Mental and Substance Use Disorders

Learn about the most common mental and substance use disorders and how SAMHSA works to reduce their impact on America’s communities.

Overview

Mental and substance use disorders affect people from all walks of life and all age groups. These illnesses are common, recurrent, and often serious, but they are treatable and many people do recover. Learning about some of the most common mental and substance use disorders can help people recognize their signs and to seek help.

According to SAMHSA’s 2014 National Survey on Drug Use and Health (NSDUH) (PDF | 3.4 MB) an estimated 43.6 million (18.1%) Americans ages 18 and up experienced some form of mental illness. In the past year, 20.2 million adults (8.4%) had a substance use disorder. Of these, 7.9 million people had both a mental disorder and substance use disorder, also known as co-occurring mental and substance use disorders.

Various mental and substance use disorders have prevalence rates that differ by gender, age, race, and ethnicity. To read more about this, visit the Specific Populations and Health Disparities topics, and to find SAMHSA data that can be sorted on various factors, visit the NSDUH page.

SAMHSA’s mission is to reduce the impact of mental and substance use disorders on America’s communities. SAMHSA works to prevent and treat mental and substance use disorders and provide supports for people seeking or already in recovery.

Mental Disorders

Mental disorders involve changes in thinking, mood, and/or behavior. These disorders can affect how we relate to others and make choices. Mental disorders take many different forms, with some rooted in deep levels of anxiety, extreme changes in mood, or reduced ability to focus or behave appropriately. Others involve unwanted, intrusive thoughts and some may result in auditory and visual hallucinations or false beliefs about basic aspects of reality. Reaching a level that can be formally diagnosed often depends on a reduction in a person’s ability to function as a result of the disorder.

Anxiety disorders are the most common type of mental disorders, followed by depressive disorders. Different mental disorders are more likely to begin and occur at different stages in life and are thus more prevalent in certain age groups. Lifetime anxiety disorders generally have the earliest age of first onset, most commonly around age 6. Other disorders emerge in childhood, approximately 11% of children 4 to 17 years of age (6.4 million) have been diagnosed with attention deficit hyperactivity disorder (ADHD) as of 2011. Schizophrenia spectrum and psychotic disorders emerge later in life, usually in early adulthood. Not all mental health issues first experienced during childhood or adolescence continue into adulthood, and not all mental health issues are first experienced before adulthood. Mental disorders can occur once, reoccur intermittently, or be more chronic in nature. Mental disorders frequently co-occur with each other and with substance use disorders. Because of this and because of variation in symptoms even within one type of disorder, individual situations and symptoms are extremely varied.

Serious Mental Illness

Serious mental illness among people ages 18 and older is defined at the federal level as having, at any time during the past year, a diagnosable mental, behavior, or emotional disorder that causes serious functional impairment that substantially interferes with or limits one or more major life activities. Serious mental illnesses include major depression, schizophrenia, and bipolar disorder, and other mental disorders that cause serious impairment. In 2014, there were an estimated 9.8 million adults (4.1%) ages 18 and up with a serious mental illness in the past year. People with serious mental illness are more likely to be unemployed, arrested, and/or face inadequate housing compared to those without mental illness.

Serious Emotional Disturbance

The term serious emotional disturbance (SED) is used to refer to children and youth who have had a diagnosable mental, behavioral, or emotional disorder in the past year, which resulted in functional impairment that substantially interferes with or limits the child’s role or functioning in family, school, or community activities. A Centers for Disease Control and Prevention (CDC) review of population-level information found that estimates of the number of children with a mental disorder range from 13 to 20%, but current national surveys do not have an indicator of SED.

Learn more about the most common mental disorders in the United States.

Learn more about mental health treatment at the Behavioral Health Treatments and Services topic.

Substance Use Disorders

Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.

In 2014, about 21.5 million Americans ages 12 and older (8.1%) were classified with a substance use disorder in the past year. Of those, 2.6 million had problems with both alcohol and drugs, 4.5 million had problems with drugs but not alcohol, and 14.4 million had problems with alcohol only.

Learn more about most common substance use disorders in the United States.

Co-occurring Mental and Substance Use Disorders

The coexistence of both a mental health and a substance use disorder is referred to as co-occurring disorders.

According to SAMHSA’s 2014 National Survey on Drug Use and Health (NSDUH) (PDF | 3.4 MB), approximately 7.9 million adults had co-occurring disorders in 2014. During the past year, for those adults surveyed who experienced substance use disorders and any mental illness, rates were highest among adults ages 26 to 49 (42.7%). For adults with past-year serious mental illness and co-occurring substance use disorders, rates were highest among those ages 18 to 25 (35.3%) in 2014.

Learn more about co-occurring disorders and available treatment.

SAMHSA’s Efforts

SAMHSA strives to ensure that Americans can access effective prevention and treatment services for mental and substance use issues, particularly for those with the most serious conditions. Recovery from these disorders is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. SAMHSA offers a number of programs, initiatives, and resources to help people recognize mental and/or substance use disorders and reach out for help. Explore more about SAMHSA’s efforts in prevention, treatment, and recovery support.

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Last Updated: 03/08/2016