A Silent Public Health Crisis

Mental Illness Awareness Week is an opportunity to stop the whispering and speak up about mental illness to our friends, co-workers and legislators. We cannot afford to wait for the next national tragedy.
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Americans have heard about a slew of public health crises so far this year. Michelle Obama cited childhood obesity. The FDA warned about tainted food and drugs, while the White House's Office of National Drug Control Policy applied the term to prescription drug abuse. Without a doubt, anyone who saw the movie Contagion would label infectious diseases a pressing public health crisis.

While all of these issues may indeed be legitimate crises, none are as widespread or contribute as much to the burden of illness in the U.S. as do mental illnesses. With October 2-8 being Mental Illness Awareness Week, it's an ideal time to break the silence and stigma that often surround the topic.

The Centers for Disease Control and Prevention (CDC) find that about half of U.S. adults will develop a mental illness during their lifetime. One in four adults experiences a mental disorder in any given year, and one in 17 lives with a serious mental illness like schizophrenia, major depression or bipolar disorder. By 2020, mental and substance use disorders will surpass all physical diseases worldwide as major causes of disability.

Perhaps it is natural that most people associate public health crises with physical illnesses. Yet here again, a CDC report released in September found that cardiovascular disease, diabetes, obesity and other chronic diseases are associated with mental illness. The report found that treatment of the mental illness also can reduce the effect of chronic diseases.

Sadly, almost 40 percent of people with mental and substance use disorders never get treated. Those who seek treatment typically do so after a decade or more of delays, during which time they are likely to develop additional problems. A survey by the Substance Abuse and Mental Health Services Administration found that of the 2.5 million adults with mental and substance use disorders, only slightly more than 11 percent received treatment for both disorders.

The good news is that treatment works. According to the National Advisory Mental Health Council, the treatment success rate for bipolar disorder is a remarkable 80 percent. The recovery rates for other serious mental illnesses follow suit: major depression (65-80 percent), schizophrenia (60 percent) and addiction (70 percent).

Effective mental health and addiction treatments also reduce costs. A Surgeon General's report finds that $1.00 invested in substance use treatment has a return of $7.00 in cost savings on crime and criminal justice costs alone. After all, people in recovery work, pay taxes, buy homes and contribute positively to society. Without adequate treatment, people with mental illness often end up in emergency rooms, homeless or in jail, all of which end up costing taxpayers more money in the long run.

Yet even in a year starting with the tragedy in Tucson and followed six months later by the shooting rampage in Grand Rapids, MI, states continue to make severe budget cuts that threaten mental health services nationwide. In fiscal year 2011, 24 states slashed provider reimbursement rates for Medicaid -- the most important source of funding of public mental health services. The nation's governors have proposed further cuts to Medicaid spending in 2012, even as they predict an increase in people enrolling in mental health services.

Mental Illness Awareness Week is an opportunity to stop the whispering and speak up about mental illness to our friends, co-workers and legislators. We cannot afford to wait for the next national tragedy to recognize that mental illness is a public health crisis that deserves our nation's attention and support.

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