Increase the proportion of adolescents with depression who get treatment — MHMD‑06 Data Methodology and Measurement

This objective is a Leading Health Indicator (LHI). Learn about LHIs.

About the National Data

Data

Baseline: 41.4 percent of adolescents aged 12 to 17 years with MDEs received treatment in the past 12 months, as reported in 2018

Target: 46.4 percent

Numerator
Number of adolescents aged 12 to 17 years with a MDE within the past 12 months who received treatment.
Denominator
Number of adolescents aged 12 to 17 years with a MDE in the past 12 months.
Target-setting method
Percentage point improvement
Target-setting method details
Percentage point improvement from the baseline using Cohen's h effect size of 0.10.
1
Target-setting method justification
Trend data were evaluated for this objective, but it was not possible to project a target because the trend was flat. A percentage point improvement was calculated using Cohen's h effect size of 0.1. This method was used because it was a clinically meaningful improvement from the baseline.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2018 National Survey on Drug Use and Health:

Numerator and Denominator:
During the past 12 months, have you stayed overnight or longer in any type of hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?
  1. Yes
  2. No
  3. Don't know/Refused
During the past 12 months, how many nights altogether did you stay in a hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?<

Think about the last time you stayed overnight or longer in a hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason you were admitted there?

  1. You thought about killing yourself or tried to kill yourself
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other emotional or behavioral problem for which you last stayed overnight in a hospital?
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other reason
  8. Don't know/Refused
Please type in the most important other reason for your last overnight stay in a hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs.

During the past 12 months, did you stay overnight or longer in a residential treatment center to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?

  1. Yes
  2. No
  3. Don't know/Refused
How many nights altogether did you stay in a residential treatment center to receive treatment for emotional or behavioral problems that were not caused by alcohol or drugs?

Think about the last time you stayed overnight or longer in a residential treatment. What was the reason you were admitted there?

  1. You thought about killing yourself or tried to kill yourself
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other emotional or behavioral problem for which you last stayed overnight in a residential treatment center? <
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other reason
  8. Don't know/Refused
During the past 12 months, did you stay overnight or longer in foster care or in a therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol or drugs?
  1. Yes
  2. No
  3. Don't know/Refused
How many nights altogether did you stay in foster care or in a therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol or drugs?

Think about the last time you stayed overnight or longer in foster care or in a therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason you were placed there?

  1. You thought about killing yourself or tried to kill yourself
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other emotional or behavioral problem for which you last stayed overnight or longer in foster care or a therapeutic foster care home?
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other Reason
  8. Don't know/Refused
Please type in the most important other reason for your last overnight stay in foster care or in a therapeutic foster care home to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs.

During the past 12 months, did you receive treatment or counseling at a partial day hospital or day treatment program because you had problems with your behavior or emotions that were not caused by alcohol or drugs?

  1. Yes
  2. No
  3. Don't know/Refused
During the past 12 months, how many times did you visit a partial day hospital or day treatment program because you had emotional or behavioral problems that were not caused by alcohol or drugs?

Think about the last time you visited a partial day hospital or day treatment program because you had emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your visit?

  1. You thought about killing yourself or tried to kill yourself
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other emotional or behavioral problem for which you last visited a partial day hospital or day treatment program?
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other reason
  8. Don't know/Refused
Please type in the most important other reason for your last visit to a partial day hospital or day treatment program to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs.

During the past 12 months, did you receive treatment or counseling at a mental health clinic or center because you had problems with your behavior or emotions that were not caused by alcohol or drugs?

  1. Yes
  2. No
  3. Don't know/Refused
How many times did you visit a mental health clinic or center to receive treatment or counseling because you had emotional or behavioral problems that were not caused by alcohol or drugs?

Think about the last time you visited a mental health clinic or center to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your visit?

  1. You thought about killing yourself or tried to kill yourself
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other emotional or behavioral problem for which you last visited a mental health clinic or center?
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other reason
  8. Don't know/Refused
Please type in the most important other reason for your last visit to a mental health clinic or center to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. During the past 12 months, did you receive treatment or counseling from a private therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems that were not caused by alcohol or drugs?
  1. Yes
  2. No
  3. Don't know/Refused
How many times did you receive treatment or counseling from a private therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems that were not caused by alcohol or drugs?

Think about the last time you visited a private therapist, psychologist, psychiatrist, social worker, or counselor to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your visit?

  1. You thought about killing yourself or tried to kill yourself
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other emotional or behavioral problem for which you last visited a private therapist, psychologist, psychiatrist, social worker or counselor?
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other reason
  8. Don't know/Refused
Please type in the most important other reason for your last visit to a private therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems that were not caused by alcohol or drugs.

