Emerging Issues

A multifaceted and sustained approach is required to address the broader systemic challenges of a fragmented mental health care system, the social stigma attached to mental illness, and mental health's continued lack of parity with physical health regarding insurance coverage.⁶ Expanded research into the workings of the brain and the development of new psychopharmaceuticals and other treatment methods must be combined with evidence-based improvements and expansions in mental health care services.^{24, 25}

Several issues of concern are emerging, including co-occurring mental health and substance abuse disorders and the outcomes resulting from this combination. Approximately half of the adults who have a diagnosable mental disorder will also have a substance abuse disorder at some point during their lifetime.⁶ Co-occurring disorders tend to be more chronic and disabling than either disorder alone. Individuals with co-occurring disorders are more likely to experience a chronic course or to require more services than persons with either type of disorder alone.²⁶

Early intervention and treatment can lessen the severity of co-occurring disorders.²⁶ Too often, however, individuals are treated for only one of the two disorders, if they are treated at all. Furthermore, the fragmented nature of the mental health care system presents additional challenges to the development of integrated treatment and overall care for individuals who have co-occurring disorders.⁶ Another emerging issue is the need for further research and collaboration between the mental health field and the substance abuse treatment field to better identify this population and develop effective treatments.

As the baby boom population grows older, several issues related to mental health among older adults are emerging. Increasing numbers of new cases of depression and the accompanying risk of suicide among older adults will be important. The co-occurrence of depression and chronic diseases associated with aging, such as cardiovascular disease, rheumatologic disorders, diabetes, and high blood pressure, are adding additional burdens to the health care system.¹⁶ In addition, increasing numbers of new cases of dementia and the associated costs of treatment continue to be subjects of concern.

Finally, in the changing environmental landscape in which people live, issues like terrorism- and war-related posttraumatic stress disorder and difficulties in providing culturally competent care in a diverse society may present increasing challenges and are important to consider when addressing health disparities.

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