Brief State Variation in Substance Use Disorder and Mental Health Treatment
Victoria Lynch, Maya Payton, Lisa Clemans-Cope
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The availability and characteristics of substance use disorder (SUD) and mental health treatment facilities play a critical role in addressing the growing behavioral health crisis in the United States. Yet, no comprehensive statistics about differences across states and territories are available. This study helps address knowledge gaps by providing descriptive statistics about the treatment of co-occurring SUD and mental health conditions at behavioral health facilities; types of facilities available and services offered; bed utilization; availability of medication for opioid use disorder and alcohol use disorder; and type of facility operation, facility ownership, and funding sources.

WHY THIS MATTERS

Research shows that patient access to and experience with SUD and mental health facility services depends on facility characteristics such as level of SUD and mental health services integration; type of setting, ownership, and funding sources; and state. Variation in facility characteristics may have important implications for patient access, quality of care, and treatment outcomes. Comprehensive statistics on state and territory variation in SUD and mental health treatment facility characteristics can contribute to understanding the factors contributing to these differences and developing targeted policy solutions to improve the equitable delivery of behavioral health services nationwide.

WHAT WE FOUND

  • Nationally, only 15.5 percent of facilities focused on treating both SUD and mental health disorders. This share varied substantially across states, from 28.7 percent and higher in the top decile of states (the highest five states) to 7.4 percent and lower in the bottom decile (the lowest five states).
  • A total of 70.8 percent of facilities that focused on SUD or SUD and mental health treatment (hereafter “SUD facilities”) offered mental health services, ranging from 89.5 percent and higher in the top state decile to 50.5 percent and lower in the bottom decile. We found that 52.9 percent offered suicide prevention services.
  • We found that 61.0 percent of facilities that focused on mental health or mental health and SUD treatment (hereafter “mental health facilities”) offered SUD treatment, and 61.9 percent provided integrated SUD and mental health treatment.
  • Most SUD facilities provided outpatient care (82.9 percent), while relatively few offered residential (23.7 percent) or inpatient (6.0 percent) treatment.
  • Inpatient and residential SUD treatment beds were often at or over capacity. Inpatient SUD treatment bed utilization was at or over capacity (100 percent utilization or higher on date of survey) in 23 states and 140 percent of capacity or higher in 14 states. For residential SUD treatment bed utilization, facilities in 20 states were at or over capacity, and 140 percent of capacity or higher in eight states.
  • Among mental health facilities, outpatient care was most common (64.3 percent), while 17 percent offered 24-hour residential care and 13 percent provided 24-hour inpatient care.
  • Inpatient mental health treatment bed utilization averaged 150 percent nationally and was at or over capacity in 19 states, with 14 states at 140 percent of capacity or higher. Residential mental health treatment bed utilization averaged 90 percent nationally, with facilities in 12 states at or over capacity and five states at 140 percent of capacity or higher.
  • We found that 62.4 percent of SUD facilities offered medication for opioid use disorder, and 50.7 percent offered medication for alcohol use disorder, with substantial state variation.
  • Most SUD facilities were privately owned (85.1 percent). The share of private nonprofits with no government funding (excluding payments for clients, such as Medicaid, Tricare, and Medicare enrollees) ranged from 44.3 percent and higher in the top state decile to 7.7 percent and lower in the bottom decile.

HOW WE DID IT

We relied on the 2022 National Substance Use and Mental Health Services Survey to produce descriptive statistics on SUD and mental health treatment facilities in 53 geographic areas, including the 50 states, the District of Columbia, Puerto Rico, and six other territories combined.

Research and Evidence Health Policy Justice and Safety Technology and Data
Expertise Health Care Coverage, Access, and Affordability Victim Safety and Justice
Research Methods Data analysis
Tags Behavioral health and justice Health care systems and managed care plans Mental health Nonprofit data and statistics Behavioral health Substance use
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