or unknown treatment data were excluded. 6 Estimates were based only on responses to suicide items in the NSDUH Mental Health module. Respondents with unknown suicide information were excluded. 7 Estimates of serious mental illness (SMI) and any mental illness (AMI) presented in this publication may differ from estimates in other publications as a result of revisions made to the NSDUH mental illness estimation models in 2012. Other NSDUH mental health measures presented were not affected. The 2013 and 2014 Barometer reports include the revised SMI and AMI estimates. For further information, see Revised Estimates of Mental Illness from the National Survey on Drug Use and Health, which is available on the SAMHSA Web site at http://www.samhsa.gov/data/sites/default/files/nsduh148/nsduh148/sr148-mentalillness-estimates.pdf. 8 Respondents were not to include treatment for drug or alcohol use. Respondents with unknown treatment/ counseling information were excluded. Estimates were based only on responses to items in the NSDUH Adult Mental Health Service Utilization module. 18

DEFINITIONS Any mental illness (AMI) among adults aged 18 or older is defined as currently or at any time in the past year having had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Adults who had a diagnosable mental, behavioral, or emotional disorder in the past year, regardless of their level of functional impairment, were defined as having AMI. Binge alcohol use is defined as drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. Dependence on or abuse of alcohol or illicit drugs is defined using DSM-IV criteria. Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days. Illicit drugs is defined as marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically, based on data from original National Survey on Drug Use and Health (NSDUH) questions, not including methamphetamine use items added in 2005 and 2006. Illicit drug use treatment and alcohol use treatment refer to treatment received in order to reduce or stop illicit drug or alcohol use, or for medical problems associated with illicit drug or alcohol use. They include treatment received at any location, such as a hospital (inpatient), rehabilitation facility (inpatient or outpatient), mental health center, emergency room, private doctor s office, self-help group, or prison/jail. Major depressive episode (MDE) is defined as in the DSM-IV, which specifies a period of at least 2 weeks in the past year when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. Mental health treatment/counseling is defined as having received inpatient or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Nonmedical use of psychotherapeutics includes the nonmedical use of pain relievers, tranquilizers, stimulants, or sedatives and does not include over-the-counter drugs. Serious mental illness (SMI) is defined by SAMHSA as adults aged 18 or older who currently or at any time in the past year have had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) of sufficient duration to meet diagnostic criteria specified within the DSM-IV that has resulted in serious functional impairment, which substantially interferes with or limits one or more major life activities. Treatment for depression is defined as seeing or talking to a medical doctor or other professional or using prescription medication for depression in the past year. 19

SOURCES American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: Author. Center for Mental Health Services. (2015). 2014 CMHS Uniform Reporting System Output Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Retrieved from http://www.samhsa.gov/data/us_map The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older, and also includes mental health issues and mental health service utilization for adolescents aged 12 to 17 and adults aged 18 or older. Conducted by the Federal Government since 1971, the survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence. The data used in this report are based on information obtained from approximately 67,500 individuals aged 12 or older per year in the United States. Additional information about NSDUH is available at http://www.samhsa.gov/data/population-data-nsduh. 20

HHS Publication No. SMA 16 Baro 2015 OR 2015 U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality www.samhsa.gov