How Many Nursing Home Residents Live with a Mental Illness?

A number of data sets can be used to estimate the size of the nursing home population with mental illness; however, estimates vary because of differences in data collection. The 2004 National Nursing Home Survey (NNHS) estimates that 6.8 percent of nursing home residents had a primary diagnosis of mental illness in that year (6.0 percent of those 65 and older, and 12.9 percent of those under 65). Comparable populations in the Medicaid Analytic eXtract (MAX) data set had fewer mental illness diagnoses, and those in the nursing facility Minimum Data Set (MDS) had more. The authors conclude that the estimates from the NNHS are more reliable, but they are available only at the national level. State- and facility-level estimates would have to be generated with the MDS or MAX data sets, with users being aware of differences in recorded diagnoses among the three, especially the relatively limited diagnoses in the MAX and imprecise diagnoses in the MDS.