2014-16 National Mental Health Services Survey (N-MHSS)

Forms and Documents

Document Name	Status
Form 2014 N-MHSS (Full- Facilities Universe in 2014 and 2016 Form and Instruction	Modified
Form 2015 N-MHSS-Locato Locator Survey 2015 Form and Instruction	New
Form 2015 N-MHSS-Locato New Facilities 2014-16 Form and Instruction	Modified
2014 N-MHSS_OMB SS-B_112513.docx Supporting Statement B	2013-11-25
Attachment A12 - List of Expert Panel Members_Nov 2011.docx Supplementary Document	2013-11-25
Attachment A11 - 2014 N-MHSS Online Information Site Materials_Page 1.docx Supplementary Document	2013-11-25
Attachment A11 - 2014 N-MHSS Online Information Site Materials_FAQs.docx Supplementary Document	2013-11-25
Attachment A10 - 2014 N-MHSS Thank You Notification for Completed Surveys.docx Supplementary Document	2013-11-25
Attachment A9 - 2014 N-MHSS Cover Letter (Second Mailing) and Online Questionnaire Access Instructions_Pg 2.docx Supplementary Document	2013-11-25
Attachment A9 - 2014 N-MHSS Cover Letter (Second Mailing) and Online Questionnaire Access Instructions_Pg 1.docx Supplementary Document	2013-11-25
Attachment A8 - 2014 N-MHSS Second Thank You-Reminder Letter.docx Supplementary Document	2013-11-25
Attachment A7 - 2014 N-MHSS First Thank You-Reminder Letter.docx Supplementary Document	2013-11-25
Attachment A6 - 2014 N-MHSS Cover Letter (First Mailing) and Online Questionnaire Access Instructions_Pg 2.docx Supplementary Document	2013-11-25
Attachment A6 - 2014 N-MHSS Cover Letter (First Mailing) and Online Questionnaire Access Instructions_Pg 1.doc Supplementary Document	2013-11-25
Attachment A5 - 2014 N-MHSS Advance Letter.docx Supplementary Document	2013-11-25
Attachment A3 - 2014 N-MHSS Web Screens for Online Questionnaire.docx Supplementary Document	2013-11-25
Attachment A4 - 2014 N-MHSS CATI Questionnaire.docx Supplementary Document	2013-11-25
2014 N-MHSS_OMB SS-A_112513.docx Supporting Statement A	2013-11-25

IC Document Collections

IC ID	Document Title	Status
7528	Facilities Universe in 2014 and 2016 Form and Instruction	Modified
209518	Locator Survey 2015 Form and Instruction	New
202152	New Facilities 2014-16 Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0119	ICR Reference No: 201311-0930-002
Status: Historical Active	Previous ICR Reference No: 201205-0930-001
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 21018
Title: 2014-16 National Mental Health Services Survey (N-MHSS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/27/2014
	Date Received in OIRA: 11/27/2013
Terms of Clearance: SAMHSA shall consider a sampling approach for the facility characteristics information of the universe survey or demonstrate other means of reducing the burden of the information collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved	06/30/2015
Responses	20,400	0	16,500
Time Burden (Hours)	20,604	0	6,930
Cost Burden (Dollars)	0	0	0

---

Abstract: The 2014-16 N-MHSS differs from the previous version of the survey in the following ways: (a) to facilitate completing the survey online, definitions of terms and other survey information will be offered at the survey website; (b) the eligibility criteria for inclusion in the survey, previously outlined in a flyer accompanying the survey, have now been incorporated into the questionnaire as screening questions; and (c) the questionnaire has been reorganized for greater simplicity and shortened by eliminating several questions identified as no longer relevant.

---

Authorizing Statute(s): US Code: 42 USC 505 Name of Law: Data Collection
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 54902	09/06/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 67377	11/12/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Facilities Universe in 2014 and 2016	2014 N-MHSS (Full-Scale) Paper Questionnaire	2014 N-MHSS (Full-Scale) Paper Questionnaire
New Facilities 2014-16	2015 N-MHSS-Locator Survey Paper Questionnaire	2015 N-MHSS-Locator Survey Paper Questionnaire
Locator Survey 2015	2015 N-MHSS-Locator Survey Paper Questionnaire	2015 N-MHSS-Locator Survey Paper Questionnaire

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	20,400	16,500	0	3,900	0	0
Annual Time Burden (Hours)	20,604	6,930	0	13,674	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Currently, the total annual burden hours for the abbreviated 2012 N-MHSS-Locator Survey is 6,930 hours based on an estimated response time of 25 minutes for an estimated 16,500 facility respondents. SAMHSA/CBHSQ is now requesting a total annual burden of 11,594 hours for the N-MHSS. The increase of 4,664 hours is due to a program change. The number of mental health facilities is derived from an expanded search of departments/offices within each state with responsibility for the funding or licensing of mental health treatment facilities; of national and regional accreditation entities; and other national provider organizations and associations. This number is based on an estimated response time of 45 minutes for an estimated 17,000 facility respondents in the full-scale survey in 2014 and 2016, an estimated response time of 25 minutes for an estimated 17,000 facility respondents in the Locator Survey in 2015, and an estimated response time of 25 minutes for an estimated 1,700 facility respondents in the Between-Survey Update in 2014, 2015, and 2016. The increase is also due to the N-MHSS Between-Survey Update activity which identifies and collects data from new facilities on a rolling basis throughout the year.

---

Annual Cost to Federal Government: $2,640,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/27/2013

---