The Surgeon General Addresses Mental Health

Leonard Holmes, Ph.D.                       http://mentalhealth.about.com

On December 13, 1999 the Surgeon General of the United States, David Satcher, released the first comprehensive report on mental health that has ever been released by that office.  This report addresses mental health and mental illness in a truly comprehensive way.  A thorough review of the scientific literature and of the state of clinical practice went into the report.  This is a really good starting point for those interested in better understanding mental health and mental illness. 

One contribution of the report is that it provides good definitions of mental health and mental illness.  According to the Surgeon General's Report:

Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity.

Mental illness is the term that refers collectively to all diagnosable mental disorders. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning. Alzheimer’s disease exemplifies a mental disorder largely marked by alterations in thinking (especially forgetting). Depression exemplifies a mental disorder largely marked by alterations in mood. Attention-deficit/hyperactivity disorder exemplifies a mental disorder largely marked by alterations in behavior (overactivity) and/or thinking (inability to concentrate). (Surgeon General's Report Chapter 1, Section 1.)

Thus we have a common ground for understanding the issues to follow.  Some of the main points from the report:

• Mental disorders are real health conditions. 
• The efficacy of mental health treatments is well documented.
• A range of treatments exists for most mental disorders.
• There is no "one size fits all" treatment for mental disorders.
• Mental disorders are disabling.
• Mental health and mental illness are points on a continuum.
• The mind and the body are inseparable.
• The stigma against mental illness hinders people from seeking help.
• Mental health and mental illness change over the lifespan.
• One in five Americans experience a mental illness in any give year.
• Many of these do not seek help because of stigma or barriers to care.
• Mental health services are delivered through a complex system that does not always coordinate treatment well.
• Parity legislation is one solution that may help people get needed care.
• Managed care has helped some things and created other problems.

The report suggests the following for the future course of mental health care:

1. Continue to build the science base.
2. Overcome the stigma.
3. Improve the public awareness of effective treatment.
4. Ensure the supply of mental health services and providers.
5. Ensure delivery of state of the art treatment.
6. Tailor treatment to age, gender, race, and culture.
7. Facilitate entry into treatment.
8. Reduce financial barriers to treatment 

To review the report on your own, follow these links:

• The Executive Summary is a Good Place to Start | (PDF version)
• Chapter 1: Introduction and Themes | (PDF version)
• Chapter 2: The Fundamentals of Mental Health and Mental Illness | (PDF version)
• Chapter 3: Children and Mental Health | (PDF version)
• Chapter 4: Adults and Mental Health |  (PDF version)
• Chapter 5: Older Adults and Mental Health | (PDF version)
• Chapter 6: Organization and Financing of Mental Health Services | (PDF version)
• Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues | (PDF version)
• Chapter 8: A Vision for the Future—Actions for Mental Health in the New Millennium | (PDF version)

Leonard Holmes, Ph.D.                       http://mentalhealth.about.com

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