| I am pleased to issue the first-ever Surgeon | | | | treatment of mental illness must be attentive to |
| General's Report on MentalHealth. In doing so, I | | | | these factors. |
| am alerting the American people that mental | | | | Patients often prefer to be treated by mental |
| illness is a critical public health problem that must | | | | health professionals who are of the same racial |
| be addressed immediately. As a society, we | | | | and ethnic background, a fact that underscores |
| assign a high priority to disease prevention and | | | | the need to wain more minorities in the mental |
| health promotion; so, too, must we ensure that | | | | health professions. Facilitate Entry into Treatment: |
| mental health and the prevention of mental | | | | Access to mental health services can be |
| disorders share that priority. | | | | improved immediately if we enhance the abilities |
| Mental illness is the second leading cause of | | | | of primary care providers, public schools, the child |
| disability in major market economies such as the | | | | welfare system and others to help people with |
| United States, with mental disorders collectively | | | | mental health problems seek treatment. In |
| accounting for more than 15% of all disabilities. | | | | addition, ensuring ready access to appropriate |
| Mental disorders--depression, schizophrenia, eating | | | | services for people with severe mental disorders |
| disorders, depressive (bipolar) illness, anxiety | | | | promises to significantly reduce the need for |
| disorders, attention deficit hyperactivity disorder | | | | involuntary care, which is sometimes required in |
| and Alzheimer's disease, to name a few--are as | | | | order to prevent behavior that could be harmful |
| disabling and serious as cancer and heart disease | | | | to oneself or others.o Reduce Financial Barriers to |
| in terms of premature death and lost productivity. | | | | Treatment: Equality or parity between mental |
| Few Americans are untouched by mental illness, | | | | health coverage and other health coverage is an |
| whether it occurs within one's family or among | | | | affordable and effective way to decrease the |
| neighbors, co-workers or members of the | | | | number of ill people who are not receiving proper |
| community. In fact, in any one year, one in five | | | | treatment. |
| Americans--including children, adolescents, adults | | | | The U.S. system is extremely complex; it is a |
| and the elderly--experience a mental disorder. | | | | hybrid system that serves many people well, but |
| Unfortunately, over half of those with severe | | | | often seems fragmented and inaccessible to |
| mental illness do not seek treatment. This is | | | | those with the most extensive problems and |
| mostly due to some very real barriers to access, | | | | fewest financial resources. Critical gaps exist |
| foremost among them the stigma that people | | | | between those who need services and those who |
| attach to mental illness and the lack of parity | | | | receive them; only about 40% of those with |
| between insurance coverage for mental health | | | | severe disorders use any services at all. |
| services and other health care services. | | | | Although research shows little direct evidence of |
| Over the past 2 5 years, there has been a | | | | problems with quality in mental health service |
| scientific revolution in the fields of mental health | | | | programs, there are signs that programs could be |
| and mental illness that has helped remove the | | | | better implemented, especially ones that serve |
| stigma. The brain has emerged as the central | | | | children and people with serious impairment. While |
| focus for studies of mental health and mental | | | | an array of quality monitoring and improvement |
| illness, with emphasis on the activities that underlie | | | | methods have been developed, incentives to |
| our abilities to feel, learn, remember and, when | | | | improve conditions lag behind incentives to reduce |
| brain activity goes awry, experience mental health | | | | costs. |
| problems or a mental illness. We now know that | | | | These inequities in insurance coverage for mental |
| not only do the workings of the brain affect | | | | and physical health care have prompted 27 states |
| behavior, emotions and memory, but that | | | | to adopt legislation requiring parity, and compelled |
| experience, emotion and behavior also affect the | | | | President Clinton to order the Federal Employees |
| workings of the brain. | | | | Health Benefits Program to provide parity for |
| As information about the brain accumulates, the | | | | federal employees by the year 2001. Some |
| challenge then becomes to apply this new | | | | localized attempts at creating parity so far have |
| knowledge to clinical practice. | | | | resulted in better mental health service access at |
| Today, mental disorders can be correctly | | | | negligible cost increases for managed care |
| diagnosed and, for the most part, treated with | | | | organizations. |
| medications or short-term psychotherapy, or with | | | | Issues relating to mental health and mental illness |
| a combination of approaches. The single most | | | | have been overlooked or ignored in this country |
| explicit recommendation I make in my report is to | | | | too often and for too long. While we cannot |
| seek help if you have a mental health problem or | | | | change the past, I am convinced that we can |
| think you have symptoms of a mental disorder. It | | | | shape a better future. |
| is my firm conviction that mental health is | | | | IMAGES FROM WITHIN |
| indispensable to personal well-being and balanced | | | | Truth be told, we tend to consider mental illness in |
| living. Overall quality of life is tremendously | | | | the abstract, as the misfortune of strangers. In |
| improved when a mental disorder is diagnosed | | | | these compelling portraits, however, photographer |
| early and treated appropriately. | | | | Marc Hauser reveals the individuality and humanity |
| My report presents an in-depth look at mental | | | | of sufferers of mental illness. They are cat |
| health services in the U.S. and at the scientific | | | | owners and car lovers, uncles and neighbors. They |
| research that supports treatment interventions | | | | are all clients of the Lockport Center for |
| for people with mental disorders. Summarized | | | | Behavioral Health in Will County, Illinois. A complete |
| briefly below, it attempts to describe trends in the | | | | collection of their portraits, with text by Alisa |