During the past 12 months, did you receive treatment or counseling from an in-home therapist, counselor, or family preservation worker for emotional or behavioral problems that were not caused by alcohol or drugs?

During the past 12 months, how many times did you receive treatment or counseling from an in-home therapist, counselor, or family preservation worker for emotional or behavioral problems that were not caused by alcohol or drugs?

Think about the last time you saw an in-home therapist, counselor, or family preservation worker to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for this visit?

  1. You thought about killing yourself or tried to kill yourself
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other emotional or behavioral problem for which you last saw an in-home therapist, counselor, or family preservation worker?
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other reason
  8. Don't know/Refused
Please type in the most important other reason you last saw an in-home therapist, counselor, or family preservation worker for emotional or behavioral problems that were not caused by alcohol or drugs.

During the past 12 months, did you receive treatment or counseling from a pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or drugs?

  1. Yes
  2. No
  3. Don't know/Refused
How many times did you receive treatment or counseling from a pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or drugs?

Think about the last time you visited a pediatrician or other family doctor to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your visit?

  1. You thought about killing yourself or tried to kill yourself
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other emotional or behavioral problem for which you last visited a pediatrician or other family doctor?
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other reason
  8. Don't know/Refused
Please type in the most important other reason for your last visit to a pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or drugs.

Sometimes students get treatment or counseling through the school system. This counseling is often provided by school social workers, school psychologists or school counselors. During the past 12 months, that is, since [DATEFILL], did you receive any treatment or counseling from a school social worker, a school psychologist, or a school counselor for emotional or behavioral problems that were not caused by alcohol or drugs?

  1. Yes
  2. No
  3. Don't know/Refused
Think about the last time you talked with a school social worker, school psychologist, or school counselor about emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your talk?
  1. You thought about killing yourself or tried to kill yourself.
  2. You felt depressed
  3. You felt very afraid and tense
  4. You were breaking rules and "acting out"
  5. You had eating problems
  6. Some other reason
  7. Don't know/Refused
What was the other reason for your last talk with a school social worker, school psychologist or school counselor?
  1. You had trouble controlling your anger
  2. You had gotten into physical fights
  3. You had problems at home or in your family
  4. You had problems with your friends
  5. You had problems with people other than your friends or family
  6. You had problems at school
  7. Some other
  8. Don't know/Refused
Please type in the most important other reason for your last talk with a school social worker, school psychologist or school counselor.

At any time during the past 12 months, that is since [DATEFILL], did you attend a school for students with emotional or behavioral problems?

  1. Yes
  2. No
  3. Don't know/Refused
Regular schools sometimes provide programs for students with emotional or behavioral problems. Did you participate in a school program that was just for students with emotional or behavioral problems?
  1. Yes
  2. No
  3. Don't know/Refused
During the past 12 months, that is, since [DATEFILL], did you stay overnight or longer in any type of juvenile detention center, sometimes called "juvie", prison, or jail?
  1. Yes
  2. No
  3. Don't know/Refused
How many nights altogether did you stay in any type of juvenile detention center, prison or jail?

While you were in a juvenile detention center, prison or jail during the past 12 months, did you receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?

  1. Yes
  2. No
  3. Don't know/Refused
Have you ever in your life had a period of time lasting several days or longer when most of the day you felt sad, empty, or depressed?
  1. Yes
  2. No
  3. Don't know/Refused
Have you ever had a period of time lasting several days or longer when most of the day you you felt very discouraged or hopeless about how things were going in your life?
  1. Yes
  2. No
  3. Don't know/Refused
Have you ever had a period of time lasting several days or longer when you lost interest and became bored with most things you usually enjoy, like work, hobbies, and personal relationships?
  1. Yes
  2. No
  3. Don't know/Refused
During times when you felt sad, empty, or depressed most of the day, did you ever feel discouraged about how things were going in your life?
  1. Yes
  2. No
  3. Don't know/Refused
During the times when you felt sad, empty, or depressed, did you ever lose interest and become really bored with most things like school, work, hobbies, and other things that are usually fun for you, like listening to music, watching TV, movies, or sports, playing computer games, or going out with friends?
  1. Yes
  2. No
  3. Don't know/Refused
During times when you felt sad, empty, or depressed, did you ever lose interest and become really bored with most things like school, work, hobbies, and other things that are usually fun for you, like listening to music, watching TV, movies, or sports, playing computer games, or going out with friends?
  1. Yes
  2. No
  3. Don't know/Refused
During times when you felt discouraged about how things were going in your life, did you ever lose interest and become really bored with most things like school, work, hobbies, and other things that are usually fun for you, like listening to music, watching TV, movies, or sports, playing computer games, or going out with friends?
  1. Yes
  2. No
  3. Don't know/Refused
Did you ever have a period of time like this that lasted most of the day almost every day for two weeks or longer?
  1. Yes
  2. No
  3. Don't know/Refused
Did you ever have a period of time like this that lasted most of the day, almost every day, for two weeks or longer?
  1. Yes
  2. No
  3. Don't know/Refused
Think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent. During those times, how long did your [FEELNOUN] usually last?
  1. Less than 1 hour
  2. At least 1 hour but less than 3 hours
  3. At least 3 hours but less than 5 hours
  4. 5 hours or more
  5. Don't know/Refused
Still thinking of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent, how strong were your bad feelings during those times?
  1. Mild
  2. Moderate
  3. Severe
  4. Very severe
  5. Don't know/Refused
Again, think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent. How often, during those times, did you feel so bad that nothing could cheer you up?
  1. Often
  2. Sometimes
  3. Not very often
  4. Never
  5. Don't know/Refused
Once again, please think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent. How often, during those times, did you feel so bad that you could not carry out your daily activities?
  1. Often
  2. Sometimes
  3. Not very often
  4. Never
  5. Don't know/Refused
People who have problems with their mood often have other problems at the same time. These problems may include things like changes in:sleep, eating, energy, the ability to keep their mind on things, feeling badly about themselves. Did you ever have any of these problems during a period of time when you [FEELFILL] for two weeks or longer?
  1. Yes
  2. No
  3. Don't know/Refused
Can you think of the worst time when you [FEELFILL] for two weeks or longer and also had these other problems at the same time?
  1. Yes
  2. No
  3. Don't know/Refused
How old were you when that worst period of time started?

