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This section provides an overview of the prevalence rates applied to 2000 Census data (the most recent census) for Georgia in order to generate county prevalence estimates. These estimates were generated by Dr. Charles Holzer of the Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch. His estimates are based on the National Comorbidity Survey and a set of SED studies commissioned by the Centers for Medicare and Medicaid Services (CMS) and published in the Federal Register. These studies have found prevalence to be related to such factors as gender, poverty, race, marital status, educational status, age, and type of residence (household vs. group or institutional living). The estimation methodology divides county Census data into 8100 cells representing the different combinations of the above listed characteristics. Then the appropriate prevalence rate for people with those characteristics is applied. The prevalence for all the cells is then rolled up to provide an estimated prevalence for the county and then state totals.4 The data is classified in a way that also allows stratification estimates by such characteristics as race, age, education, etc.

The following table shows Georgia’s prevalence rates for different subpopulations using this method of estimation. Detailed accounts of Prevalence can be found in APPNEDICES III-3 – III-6. Georgia’s overall rate using this method is 6.7%, with youth 17 and under having a somewhat higher rate and adults a somewhat lower rate. Youth rates varied little by age group, while adults experienced a rate exceeding 10% between ages 18 and 20, largely falling through the rest of adulthood and reaching a low of 5% at about age 50 and rising slightly thereafter. Genders differed little between boys and girls, but women had a considerably higher rate, almost 8%, than men, at only 5%.

Table III-3

Georgia Rates of Prevalence for Serious Emotional Disturbance and Serious Mental Illness

Using Holzer Estimation Methods

Total Population - All ages 6.69%

4 _{See http://psy.utmb.edu./estimation/estimation.htm for additional description of the methodology and sources used in} these estimates.

Georgia Mental Health Gap Analysis

- 30 - Table III-3

Georgia Rates of Prevalence for Serious Emotional Disturbance and Serious Mental Illness

Using Holzer Estimation Methods

Youth Adults

Age Percent Age Percent

Youth total 7.4% Adult total 6.43%

0-5 7.44% 18-20 10.32% 6 -11 7.35% 21-24 7.85% 12-17 7.43% 25-34 5.86% 35-44 7.39% 45-54 4.99% 55-64 5.28% 65+ 5.97%

Gender Youth age 0-17 Adults age 18 and older

Male 7.43% 5.07%

Female 7.38% 7.71%

Ethnicity Youth age 0-17 Adults age 18 and older

1.White-NH 6.95% 6.27% 2.African Am-NH 8.05% 6.77% 3.Asian-NH 7.10% 5.74% 4.Pacific I-NH 10.29% 9.79% 5.Native-NH 7.71% 4.48% 6.Other-NH 8.03% 8.86% 7.Multi-NH 7.53% 7.60% 8.Hispanic 7.94% 6.79%

Poverty level Youth age 0-17 Adults age 18 and older

1.Below 100% 10% 11.4%

2.100%-199% 8% 7.42%

3.200%-299% 7% 5.74%

4.300%+ pov 6% 4.57%

5.Undefined 12.7% 19.44%

Residence Youth age 0-17 Adults age 18 and older

Household 7.34% 6%

Institution 21.16% 25.8%

Group 9.7% 8.31%

Marital status Youth age 0-17 Adults age 18 and older

Married 4.55%

Sep/Wid/Div 10.83%

Single 7.29%

Education Youth age 0-17 Adults age 18 and older

Grades 00-11 9.76%

HS graduate 6.45%

Georgia Mental Health Gap Analysis

- 31 - Table III-3

Georgia Rates of Prevalence for Serious Emotional Disturbance and Serious Mental Illness

Using Holzer Estimation Methods

Source: Series P5 Estimates of Need for Mental Health Services For Georgia for Serious Mental Illness (wsmi01 ) for 2000 Index for Population all ages

http://psy.utmb.edu/p5profile_htm/Georgia/p5wsmi01_caindex1.htm

Among children, Georgia’s major ethnic groups showed some differences, with African Americans, Hispanics, Pacific Islanders, and Native Americans all showing elevated rates, of at least a half percentage above the state average. In contrast, white children experienced rates somewhat lower than the state average. Georgia’s major ethnic groups did not show great variation among adults. African-Americans and Hispanics were very close to the overall state average while Caucasians were somewhat less. Pacific Islanders, a small group in Georgia, showed highly elevated rates.

Prevalence rates increased with rates of poverty, with individuals lower than 200% of the federal poverty level having higher than average rates, and those with incomes higher than 200% of FPL, having lower than average rates.

People living in institutions, which includes nursing homes, prisons and hospitals -including psychiatric hospitals - had highly elevated prevalence rates. People living in group quarters, primarily college dormitories and military quarters, had somewhat elevated rates while the bulk of the population which lives in households had rates somewhat below average. Married adults experienced a much lower than average rate of serious mental illness

compared to those who are single and whose rates are somewhat above average, while those who are separated, divorced, and widowed had rates that were considerably elevated.

Finally, the higher the level of education of an individual, the lower the incidence of SMI. Adults who graduated from college have the lowest incidence of any subgroup measured in this table. High school graduates have average incidence, and those with less than a high school education have an elevated incidence.

Implications

The subpopulations in Georgia with particularly high prevalence are: Young adults

Adult females Pacific Islanders Non-white children

Georgia Mental Health Gap Analysis

- 32 - Individuals of all ages below 200% of poverty People living in institutions and group quarters Adults who are separated, divorced or widowed Adults with less than a high school education.

With this data, the state is in position to evaluate how well it is reaching these high need groups and whether the services they get are meeting their needs.