| mental health field; explore mental health across | | | | Hauser, appears in Images From Within: Portraits |
| the human life span; examine the organization and | | | | of People Confronting Mental Illness (High Tide |
| financing of mental health services; and | | | | Press, 1999). |
| recommend courses of action to further improve | | | | GREG GIANNINI |
| the quality and availability of mental health | | | | I'd describe myself as a regular person .... Most of |
| services for all Americans. The report's | | | | the time I like taking walks around my house. |
| conclusions are based on a review of more than | | | | Before I was living in a group home out in the |
| 3,000 research articles and other materials, | | | | country and there weren't that many stores or |
| including first person accounts from people who | | | | streets to walk on. I like walking to 7-Eleven and |
| have experienced mental disorders. | | | | Mr. D's fast food. |
| A Vision for the Future | | | | ROSE CLARK |
| I cannot emphasize enough the principal | | | | Sometimes I wake up so sick, but then I go to |
| recommendation of my report: Seek help if you | | | | work and feel better. Being with animals makes |
| think you have a mental health problem or | | | | me feel 100% better. Does that sound funny? |
| symptoms of a mental disorder. But because | | | | I love my boss. He's crazy. When he does |
| stigma and substantial gaps in the accessibility to | | | | surgery he dances, does the jitterbug. Sometimes |
| state-of-the-art mental health services keep | | | | I go into surgery with him to make sure all the |
| many from seeking help, I offer the nation the | | | | animals are lying down straight and not awake. |
| following additional recommendations, which are | | | | Mostly my responsibilities are taking care of the |
| intended to overcome some of these barriers:o | | | | cages and general cleaning. |
| Continue to Build the Science Base: As scientific | | | | I've been with this program for four years. Since |
| progress propels us into the next century, there | | | | then I've gone back to school and gotten a job. I |
| should be a special effort to address pronounced | | | | live in my own apartment, got two cats, and |
| gaps in current knowledge, including the urgent | | | | have a checking and savings account. |
| need for research relating to mental health | | | | TONY RIVERA |
| promotion and illness prevention.o Overcome | | | | When I first came to the Pastimes Cafe & |
| Stigma: An emerging consumer and family | | | | Antiques I told them that it reminds me of the |
| movement has, through vigorous advocacy, | | | | coffee shops in Baltimore and Maryland. They |
| sought to overcome stigma and prevent | | | | laughed and we've been friends for two yearn. |
| discrimination against people with mental illness. | | | | They know my name when I walk in. I used to |
| Powerful and pervasive, stigma prevents people | | | | know all their names but I only come every few |
| from acknowledging their mental health problems | | | | weeks now and I can't remember. They make |
| and disclosing them to others. To improve access | | | | me feel comfortable, like I'm not bothering |
| to care, stigma must no longer be tolerated. | | | | anybody. |
| Research and more effective treatments will help | | | | KATHY MOLYNEAUX |
| move this country toward care and support of | | | | I didn't know I was depressed until after college. I |
| the ill--and away from blame and stigma.o | | | | just thought everyone felt the same way I did. I |
| Improve Public Awareness of Effective | | | | had problems sleeping, feeling down, |
| Treatments: Mental health treatments have | | | | overwhelmed, worried and not happy. My |
| improved by leaps and bounds over the past 25 | | | | graduation from DePaul University in 1983 was a |
| years, but those treatments do no good unless | | | | good day. After college, I worked successfully as |
| people are aware they exist and seek them out. | | | | a nurse for 13 years. I felt like I could relate to |
| There are effective treatments for virtually | | | | the patients because I had been there myself. |
| every mental disorder. For more information on | | | | SHERYL CAUDLE |
| how to take advantage of them, call (877) | | | | My family at first didn't understand why I was so |
| 9MHEALTH.o Ensure the Supply of Mental Health | | | | depressed. My dad kept asking me why couldn't I |
| Services and Providers: Currently, there is a | | | | be happy?... I never thought I'd be able to work |
| shortage of mental health professionals serving | | | | again because of my illness. I've had to quit other |
| children and adolescents, elderly people with | | | | jobs in the past, but I don't want to quit cleaning |
| serious mental disorders and those who suffer | | | | the Boxy [a local movie theater]; I want to have |
| from mental illness-related substance abuse. There | | | | an apartment someday and a job in the |
| is also a shortage of specialists with expertise in | | | | community. Both of these things would be special |
| cognitive behavioral therapy and interpersonal | | | | to me because it would mean I've come a long |
| therapy--two forms of psychotherapy that have | | | | way. |
| proven effective for many types of mental | | | | PATTI REID |
| health problems.o Ensure Delivery of | | | | I used to live in a house with my family, but I |
| State-of-the-Art Treatments: A wide variety of | | | | have a rare disorder that makes me think about |
| effective, community-based services--carefully | | | | the past. In 1992, I got this disorder and I couldn't |
| refined through years of research--exist for even | | | | drive my car anymore. I miss driving the most. |
| the most severe mental illnesses, but they are | | | | My two big battles are smiling and taking my |
| not yet widely available in community settings. We | | | | medications. Both of these are very hard. |
| need to ensure that mental health services are as | | | | Listen to Arthur Buchanan on the Mike Litman |
| universally accessible as other health services in | | | | Show! THIS LINK WORKS, LISTEN TODAY! |
| the continuously changing health care delivery | | | | With Much Love, |
| system. We must speed the transfer of new | | | | Arthur Buchanan |
| information from the research setting into the | | | | President/CEO |
| service delivery setting.o Tailor Treatment to | | | | Out of Darkness & Into the Light |
| Individuals, Acknowledging Age, Gender, Race and | | | | 43 Oakwood Ave. |
| Culture: To be optimally effective, diagnosis and | | | | |