"SCIENTIFIC REVOLUTION" IN MENTAL HEALTH RESEARCH AND SERVICES
DECLARED IN FIRST SURGEON GENERAL'S REPORT ON MENTAL HEALTH
A range of effective, well-documented treatments exist for most mental
disorders, yet nearly half of all Americans who have a severe mental illness
fail to seek treatment, according to the first-ever Surgeon General's Report on
Mental Health. The report, commissioned by Health and Human Services
Secretary Donna E. Shalala, also focuses on the connection between mental health
and physical health, barriers to receiving mental health treatment, and the
specific mental health issues of children, adults and the elderly.
"Mental health is fundamental to a person's overall health, indispensable to
personal well being and instrumental to leading a balanced and productive life,"
said Dr. Satcher. "My message to Americans is this: If you, or a loved
one, are experiencing what you believe might be the symptoms of a mental
disorder, do not hesitate to seek effective treatment now. Insist on the
kinds of services that this report makes clear can and should be available.
While there is no single solution to any mental disorder, most people with
mental disorders have treatment optionsincluding medications and short term
psychotherapy, and community-based supportive services."
Dr. David Satcher and Secretary Shalala presented the report to Tipper Gore,
the President's advisor on mental health today, highlighting that the qualities
of mental health are essential to leading a healthy life.
"The Surgeon General's Report on Mental Health provides an historic
opportunity to deepen America's understanding of mental health," said Tipper
Gore. "Everyday, in every community, millions of Americans face mental
illness. It is an issue that touches us all. We need to continue
working to strengthen our nation's mental health system and fight the stigma
associated with mental illness so all Americans can get the treatment and
services they need to live full and productive lives."
Dr. Satcher noted that over last two decades a revolution in science and
service delivery has broadened our understanding of mental health and illness,
and improved the way in which mental health care is provided. Safe and
effective options are available to treat the mental disorders that affect one in
five Americans per year.
"This report confirms that research about the complex workings of the brain
has armed us with the knowledge needed to deliver effective treatment and better
services for most mental disorders. This report also provides us with an
unparalleled opportunity to dispel the myths and stigma surrounding mental
illness," said Secretary Shalala.
The Surgeon General urged Americans to take advantage of the tremendous
growth of science by seeking treatment, and emphasized the importance of bringing
this often hidden topic out into the open.
The report notes that disorders such as depression, schizophrenia and eating
disorders are real illnesses that, if untreated, can be as disabling and serious
as cancer and heart disease in terms of premature death and lost productivity.
Manic-depressive (bipolar) illness, anxiety disorders, attention deficit
hyperactivity disorder, autism and Alzheimer's disease are other common mental
illnesses that affect millions of Americans. However, quality of life is
tremendously improved when a mental disorder or mental health problem is
diagnosed early and treated appropriately.
The 500-page publication, Mental Health: A Report of the Surgeon
General, defines mental disorders as diagnosable conditions that impair
thinking, feeling and behavior, and interfere with a person's capacity to be
productive and enjoy fulfilling relationships. The report uses the
term mental illness to refer collectively to all diagnosable mental disorders.
The term "mental health problems" refers to the presence of signs and symptoms
that are not intense or long-lasting enough to meet the criteria for a mental
disorder. However, they are real, painful and potentially disabling.
The Substance Abuse and Mental Health Services Administration (SAMHSA) worked
with the National Institute of Mental Health (NIMH) to develop the report under
the guidance of the Surgeon General. The federal partners also established
a Planning Board to assist in the development of the report. The board
consisted of individuals who represented a broad range of expertise in mental
About 15 percent of the U.S. adult population use some form of mental health
service in any year. According to the report, however, the complex and
fragmented mental health service delivery system can create barriers to a full
range of appropriate services. Financial barriers and stigma also serve as
deterrents to the receipt of appropriate and necessary care. These factors
result in a gap between what research has shown to be optimally effective
treatments and what many people receive in actual practice settings.
"While mental disorders may touch all Americans either directly or
indirectly, all do not have equal access to treatment and service," said Dr.
Satcher. "We need to ensure that mental health services are as widely
available as other services in the continuously changing health care delivery
The report also proposes broad courses of action that will improve the
quality of mental health in the nation. These courses of action include
continuing to build the science base; overcoming stigma; improving public
awareness of effective treatment; ensuring the supply of mental health services
and providers; ensuring delivery of state-of-the-art treatments; tailoring
treatment to age, gender, race and culture; facilitating entry into treatment;
and reducing financial barriers to treatment.
The Surgeon General's report takes a life-span approach in considering mental
health and mental illness, devoting chapters to trends seen among children,
adults and the elderly. Different stages of life are associated with
vulnerability to distinct forms of mental and behavioral disorders but also with
distinctive capacities for mental health. The report examines how gender,
culture and age influence the diagnosis, course, and treatment of mental
illness. It also acknowledges the growing role of advocacy groups,
consumers, and families in improving treatment and recovery for all age
"Mental disorders and, to an even greater extent, mental health problems can
affect anyone," Dr. Satcher said. "Few Americans are untouched by mental
illness, whether it occurs within one's family or among neighbors, co-workers or
members of the community."
The report also acknowledges areas in which further research and analysis is
necessary to understand the impact of mental health issues on special
populations. These include mental health issues regarding racial and
ethnic groups, sexual orientation and people living with disabilities.
Dr. Satcher urged Americans to call the toll-free number 1-877-9-MHEALTH or
write to Mental Health, Pueblo, Colorado 81009 to receive the Executive Summary
of the report, a resource directory, fact sheets and a catalog of related
materials available from federal agencies. A full copy of Mental Health: A
Report of the Surgeon General is available on the World Wide Web at
www.surgeongeneral.gov, and may be purchased from the Superintendent of
Documents at the Government