Surgeon General Finds Mental Disorders Are Common, But Mostly Untreated

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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 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.

The Surgeon General of the United States, David Satcher, MD, PhD, notes that the revolution in science and service delivery over the last 2 decades has broadened our understanding of mental health and mental 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.

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 to 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.

About 15% of the adult population of the United States uses 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," says Dr Satcher. "We need to ensure that mental health services are as widely available as other services in the continuously changing health care delivery system."

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.

A full copy of Mental Health: A Report of the Surgeon General is available on the World Wide Web at www. and may be purchased from the Superintendent of Documents at the Government Printing Office.

Here are some excerpts from the report: