Sexual Orientation and Estimates of Adult Substance Use and Mental Health

A new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) for the first time uses data from SAMHSA’s National Survey on Drug Use and Health (NSDUH) focuses on patterns of substance use and mental illness among adults (aged 18 and older) of different sexual orientations. Overall, the report finds that adults who identify as lesbian, gay or bisexual (sexual minority adults) have higher prevalence of substance use and mental illness than adults who identified themselves as heterosexual (sexual majority adults). However, sexual minority adults were significantly more likely than sexual majority adults to receive needed treatment for mental illness and substance use disorders.

The report finds that 4.3 percent of the adult population, aged 18 or older, identify as lesbian, gay or bisexual. It is important to note that the report does not address the behavioral health of transgender or questioning people because the NSDUH does not currently include questions identifying those populations. The report was undertaken as part of SAMHSA’s ongoing effort to better gauge the behavioral health needs of all segments of the population.

“This report offers unprecedented insight into the behavioral health needs of lesbian, gay, and bisexual Americans – people critical to our community whose health concerns have often been overlooked,” SAMHSA Deputy Principal Administrator Kana Enomoto. “SAMHSA is working on efforts to reduce the impact of substance use and mental illness among LGBTQ Americans.”

Sexual minority adults were more likely to use illicit drugs, alcohol, and cigarettes than sexual majority adults. Sexual minority adult past year illicit drug use was higher than the prevalence of sexual majority adults (39.1 percent versus 17.1 percent). The higher prevalence of illicit drug use among sexual minority adults was also seen across age and gender groups, as well as among users of different illicit drugs.

Past month cigarette smoking was higher among sexual minority adults than among sexual majority adults (32.2 percent versus 20.6 percent), and this difference was seen across age and gender groups. However, sexual minority adults were less likely to be daily cigarette smokers than sexual majority adults (51.6 percent versus 59.6 percent).

Among those who needed substance use treatment, sexual minority adults were significantly more likely than sexual majority adults to receive needed treatment for substance use disorders. In the past year, 15.3 percent of sexual minority adults needing substance use treatment received it at a specialty facility, as compared to 10.6 percent of sexual majority adults needing treatment.

Sexual minority adults were more than twice as likely as sexual majority adults to have experienced any kind of mental illness in the past year (37.4 percent versus 17.1 percent). They also had a higher prevalence of past year serious mental illness than their sexual majority counterparts (13.1 versus 3.6 percent). Serious mental illness is defined as a mental, behavioral, or emotional disorder which substantially interferes with, or limits, one or more major life activities.

Among adults who have experienced any kind of mental illness in the past year, sexual minority adults were more likely to receive mental health treatment in the past year as sexual majority adults (48.5 percent versus 42.6 percent).

Population of focus: Lesbian, gay, and bisexual adults

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Date: 2016

Organization: Substance Abuse and Mental Health Services Administration