Surgeon General addresses mental illness

According to the Surgeon General's report on mental illness, nearly half of all Americans who have a severe mental illness don't seek treatment, despite the range of well-documented, effective treatments that exist for most mental health disorders.

The 500-plus page report - the first ever of its kind - also looked at the connection between mental health and physical health, barriers to receiving mental health treatment and the specific mental health issues of children, adults and the elderly.

"Mental health is fundamental to a person's overall health, indispensable to personal well-being and instrumental to leading a balanced and productive life," said Surgeon General David Satcher. "While there is no single solution to any mental disorder, most people with mental disorders have treatment options – including medications and short-term psychotherapy, and community-based supportive services."

Mental disorders are defined in the report as diagnosable conditions that impair thinking, feeling and behavior and interfere with a person's capacity to be productive and enjoy full relationships. The report uses the term mental illness to refer collectively to all diagnosable mental disorders.

According to Satcher, revolutions in science and service delivery over the last two decades have broadened understanding of mental illness and health and improved the way care for mental health is provided.

"The report confirms that research about the complex workings of the brain has armed us with the knowledge needed to deliver effective treatment and better services for most mental disorders," said Health and Human Services secretary Donna Shalala. "This report also provides us with an unparalleled opportunity to dispel the myths and stigma surrounding mental illness."

Problems and solutions

The complex and fragmented health service mental health delivery system can create barriers to a full range of appropriate services for the 15% of the U.S. adult population that use some form of mental health service in any year, said the report. Financial barriers and stigma also serve as deterrents to the receipt of appropriate and necessary care. These factors result in a gap between what research has shown to be optimally effective treatments and what many people receive in actual practice settings.

To remedy these problems, the report proposes broad courses of action that will improve the quality of U.S. mental health care. The actions include continuing to build the science base, overcoming stigma, improving public awareness of effective treatment, ensuring the supply of mental health services and providers, ensuring delivery of state-of-the-art treatments, tailoring treatment to age, gender, race and culture, facilitating entry into treatment and reducing financial barriers to treatment.

The National Mental Health Association praised the report, but warned that it was worthless if the recommendations were not put into effect. "The Surgeon General points out the extraordinary advances in treatments that have occurred in recent years," said Michael Faenza, president and CEO of the NMHA. "They don't mean a hill of beans if people don't have access to them. We need to make good use of research advances by integrating them into public policies. Millions of children and adults don't get the care they need. I hope this report is the beginning of a real revolution, turning this terrible track record around."

A full copy of the report is available on the Web at www.surgeongeneral.gov. PR