Mental Health, Mental Illness and Health Care Priorities

Mental health: The successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity; from early childhood until late life, mental health is the springboard of thinking and communication skills, learning, emotional growth, resilience, and self-esteem.

Mental illness: The term that refers collectively to all mental disorders. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.

Today, a strong consensus among Americans holds that our society can no longer afford to view mental health as separate and unequal to general health. This consensus resonates with the conviction of Surgeon General David Satcher, MD, PhD, that mental health should be part of the mainstream of health. His office released the first Surgeon General’s report ever issued on the topic of mental health and mental illness.

The science-based report conveys several messages. One is that the qualities of mental health are essential to leading a healthy life. Americans assign high priority to preventing disease and promoting personal well-being and public health; we must also assign priority to the task of promoting mental health and preventing mental disorders. These tasks are critical to the nation’s health.

A second message of the report is that mental disorders are real health conditions that have an immense impact on individuals and families throughout the US and the world. Appreciation of the clinically and economically devastating nature of mental disorders is part of a quiet scientific revolution that not only has documented the extent of the problem, but in recent years has generated many real solutions. The decision to publish the report was based, in part, on the tremendous growth of the science base that is enriching our understanding of the complexity of the brain and behavior. This understanding increasingly supports mental health practices.

Opportunities Lost
“This seminal report provides us with an opportunity to dispel the myths and stigma surrounding mental illness, said Donna E. Shalala, Secretary of Health and Human Services. “For too long the fear of mental illness has been profoundly destructive to people’s lives. In fact mental illnesses are just as real as other illnesses, and they are like other illnesses in most ways. Yet fear and stigma persist, resulting in lost opportunities for individuals to seek treatment and improve or recover.”

The review of research supports two main findings:
1. The efficacy of mental health treatments is well documented.
2. A range of treatments exists for most mental disorders.

On the strength of these findings, the single, explicit recommendation of the report is to seek help if you have a mental health problem or think you have symptoms of a mental disorder.

Seeking Help
Once a person has made the decision to seek help for a mental health problem, he or she can choose from a broad variety of helping sources, treatment approaches, and service settings. There is no “one size fits all” treatment for mental disorders. Personal preference may influence, for example, the choice of psychotherapeutic (or “talk”) therapy over the use of medications; in another case, an individual may feel most comfortable raising questions about symptoms of mental distress with a family doctor, with a trusted member of the clergy, or – if a child’s health is the subject of concern – with a teacher or school counselor. There are many individuals who are familiar with questions about mental health care and who, as a first point of contact, can provide invaluable assistance in obtaining appropriate and effective care.

Despite the efficacy of treatment options and the many possible ways of obtaining a treatment of choice, nearly half of all Americans who have a severe mental illness do not seek treatment. Most often, reluctance to seek care is an unfortunate outcome of very real barriers. Foremost among these is the stigma that many in our society attach to mental illness and to people who have a mental illness.

Overcoming Stigma Is Up To Us All
Stigma erodes confidence that mental disorders are valid, treatable health conditions. It leads people to avoid socializing, employing or working with, or renting to or living near persons who have a mental disorder, especially a severe disorder like schizophrenia. Stigma deters the public from wanting to pay for care and, thus, reduces consumers’ access to resources and opportunities for treatment and social services. A consequent inability or failure to obtain treatment reinforces destructive patterns of low self-esteem, isolation, and hopelessness. Stigma tragically deprives people of their dignity and interferes with their full participation in society. It must be overcome.

Increasingly effective treatments for mental disorders promise to be the most effective antidote to stigma. Effective interventions help people to understand that mental disorders are not character flaws but are legitimate illnesses that respond to specific treatments, just as other health conditions respond to medical interventions. Fresh approaches to disseminating research information are needed urgently. While they are being developed, this report provides information that organizations, experts, and many other individuals can use to educate all Americans about mental health and mental illness.

The Report of the Surgeon General on Mental Health was the product of collaboration between two Federal agencies. The Substance Abuse and Mental Health Services Administration (SAMHSA), which provides national leadership and funding to the states and many professional and citizen organizations that are striving to improve the availability, accessibility, and quality of mental health services, was assigned lead responsibility for coordinating the development of the report. The National Institutes of Health (NIH), which supports and conducts research on mental illness and mental health through its National Institute of Mental Health (NIMH), was a partner in this effort.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.