Then think of the most recent time you [FEELFILL] for two weeks or longer and you had these other problems at the same time. How old were you when that time started?

In answering the next questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time. During that time, did you feel sad, empty, or depressed for most of the day nearly every day?

  1. Yes
  2. No
  3. Don't know/Refused
During that [TIMEFILL] period of time, did you feel discouraged about how things were going in your life most of the day nearly every day?
  1. Yes
  2. No
  3. Don't know/Refused
During that [TIMEFILL] period of time, did you become bored with almost everything like school, work, hobbies, and things you like to do for fun?
  1. Yes
  2. No
  3. Don't know/Refused
During that [TIMEFILL] period of time, did you feel like nothing was fun even when good things were happening?
  1. Yes
  2. No
  3. Don't know/Refused
In answering these questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time. Did you eat much less than usual almost every day during that time?
  1. Yes
  2. No
  3. Don't know/Refused
Did you eat much more than usual almost every day?
  1. Yes
  2. No
  3. Don't know/Refused
Did you gain weight without trying to during that [TIMEFILL] period of time?
  1. Yes
  2. No
  3. Don't know/Refused
Did you gain weight without trying to because you were growing?
  1. Yes
  2. No
  3. Don't know/Refused
Did you gain weight without trying to because you were pregnant?
  1. Yes
  2. No
  3. Don't know/Refused
How many pounds did you gain?

Did you lose weight without trying to?

  1. Yes
  2. No
  3. Don't know/Refused
Did you lose weight without trying to because you were sick or on a diet?
  1. Yes
  2. No
  3. Don't know/Refused
How many pounds did you lose?

Did you have a lot more trouble than usual falling asleep or staying asleep most nights or waking too early most mornings during that [TIMEFILL] time?

  1. Yes
  2. No
  3. Don't know/Refused
During that [TIMEFILL] period of time, did you sleep a lot more than usual?
  1. Yes
  2. No
  3. Don't know/Refused
On most days during that [TIMEFILL] period of time, did you feel that you didn't have much energy?
  1. Yes
  2. No
  3. Don't know/Refused
Did you feel as though you were talking or moving more slowly than usual on most days during that [TIMEFILL] period of time?
  1. Yes
  2. No
  3. Don't know/Refused
Did anyone else notice that you were talking or moving more slowly than usual?
  1. Yes
  2. No
  3. Don't know/Refused
Were you so restless or jittery that you walked up or down or couldn't sit still?
  1. Yes
  2. No
  3. Don't know/Refused
Did anyone else notice that you couldn't sit still?
  1. Yes
  2. No
  3. Don't know/Refused
On most days during that [TIMEFILL] time, did your thinking seem slower than usual or seem mixed up?
  1. Yes
  2. No
  3. Don't know/Refused
On most days, did you have a lot more trouble than usual keeping your mind on things?
  1. Yes
  2. No
  3. Don't know/Refused
Were you unable to make up your mind about things you ordinarily have no trouble deciding about?
  1. Yes
  2. No
  3. Don't know/Refused
Did you feel that you were not as good as other people nearly every day?
  1. Yes
  2. No
  3. Don't know/Refused
Did you feel totally worthless nearly every day?
  1. Yes
  2. No
  3. Don't know/Refused
The next questions are about thoughts of death or suicide. Did you often think a lot about death, either your own, someone else's, or death in general?
  1. Yes
  2. No
  3. Don't know/Refused
During that time, did you ever think that it would be better if you were dead?
  1. Yes
  2. No
  3. Don't know/Refused
Did you think about killing yourself?
  1. Yes
  2. No
  3. Don't know/Refused
Did you make a plan to kill yourself?
  1. Yes
  2. No
  3. Don't know/Refused
Did you make a suicide attempt or try to kill yourself?
  1. Yes
  2. No
  3. Don't know/Refused
You mentioned having some of the problems I just asked you about. During that [TIMEFILL] period of time, how much did your [FEELNOUN] interfere or cause problems with your school work, your job, or your relationships with family and friends?
  1. Not at all
  2. A little
  3. Some
  4. A lot
  5. Extremely
  6. Don't know/Refused
How often were you unable to carry out your daily activities or to take care of yourself because of these problems with your mood?
  1. Often
  2. Sometimes
  3. Not very often
  4. Never
  5. Don't know/Refused
Think of the very first period of time in your life lasting two weeks or longer when you [FEELFILL] and also had some of the other problems we just asked about. Can you remember your exact age?
  1. Yes
  2. No
  3. Don't know/Refused
How old were you?

