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Knowledge Must Be Shared

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




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