October 8, 2009

Mental Health Support and Self-Help Groups

There has been an increasing awareness of the role that mental health support and self-help groups play in recovery from mental illnesses. Mental health support and self-help groups, historically considered as an alternative to traditional mental health treatment, are now recognized as partners in the continuum of mental health care.¹ The National Survey on Drug Use and Health (NSDUH) gathers information that can help provide a better understanding of the extent to which these groups are used, the characteristics of the people who use them, and the relationship between the more traditional modes of mental health treatment and mental health support or self-help groups.

This issue of The NSDUH Report examines the characteristics of adults (i.e., persons aged 18 or older) who received treatment, counseling, or support for emotions, nerves, or mental health in the past year from an in-person support or a self-help group (support and self-help groups hereafter are referred to collectively as self-help groups). All findings presented in this report are annual averages based on combined 2005 to 2008 NSDUH data.

An annual average of 2.4 million adults aged 18 or older (1.1 percent of the population in that age group) received support from a mental health self-help group in the past year. The majority were female (61.2 percent)—a proportion higher than expected based on the proportion of females in the total population (Table 1).

Of the adults who received support from a mental health self-help group, 10.6 percent were aged 18 to 25, 55.3 percent were aged 26 to 49, and 34.1 percent were aged 50 or older. The proportion of adults aged 26 to 49 was higher among persons using mental health self-help groups than among the general adult population. Three fourths (75.2 percent) of those who received support from a mental health self-help group were white, and fewer than half (46.8 percent) were employed full time; these proportions also differed from the expected proportions.

An average of 28.8 million adults received traditional types of mental health treatment (i.e., inpatient care, outpatient care, or prescription medication) in the past year.

Of the 2.4 million adults who received support from a mental health self-help group in the past year, 1.6 million, or 65.6 percent, also received traditional mental health treatment (Figure 1). This number includes 186,000 (7.7 percent of self-help group users) who also received inpatient care, 1.2 million (51.0 percent) who also received outpatient care, and 1.3 million (53.2 percent) who also received prescription medication. An estimated 829,000 users of self-help groups (34.4 percent) did not receive traditional mental health treatment in the past year.

Figure 1. Estimated Numbers (in 1,000s) of Adults Aged 18 or Older Who Received Support from Mental Health Self-Help Groups in the Past Year and Who Received Past Year Traditional Mental Health Treatment: 2005 to 2008

About 5.5 percent of adults who received any traditional type of mental health treatment in the past year also received support from a mental health self-help group in that time period. Use of self-help groups was reported by 9.8 percent of those who received inpatient mental health care in the past year, 8.2 percent of those who got outpatient care, and 5.3 percent of those treated with prescription medications. The proportion using self-help groups was 8.8 percent among adults who received two or more of these traditional types of mental health care and 14.2 percent among those who received all three types.

Among adults who received any traditional type of mental health treatment, those aged 26 to 49 were more likely than those aged 18 to 25 or 50 or older to have also received support from a mental health self-help group (Figure 2). Receipt of support from a mental health self-help group by those who received past year traditional mental health treatment ranged from a low of 3.8 percent among Asians to a high of 8.1 percent among blacks or African Americans (Figure 3). Among persons who received traditional mental health treatment in the past year, similar percentages of females and males also received support from a mental health self-help group (5.2 and 6.1 percent, respectively).

Figure 2. Received Support from a Mental Health Self-Help Group in the Past Year among Adults Aged 18 or Older Who Received Past Year Traditional Mental Health Treatment, by Age Group: 2005 to 2008

Figure 3. Received Support from a Mental Health Self-Help Group in the Past Year among Adults Aged 18 or Older Who Received Past Year Traditional Mental Health Treatment, by Race/Ethnicity: 2005 to 2008

A continuum of services and supports is important for recovery from mental health problems. For many people, mental health support and self-help groups complement treatment in the traditional mental health sector; two thirds (65.6 percent) of the people who received support for mental health problems from self-help groups also received traditional mental health services (inpatient care, outpatient care, and prescription medication). What was once viewed as an alternative can now be considered an element of mainstream services and supports, especially as even newer "alternatives" to traditional treatment emerge through such avenues as consumer-operated services providing a range of community-based services, wellness programs, peer-provided Medicaid-reimbursable services, Internet support groups, and peer-run crisis alternatives.