Glossary

Notes on Terminology Used

Various terms are used to describe mental health, mental illness, substance use disorder and other addictions, as well as the populations who face these conditions and the services provided to treat them. In this section, we explore these terms and offer context for some of the choices we have made for our project. We provide our definitions and interpretations of these terms to clarify their meaning in the reports and minimize confusion. 

Behavioral Health and MHSUD

In the research literature and policy space, the phrases “behavioral health conditions” and “mental health and substance use disorders” are sometimes used interchangeably, but these related terms can have distinct meanings:

Behavioral Health (BH) conditions broadly encompasses both mental health and substance use disorders. It refers to the connection between behaviors and overall health, including how mental health conditions, substance use, and behaviors impact an individual’s overall well-being. BH conditions can also refer to behavioral problems that may not necessarily fall under a specific mental health diagnosis but still impact a person’s life, such as eating disorders, or compulsive behaviors.

Mental Health and Substance Use Disorders (MHSUD) refers to issues related to mental health conditions and substance use problems.

To remain consistent with the majority of existing research literature and the policy conversation, we have chosen to refer to the workforce who treat this wide range of conditions as the “behavioral health workforce” or BH workforce. 

Given that our reports’ scope will be limited to examining access issues for people with mental health conditions, such as mood disorders and substance use disorders, we will use the term “MHSUD” to generally refer to the broader set of conditions and services. For example, you might see a statement such as the following: the existing BH workforce treats a variety of MHSUD conditions.

Patient Population

In the research literature, policy, and advocacy, several terms have been used to refer to individuals experiencing MHSUD conditions, such as “client,” “consumer,” or “patient.” Countless other outdated, derogatory terms exist to stigmatize people with MHSUD, whose use is discouraged by leading organizations in the BH field. We avoid the use of this stigmatizing language and try to use person-first language when referring to people with MHSUD conditions wherever appropriate. We use the term “patient” when referring to the relationship that a person with a MHSUD condition has with a behavioral health provider to acknowledge the provider-patient relationship.

Medication Treatment for Substance Use Disorders

People experiencing substance use disorders often require medication to mitigate withdrawal symptoms and drug dependency. Several terms are used to refer to this process, including detox, withdrawal management, and medically managed detoxification. Wherever applicable, we refer to this treatment as “medically managed withdrawal” or MMW.

Key Definitions

Alcohol use disorder	Alcohol use disorder is a condition caused by patterns of alcohol consumption that lead to prolonged intoxication, harmful use, dependence, and/or extreme withdrawal
Behavioral health	Behavioral health (BH) encompasses both mental health and substance use issues. It refers to the connection between behaviors and overall health, including how mental health conditions, substance use, and behaviors impact an individual’s overall well-being. Behavioral health includes mental health, substance use, behavioral issues, life stressors, crises, and stress-related physical symptoms
Behavioral health conditions	Behavioral health conditions are a broad range of conditions that affect an individual’s thoughts, mood, and behavior to the extent that their day-to-day function is impaired. These conditions are defined by the DSM-5 and diagnosed by specialized professionals. Throughout this research, we refer to these conditions as mental health and substance use (MHSUD) conditions to reflect our focus on those sub-domains of behavioral health.
Co-occurring disorders	Individuals with more than one behavioral health condition or diagnosis are referred to as having co-occuring conditions or disorders. For example, substance use disorders often co-occur with mood disorders.
Counselors	Behavioral health counselors are a sub-group of behavioral health providers who offer specialized treatment, such as psychotherapy, for individuals with MHSUD conditions. Often these providers cannot prescribe medication, but can collaborate with prescribers. “Counselors” is a broader term that is used to collectively refer to several provider types, including licensed professional counselor, licensed alcohol counselor, drug abuse counselor, and others.
Developmental disorders	Developmental disorders encompass conditions associated with intellectual disability, such as Asperger’s, autism spectrum disorder, attention-deficit hyperactivity disorder, impulse control disorder, and others. These conditions often onset at childhood and may impair brain and nervous system development and maturation. While developmental disorders fall within the umbrella of behavioral health conditions, they are outside the scope of this research.
Integrated care	Integrated care refers to the coordinated delivery of physical and mental health care, often involving collaboration between primary care providers and behavioral health specialists to improve patient outcomes by addressing both physical and psychological needs in a unified treatment plan.
Medication assisted treatment (MAT)	Medication assisted treatment (MAT) is a type of SUD/AUD treatment that relies on the use of FDA-approved medication. These medications, most commonly methadone and buprenorphine, are paired with counseling and therapy.
Paraprofessionals	Paraprofessionals are a sub-group of behavioral health providers with lived experience in recovery who provide non-clinical support, guidance, and mentorship to those struggling with mental health and substance use disorders, complementing professional treatment services. Paraprofessionals include peer support workers, community health workers, behavioral health technicians, and others.
Prescribers	Prescribers are a sub-group of behavioral health providers who are qualified to prescribe behavioral health-related medications. Though qualifications may vary by state and local laws, this category often includes psychiatrists, nurse practitioners, primary care physicians, psychiatric pharmacists, and physician assistants.
Stigma	Stigma refers to the culturally-imposed negative qualities and/or characteristics that may be associated with individuals who experience behavioral health conditions. Stigma can often lead to social exclusion and discrimination for individuals with behavioral health conditions and the professionals who treat these conditions, which can delay care and treatment.
Substance use disorder	Substance use disorder is caused by a continued substance use despite negative effects to an individual, to the extent that the individual is periodically or chronically intoxicated, compulsively takes the substance (or substances), and has difficulty stopping or modifying substance use.