Effectiveness of Care: Mental Health and Substance Abuse 2008 National Healthcare Quality and Disparities ReportsThe National Healthcare Quality Report (NHQR) is a comprehensive national overview of quality of health care in the United States. It is organized around four dimensions of quality of care: effectiveness, patient safety, timeliness, and patient centeredness. Effectiveness of Care: Mental Health and Substance AbuseTreatment of Depression Suicide deaths per 100,000 population Adults diagnosed with a new episode of depression who had optimal practitioner contacts for medication management during the acute treatment phase Adults diagnosed with a new episode of depression and initiated on an antidepressant drug who received a continuous trial of medication treatment during the acute treatment phase Adults diagnosed with a new episode of depression and initiated on an antidepressant drug who remained on an antidepressant medication throughout the continuation phase of treatment Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months Adults treated for a major depressive episode who experienced improvement Adults with a mood, anxiety, or impulse control disorder in the past year who received minimally adequate treatment Treatment of Substance Abuse People age 12 and over who needed treatment for illicit drug use and who received such treatment at a specialty facility in the last 12 months People age 12 and over treated for substance abuse who completed treatment courseTreatment of DepressionMeasure TitleSuicide deaths per 100,000 population.Measure SourceHealthy People 2010.National Tables7_1_1.1 Suicide deaths per 100,000 population, United States, 1999 and 2005.7_1_1.2 Suicide deaths per 100,000 population, United States, 2005, by:Race.Ethnicity.Education.National Data SourceCenters for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Vital Statistics System - Mortality (NVSS-M).National DenominatorU.S. resident population.National NumeratorNumber of deaths due to suicide (International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] codes X60-X84, Y87.0).State Tables7_1_1.3 Suicide deaths per 100,000 population, by State, 1999 and 2005.State Data SourceCDC, NCHS, NVSS-M.State DenominatorResident population, by State.State NumeratorSame as national.CommentsSuicides may be undercounted because of difficulty a coroner or medical examiner may have in determining suicidal intent.Rates are age adjusted to the 2000 standard population.This measure is referred to as measure 18-1 in Healthy People 2010 documentation.Top of PageTreatment of DepressionMeasure TitleAdults diagnosed with a new episode of depression who had optimal practitioner contacts for medication management during the acute treatment phase.Measure SourceNational Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS).TableData table will not be presented this year.Data SourceNCQA, HEDIS.DenominatorU.S. enrollees of Medicaid, Medicare, or commercial health plans, age 18 and over, with a pharmacy benefit, diagnosed with a new episode of major depression (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 296.2, 296.3, 298.0, 300.4, 309.1, 311).NumeratorSubset of the denominator who had optimal practitioner contact: at least 3 followup office visits with a primary care or mental health provider in the 12-week acute treatment phase after a diagnosis of depression and prescription of antidepressant medication.Top of PageTreatment of DepressionMeasure TitleAdults diagnosed with a new episode of depression and initiated on an antidepressant drug who received a continuous trial of medication treatment during the acute treatment phase.Measure SourceNational Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS).Tables7_1_3.1 Adults diagnosed with a new episode of depression and initiated on an antidepressant drug who received a continuous trial of medication treatment during the acute treatment phase, United States, 2001 and 2007.Data SourceNCQA, HEDIS.DenominatorU.S. enrollees of Medicaid, Medicare, or commercial health plans, age 18 and over, with a pharmacy benefit, diagnosed with a new episode of major depression (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 296.20-296.25, 296.30-296.35, 298.0, 300.4, 309.1, 311) and initiated on an antidepressant drug.NumeratorSubset of the denominator receiving a continuous trial of antidepressant medication treatment during the acute treatment phase (first 12 weeks following initial diagnosis).CommentsA new episode is defined as no prior diagnosis of depression of any magnitude (ICD-9-CM codes 296.2-296.9, 298.0, 300.4, 309.0, 309.1, 309.28, 311) within 120 days of the first episode occurring during the study year.Refer to HEDIS technical specifications for a more thorough discussion of measure requirements.Top of PageTreatment of DepressionMeasure TitleAdults diagnosed with a new episode of depression and initiated on an antidepressant drug who remained on an antidepressant medication throughout the continuation phase of treatment.Measure SourceNational Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS).TableData table will not be presented this year.Data SourceNCQA, HEDIS.DenominatorU.S. enrollees of Medicaid, Medicare, or commercial health plans, age 18 and over, with a pharmacy benefit, diagnosed with a new episode of major depression (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 296.2, 296.3, 298.0, 300.4, 309.1, 311) and initiated on an antidepressant drug.NumeratorSubset of the denominator receiving antidepressant medication and remaining on medication throughout the continuation treatment phase (6 months following initial diagnosis).Top of PageTreatment of DepressionMeasure TitleAdults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months.Measure SourceSubstance Abuse and Mental Health Services Administration (SAMHSA).Tables7_1_5.1 Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months, United States, 2004 and 2006.7_1_5.2 Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months, United States, 2006, by:Race.Ethnicity.Family income.Education.Data SourceSAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).DenominatorAdults age 18 and over with a major depressive episode in the past year.NumeratorSubset of the denominator who received treatment or counseling in the past year.CommentsMajor depressive episode (MDE) is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of the symptoms of depression described in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Respondents with unknown data for past year MDE measures were excluded.Negative or poor refers