2019-22 National Mental Health Services Survey (N-MHSS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Full Scale - Paper Facilities Universe in 2020 and 2022	Form and Instruction	Modified	Available
Form Locator Survey Locator Survey 2021	Form and Instruction	Modified	Available
Form Locator Survey New Facilities 2017-19	Form and Instruction	Modified	Available
Attachment A.10_2020 N-MHSS Definitions Packet_1_9_2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.9_2020 N-MHSS Frequently Asked Questions (FAQs)_1_9_2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.7_2020 N-MHSS Cover Letter (First Mailing)_1_9_2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.6_2020 N-MHSS Advance Letter_1_9_2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.4_2021 N-MHSS Web Screens for Online Questionnaire_1_9_2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.3_2020 N-MHSS Web Screens for Online Questionnaire_1_9_2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.2a_Changes to Questionnaire_2019 and 2021 N-MHSS_1-9-2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.2_2021 N-MHSS-Locator Survey Paper Questionnaire_also for Between-Survey Update_1_9_2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.1a_Changes to Questionnaire_2018 and 2020 N-MHSS_1-9-2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Attachment A.1_2020 N-MHSS (Full-Scale) Paper Questionnaire_1_9_2020.docx	Supplementary Document	Uploaded 2020-01-14	Available
Others.pdf	Supplementary Document	Uploaded 2019-10-29	Available
Letters.pdf	Supplementary Document	Uploaded 2019-10-29	Available
WebScreens.pdf	Supplementary Document	Uploaded 2019-10-29	Available
Changes.pdf	Supplementary Document	Uploaded 2019-10-29	Available
2020 N-MHSS_OMB SS_Part B_10.29.19.docx	Supporting Statement B	Uploaded 2019-10-29	Available
2020 N-MHSS_OMB SS_Part A_10.29.19.docx	Supporting Statement A	Uploaded 2019-10-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7528	Facilities Universe in 2020 and 2022	Form and Instruction	Modified
209518	Locator Survey 2021	Form and Instruction	Modified
202152	New Facilities 2017-19	Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0119	ICR Reference No: 201910-0930-002
Status: Active	Previous ICR Reference No: 201612-0930-001
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 21018
Title: 2019-22 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 with change	Conclusion Date: 01/21/2020
	Date Received in OIRA: 12/02/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2023	36 Months From Approved	01/31/2020
Responses	35,700	0	35,700
Time Burden (Hours)	20,604	0	9,724
Cost Burden (Dollars)	0	0	0

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Abstract: The 2019-22 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.

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

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 51609	09/30/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 65830	11/29/2019
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
New Facilities 2017-19	Locator Survey	Locator Survey
Facilities Universe in 2020 and 2022	Full Scale - CATI, Full Scale - Paper	Full Scale - Paper ,   Full Scale - CATI
Locator Survey 2021	Locator Survey	Locator Survey

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ICR Summary of Burden

table that charts list 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	35,700	35,700	0	0	0	0
Annual Time Burden (Hours)	20,604	9,724	0	10,880	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 average annual burden hours for the full-scale 2019 N-MHSS Survey is 9,724 hours based on an estimated response time of 25 minutes for an estimated 17,000 facility respondents. SAMHSA/CBHSQ is now requesting an average annual total burden of 11,118 hours for the N-MHSS. This increase of 1,394 hours is due to the survey versions included in this request (two full-scale and one abbreviated, as opposed to two abbreviated and one full-scale in the prior request). 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 2020 and 2022, an estimated response time of 25 minutes for an estimated 17,000 facility respondents in the Locator Survey in 2021, and an estimated response time of 25 minutes for an estimated 1,700 facility respondents in the Between-Survey Update in 2020, 2021, and 2022.

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Annual Cost to Federal Government: $2,750,000

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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

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Common Form ICR:  No

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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: 12/02/2019

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