Other Specific Populations

Learn how SAMHSA’s programs and initiatives work to improve the behavioral health of LGBT people, veterans, people experiencing homelessness, and other specific population groups.

SAMHSA has a number of programs, initiatives, and resources available for people who are in specific settings or circumstances, including those living in rural areas, people experiencing homelessness, those involved with the criminal justice system, and veterans and military families.

Lesbian, Gay, Bisexual, and Transgender (LGBT) Individuals

LGBT people are members of every community. They are diverse, come from all walks of life, and include people of all races and ethnicities, all socioeconomic statuses, and are from all parts of the country. According to the Williams Institute’s review, conducted in 2011, an estimated 3.5% of adults in the United States identified themselves as lesbian, gay, or bisexual and an estimated 0.3% of adults are transgender. The review reported that there are approximately 9 million LGBT Americans.

Although there is a paucity of national data, more than a decade of research indicates LGBT populations have been associated with high rates of alcohol consumption and substance abuse. The American Lung Association reports that LGBT individuals are also more likely to use tobacco than the general population, with some studies estimating smoking rates as much as double the national average.

LGBT people, especially youth, also experience high levels of mental disorders such as anxiety, depression, and suicidal thoughts. LGBT youth are at high risk for suicide attempts and completions. Suicide is a particular concern for transgender people. In the largest national survey of transgender adults to date, 41% of respondents reported having attempted suicide.

Learn more about how SAMHSA addresses health equity for LGBT people at the Health Disparities topic.

SAMHSA developed the toolkit Top Health Issues for LGBT Populations – 2012 to equip practitioners and educators on the behavioral health issues facing this population group. SAMHSA also developed a Practitioner’s Resource Guide – 2014 (PDF | 1.4 MB) to assist families in supporting their LGBT children.

People Who Live in Rural Areas

Rural America makes up 90% of the U.S. landmass and is home to about one-fourth of the population.

In 2014, the rate of current illicit drug use in the past month among people ages 12 and up was 10.6% in large metropolitan areas, 10.2% in small metropolitan areas, and 8.6% in non-metropolitan areas. Within non-metropolitan areas, the rate was 9.6% in urbanized counties, 8.4% in less urbanized counties and 5% in completely rural counties. Rates for illicit drug or alcohol dependence or abuse among people ages 12 and up in 2014 were similar in large metropolitan areas (8.4%) and small metropolitan areas (8.2%), but were higher than in non-metropolitan areas (6.9%).

In 2014, the rates of past-month alcohol use among people ages 12 and up in large and small metropolitan areas (55.2% and 51.4%, respectively) were higher than in non-metropolitan areas (46%). Rates of binge drinking were similar in large and small metropolitan areas (23.5% and 22.8%, respectively). However, binge drinking among people ages 12 and up was less prevalent in non-metropolitan areas (22.8%) than in large metropolitan areas. In 2013, roughly 1 in 9 youth ages 12 to 17 were current alcohol users, regardless of whether they were in large metropolitan, small metropolitan, or non-metropolitan areas (11.9%, 11%, and 11.2%, respectively).

According to 2012 SAMHSA treatment episode data (PDF | 466 KB), rural admissions to substance abuse facilities were more likely than urban admissions to report primary abuse of alcohol (49.5% vs. 36.1%) or non-heroin opiates (10.6% vs. 4.0%). Urban admissions were more likely than rural admissions to report primary abuse of heroin (21.8% vs. 3.1%) or cocaine (11.9% vs. 5.6%).

SAMHSA’s Community Conversations About Mental Health is a toolkit that provides information on how to hold a community dialogue about mental health issues and to set goals for improving local services.

SAMHSA’s Strategic Initiative on recovery support focuses on health, home, and community. The Recovery Community Services Program responds to the need for peer-to-peer recovery support services that help prevent relapse and promote sustained recovery from alcohol and substance use disorders.

SAMHSA’s National Frontier and Rural Addiction Technology Transfer Center(link is external) offer brochures, fact sheets, guides, and toolkits to help you learn more about the rural population and its special issues and needs.

People Experiencing Homelessness

In the United States in 2013, more than 600,000 people experienced homelessness.

These individuals are at greater risk of infectious and chronic illness, poor mental health, and substance abuse, as well as being victims of violence, compared to the general population. The mortality rate for people classified with chronic homelessness is four-to-nine times higher than for the general population.

Learn more about how SAMHSA addresses behavioral health issues related to homelessness at the Homelessness and Housing topic.

People Involved with the Criminal Justice System

In 2012, an estimated 1.5 million adults ages 18 and up were on parole or other supervised release from prison at some time during the past year. People within the criminal justice system face high rates of infectious and chronic illness, and mental health and substance use disorders. In 2013, adults aged 18 or older who were on parole or a supervised release from jail during the past year had a higher rate of illicit drug use or alcohol dependence or abuse (31.7%) than their counterparts who were not on parole or supervised release during the past year (8.3%). Among adults on parole or supervised release in the past year, the percentage having any mental illness (AMI) was 33.5%, which was higher than the percentage having AMI among adults who were not on parole or supervised release in the past year (18.1%). Learn more about this group and SAMHSA’s activities at the Criminal and Juvenile Justice topic.

Veterans and Military Families

There are about 23.4 million veterans living in the United States, most of whom are male. Patterns of mental health and substance use disorders among veterans and active military personnel is a growing area of research. Available data show, however, that this population experiences high rates of post-traumatic stress disorder (PTSD) and depression. In the 5 years from 2005 to 2009, more than 1,100 members of the Armed Forces took their own lives, an average of 1 suicide every 36 hours.

SAMHSA’s National Suicide Prevention Lifeline(link is external), a 24-hour toll-free, confidential hotline, has helped more than 6 million people since its inception in January 2005. People from anywhere in the United States can call 1-800-273-TALK (8255) to be routed to the closest crisis center within Lifeline’s network of more than 160 crisis centers. Through a SAMHSA/Department of Veterans Affairs (VA) collaboration that began in FY 2007, more than 1,200 veterans, service members, and their families call the Lifeline number each day, press “1” at the prompt, and are connected to professional VA counselors. The “Veterans Crisis Line” is referred to as the “Military Crisis Line” when promoted to active duty service members, National Guard members, and reservists, so that they and their families will also know that they are welcome to use the service.

Learn more about how SAMHSA addresses the behavioral health of veterans and military families at the Veterans and Military Families topic.

Last Updated: 10/09/2015