About how old were you when you first had a period of time like this?

In your entire life, how many times did you feel [FEELNOUN] for two weeks or longer while also having some of the other problems we asked about? If you are not sure of your answer, just make your best guess.

In the past 12 months, did you have a period of time when you felt [FEELNOUN] for two weeks or longer while also having some of the other problems we asked about?

  1. Yes
  2. No
  3. Don't know/Refused
Think about the time in the past 12 months when [NUMPROBS] with your mood [WASWERE] the worst. Using the 0 to 10 scale shown below, where 0 means no problems and 10 means very severe problems. How much did your [FEELNOUN] cause problems with your chores at home?

During that time in the past 12 months when your [FEELNOUN] was worst, how much did this cause problems with your ability to do well at school or work?

How much did your [FEELNOUN] cause problems with your ability to get along with your family during that time?

How much did your [FEELNOUN] cause problems with your ability to have a social life during that time?

About how many days out of 365 in the past 12 months were you totally unable to go to school or work or carry out your normal activities because of your [FEELNOUN]?

At any time in the past 12 months, did you see or talk to a medical doctor or other professional about your [FEELNOUN]?

During the past 12 months, which professionals did you see or talk to about [NUMPROBS] with your mood?

  1. General practitioner or family doctor
  2. Other medical doctor like a cardiologist, gynecologist, urologist
  3. Psychologist
  4. Psychiatrist or psychotherapist
  5. Social Worker
  6. Counselor
  7. Other mental health professional, like a mental health nurse
  8. A nurse, occupational therapist, or other health professional
  9. A religious or spiritual advisor like a minister, priest, or rabbi
  10. An herbalist, chiropractor, acupuncturist, or massage therapist
  11. Another type of helping professional
  12. Don't know/Refused
Are you currently receiving treatment or counseling for [NUMPROBS] with your mood?
  1. Yes
  2. No
  3. Don't know/Refused
During the past 12 months, did you take prescription medication that was prescribed for [NUMPROBS]?
  1. Yes
  2. No
  3. Don't know/Refused
Are you currently taking prescription medication that was prescribed for [NUMPROBS]?
  1. Yes
  2. No
  3. Don't know/Refused
During the past 12 months, how much has this prescription medication helped you?
  1. Not at all
  2. A little
  3. Some
  4. A lot
  5. Extremely
  6. Don't know/Refused
During the past 12 months, how much has treatment or counseling helped you?
  1. Not at all
  2. A little
  3. Some
  4. A lot
  5. Extremely
  6. Don't know/Refused

Methodology notes

The Major Depressive Episode (MDE) statistics are annual (last twelve month) prevalence rates. A modified version of the Composite International Diagnostic Interview is administered to assess criteria necessary for a diagnosis of MDE based on DSM IV for adolescents. A person was defined as having had an MDE if he or she had a period of time in the past 12 months when he or she felt depressed or lost interest or pleasure in daily activities for 2 weeks or longer, and had at least five or more of the following nine symptoms in the same 2-week period, in which at least one of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day, nearly every day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day; (3) significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day; (4) insomnia or hypersomnia nearly every day; (5) psychomotor agitation or retardation nearly every day; (6) fatigue or loss of energy nearly every day; (7) feelings of worthlessness nearly every day; (8) diminished ability to think or concentrate or indecisiveness nearly every day; and (9) recurrent thoughts of death or recurrent suicide ideation. This definition is based on the definition found in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).


1. Effect size h=0.1 was chosen to correspond with 10% improvement from a baseline of 50%.