Mental disorders have an enormous impact on the overall health of the Nation.¹ Four of the 10 leading causes of disability for persons aged 5 years and older involve mental disorders.¹ Within developed nations, including the United States, major depression is the leading cause of disability. More than one in four adults in the United States have suffered from some form of mental illness in the past 12 months, and among these 22 percent have experienced serious mental illness (SMI).^{2, 3, 4} Nearly half of all Americans will meet the criteria for a mental disorder some time in their life, with first onset usually in childhood or adolescence.⁴ Suicide is one tragic consequence of undiagnosed, untreated, or undertreated mental illness.

The United States continues to recognize the challenges resulting from mental illness⁵ and, in 2002, established the President's New Freedom Commission on Mental Health. In 2003, the direct and indirect yearly economic costs of mental illness were estimated to total $150 billion, not including the costs of research.⁶ The Government's findings confirm that unmet needs and identified barriers to care for persons with mental illnesses continue to exist.

Progress has been made in the Healthy People 2010 mental health objectives. The objective for primary care screening and assessment exceeded its target. Objectives for juvenile justice facility screening and State plans addressing elderly persons both moved toward their targets.

Within the U.S. Department of Health and Human Services (HHS), agencies including the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institutes of Health (NIH), and the Health Resources and Services Administration (HRSA) are working in partnership with the nine Cabinet-level Departments to transform mental health care for all Americans by focusing on a wide range of research and programs to improve mental health care delivery systems.

Significant gains have been made in integrating mental health care services into federally funded primary care centers and juvenile residential facilities, as well as in improving the monitoring of strategic planning for mental health at the State level. Trend data on the efforts to eliminate health disparities remain limited, although available data suggest that disparities exist in the treatment of mental disorders.