Resolutions for Mental Healthcare in the New Millennium

The first Surgeon General's Report on Mental Health was issued on December 13, 1999, at the end of what has been declared by the United States Congress the "Decade of the Brain;" ninety percent of our knowledge of the complex workings of the brain has been discovered in the 1990s. The long term consequences of this groundbreaking report on mental health remain to be seen, but past Surgeon General Reports have greatly influenced this nation's public policy.

More than 51 million Americans have a mental disorder in a single year, yet less than 16 percent of those affected seek treatment. It is estimated that between eight and twelve million American children have emotional or behavioral problems that significantly interfere with their daily functioning, but nearly two-thirds of these children do not receive mental health services. In Washington County, mental health services have been provided to more individuals in the first half of fiscal year 1999-2000 than have previously been provided in any full year. This is not necessarily an indication that a much greater number of people need services, but more likely a result of recent improvements in the quality, accessibility, diversity, and volume of mental health services in the county. And it is still a sobering reality that for every Washington County resident who seeks treatment, there are at least two residents affected by mental illness that do not. Surgeon General Satcher states in his report that he believes we are poised to take what we now know about the brain and brain disorders and advance the state of mental health in this country. He concludes that a wide range of treatments, whose efficacy has been documented, exists for most mental disorders. The most common mental disorders, major depression and anxiety disorders, can be successfully treated in 80 to 85 percent of all cases. There clearly exists a huge gap between the successful treatments available and the access of those treatments. Our challenge is to fully understand and acknowledge Dr. Satcher's sentiment when he says, "Mental health is fundamental to a person's overall health, indispensable to personal well being and instrumental to leading a balances and productive life." As a community, a county, a state, and a nation, our resolutions for mental health in the new millennium must focus on narrowing service gaps and assuring that our neighbors, friends and families have access to affordable, effective mental health services. Maintain a holistic perspective. Seventeenth century philosopher Rene Descartes popularized the concept that the mind and the body function separately. This concept is still rampant in this country, though we now know that the two are inseparable. We are often eager to support and fund services and treatments that address illness in every organ but the brain. Improve public awareness and support. Until we fully endow mental health services with adequate finances and public support, and until our community is aware of the choices available for effective treatment, the vast majority of those individuals affected by mental disorders will not seek treatment and will suffer needlessly. Overcome stigma. Persistent throughout history, the stigmatization of people with mental disorders is manifested by stereotyping, fear, blame, anger, and avoidance. This serves to silence and isolate those who most need mental health care, reduces their access to housing and employment opportunities, and gives rise to feelings of worthlessness and hopelessness. Reduce financial barriers to treatment. Many people are not aware when finances are not an obstacle. Community mental health services in Washington County are provided on a sliding fee scale. However, insurance coverage for mental disorders is abysmal in comparison to other illnesses. Because the effectiveness of mental health care in recent years has greatly increased, while, under managed care, expenditures have decreased, equality between mental health and other health care coverage is affordable, attainable, and just plain good policy.