MH-CLD, while providing valuable information about mental health service use, does not represent the total national demand for mental health treatment or describe the mental health status of the national population. MH-CLD is a compilation of client-level data from facilities that SMHAs operate.
Different factors affect which types of facilities provide data, including differences in state licensure, certification, accreditation, and disbursement of public funds. For example, some SMHAs regulate private facilities and individual practitioners, while others do not. Moreover, in some states, mental health services are provided in correctional facilities under the guidance of mental health agencies, while in other states they are not.
Up to three mental health diagnoses per individual can be reported to MH-TEDS or MH-CLD. These diagnoses may not reflect all diagnoses for people served. Furthermore, some individuals have no valid mental health diagnosis reported. If the missing diagnosis is not randomly distributed across facilities, estimated prevalence rates of mental health diseases may be biased.