to household incomes below the Federal poverty line; near poor/low, over the poverty line to just below 200 percent of the poverty line; middle, 200 percent to just below 400 percent of the poverty line; and high, 400 percent of the poverty line and over.Top of PageTreatment of DepressionMeasure TitleChildren ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months.Measure SourceSubstance Abuse and Mental Health Services Administration (SAMHSA).Tables7_1_6.1 Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months, United States, 2004 and 2006.7_1_6.2 Children ages 12-17 with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months, United States, 2006, by:Race.Ethnicity.Family income.Data SourceSAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).DenominatorChildren ages 12-17 with a major depressive episode in the last 12 months.NumeratorSubset of the denominator who received treatment.Top of PageTreatment of DepressionMeasure TitleAdults treated for a major depressive episode who experienced improvement.Measure SourceSubstance Abuse and Mental Health Services Administration (SAMHSA).Tables7_1_7.1 Perception of help received from treatment or counseling among people age 12 and over with a major depressive episode (MDE) in the last 12 months, United States, 2006.7_1_7.2 Perception of help received from treatment or counseling among people age 12 and over with a major depressive episode (MDE) in the last 12 months, United States, 2004.Data SourceSAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).DenominatorPeople age 12 and over with a major depressive episode who received treatment or counseling for depression in the last 12 months.NumeratorSubset of the denominator who experienced improvement.CommentsMajor depressive episode (MDE) is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of the symptoms of depression described in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Respondents with unknown data for past year MDE measures were excluded.Top of PageTreatment of DepressionMeasure TitleAdults with a mood, anxiety, or impulse control disorder in the past year who received minimally adequate treatment.Measure SourceNational Institutes of Health (NIH), National Institute of Mental Health (NIMH), Collaborative Psychiatric Epidemiology Surveys (CPES).Tables7_1_8.1 Adults age 18 and over with a mood, anxiety, or impulse control disorder in the past year who received minimally adequate treatment, United States, 2001-2003.Data SourceNIH, NIMH, CPES.DenominatorU.S. population age 18 and over who had a mood, anxiety, or impulse control disorder in the past year.NumeratorSubset of the denominator who received minimally adequate treatment, defined as either of the following criteria: (1) at least 60 days of an appropriate medication and 4 visits to a physician; or (2) psychotherapy, including at least 8 visits to a health care or human services professional lasting an average of 30 or more minutes.CommentsThe Composite International Diagnostic Interview (CIDI) was used to make psychiatric diagnoses consistent with the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).Minimally adequate treatment is defined as at least 60 days of an appropriate medication and 4 visits to a physician or at least 8 visits to a health care or human services professional lasting an average of 30 or more minutes in the past year.Top of PageTreatment of Substance AbuseMeasure TitlePeople age 12 and over who needed treatment for illicit drug use and who received such treatment at a specialty facility in the last 12 months.Measure SourceSubstance Abuse and Mental Health Services Administration (SAMHSA).Tables7_2_1.1 People age 12 and over who needed treatment for illicit drug use and who received such treatment at a specialty facility in the last 12 months, United States, 2003 and 2006.7_2_1.2 People age 12 and over who needed treatment for illicit drug use and who received such treatment at a specialty facility in the last 12 months, United States, 2006, by:Race.Ethnicity.Family income.Education.Data SourceSAMHSA, Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).DenominatorPeople age 12 and over who needed treatment for any illicit drug use.NumeratorSubset of the denominator who received treatment for illicit drug use at a specialty facility in the last 12 months.CommentsTreatment at a specialty facility refers to an inpatient hospital or an inpatient or outpatient rehabilitation facility or mental health center treating drug use, or treatment of medical problems associated with drug use.Respondents were classified as needing treatment for an illicit drug problem if they met any of three criteria during the past year: (1) dependence on any illicit drug, (2) abuse of any illicit drug, or (3) treatment at a specialty facility for an illicit drug problem. Illicit drugs include marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, and heroin and nonmedical use of prescription psychotherapeutic drugs.Estimates by family income are provided only for adults age 18 and over. Negative or poor refers to household incomes below the Federal poverty line; near poor/low, over the poverty line to just below 200 percent of the poverty line; middle, 200 percent to just below 400 percent of the poverty line; and high, 400 percent of the poverty line and over.Estimates by education are only available for adults age 18 and over.Top of PageTreatment of Substance AbuseMeasure TitlePeople age 12 and over treated for substance abuse who completed treatment course.Measure SourceSubstance Abuse and Mental Health Services Administration (SAMHSA).Tables7_2_2.1 People age 12 and over treated for substance abuse who completed treatment course, United States, 2002 and 2005.Data SourceSAMHSA, Office of Applied Studies, Substance Abuse Treatment Episode Data Set (TEDS).DenominatorDischarges from substance abuse treatment from publicly funded substance abuse treatment facilities.NumeratorSubset of the denominator who completed treatment. AHRQ Home | Questions? | Contact AHRQ | Site Map | Accessibility | Privacy Policy | Freedom of Information Act | Disclaimers U.S. Department of Health & Human Services | The White House | USA.gov: The U.S. Government's Official Web PortalAgency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 Telephone: (301) 427-1364 Current as of September 2009 Internet Citation: Effectiveness of Care: Mental Health and Substance Abuse: 2008 National Healthcare Quality and Disparities Reports. September 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr08/measurespec/mental_health_and_substance_abuse.html