The Changing Face of Community-Based Mental Health Care: Changes in the Types of Community-Based Mental Health Services Available from 2014 to 2020

The Changing Face of Community-Based Mental Health Care: Changes in the Types of Community-Based Mental Health Services Available from 2014 to 2020

Research Data Brief
Published: Jun 30, 2021
Publisher: Mathematica and Eagle Technologies
Associated Project

National Surveys of Mental Health and Substance Use Disorder Treatment Facilities

Time frame: 2016-2021

Prepared for:

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration


Luke Horner

Key Findings
  • The percentage of community-based mental health facilities offering standard treatment services, rehabilitation and support services, and many evidence-based practices has changed little since 2016. Even so, the need for mental health care has increased during the same time period, suggesting that these mental health services have become less available relative to need over the past five years.
  • The most commonly offered services, offered by more than two-thirds of facilities in 2020, were standard treatment services (behavior modification, case management, couples or family therapy, individual and group therapy, and psychotropic medication), cognitive behavioral therapy, and family psychoeducation. In addition, more than half of facilities offered dialectical behavioral therapy, integrated treatment for co-occurring disorders, and screening for tobacco use.
  • Fewer than a third of facilities offered education, housing, and vocational rehabilitation services; evidence-based practices including assertive community treatment, illness management and recovery, intensive case management, supported employment, and supported housing; psychiatric emergency walk-in services; diet and exercise counseling; mental health treatment programs or groups dedicated to eating disorders; and therapeutic foster care.

In recent years, stakeholders have perceived, and research has suggested, that community-based specialty mental health care has become less available over time. Little is known, however, about how changes over time in the availability of community-based care might vary by the type of services offered. In this brief, we use data from National Mental Health Services Survey (N-MHSS) to document changes from 2014 to 2020 in the availability of various community-based mental health services.

For these analyses, we define community-based mental health services as those offered by specialty mental health facilities that provide treatment in less-than-24-hour outpatient, partial hospitalization, or day treatment settings. N-MHSS excludes jails, prisons, and detention centers that provide treatment exclusively for people who are incarcerated or juvenile detainees. Because we aimed to assess the availability of services for the general public, we also excluded Veterans Administration medical centers and health care facilities. Our analysis period begins with 2014 because the procedures for identifying facilities for N-MHSS, which began in 2010, did not stabilize until 2014. In all cases, changes over time in the number of facilities offering each type of service (data not shown) mirror the patterns shown for percentages of facilities offering these services.

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