Mental health policy and advocacy has come a long way since the days of asylums, padded rooms and shackles in the 1900’s. Though we have made great progress in the services and care provided to individuals with mental disorders and their families, we still have work to do; here at home and around the world.
The mental health burden is the USA is high. Nearly 1 in 5 adults experiences a mental illness in any given year, this equates to approximately 43 million Americans. Of all the mental health disorders, major depressive disorder carries the heaviest burden, accounting for approximately 3.7% of all US disability adjusted life years (DALYs). The biggest flaw in US health care is the inadequacy of mental health care and services, with approximately 5.1 million adults having unmet mental health care needs. Mental disorders may not be curable but they are treatable and with consistent case management and initiation of mental health care in the primary setting, mental illnesses can be effectively controlled and highly prevented.
Currently, many mental health issues have been at the forefront of policy maker agendas. One of particular interest is the Mental Health Reform Act. The act calls for the following: (1) integration of mental health into primary care, designating an Assistant Secretary for Mental Health, (2) development of an Interagency Mental Illness Coordinating Committee, (3) establishment of grant programs for early intervention and (4) strengthening services within Medicare/ Medicaid. To date, the bill is being considered in Congress and has many influential organizations in favor of it, including: NAMI, who states “As the nation’s largest organization representing people living with serious mental illness and their families, NAMI is proud to offer our support.”
By providing much needed infrastructure for the diagnosis and management of mental illness, the Mental Health Reform act will finally give millions of struggling Americans the opportunity to live their lives free from the shadow of undiagnosed and untreated mental health issues.
UNITED STATES – JULY 30: A severe thunderstorm passes over the U.S. Capitol on Thursday, July 30, 2015. (Photo By Bill Clark/CQ Roll Call)
Social, Cultural & Behavioral Issues in PHC & Global Health 
March 5, 2016 at 2:31 am |
Thank you for this wonderful post. Mental health remains a controversial topic with outmoded prejudices and stereotypes often making people affected by mental illness a ‘taboo’ subject. Worldwide the magnitude of mental illness has been emphasised by studies on the global burden of disease. In this regard, a recent recalculation of the global burden of mental illness by Vigo and colleagues published in Lancet Psychiatry showed that mental illness account for 13.0% of disability-adjusted life-years (DALYs) and 32.4% of the years lived with disability (YLDs) worldwide, placing mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. Provided with these powerful statistics it is apparent that besides the need for advocating the respective mental health reform acts, governments and funders of global health must also place an emphasis on mitigating the human, social, and economic costs of mental illness.
March 5, 2016 at 12:55 pm |
Mental health is very pertinent to the non-communicable diseases that need to be addressed in our society today. One of the complexities around mental health is the stigma associated with it. Building a strong infrastructure is the necessary first step to dismantling the stigma associated with mental health and will get people one step closer to getting the help they need to live as full a life as possible.
March 8, 2016 at 6:25 pm |
I am glad that mental health is being taken more seriously in the United States. The appointment of an Assistant Secretary for Mental Health will hopefully increase its visibility and encourage more funding into mental health research.
I wondered what you think of mental health being included under the umbrella term of Non-Communicable Diseases (NCDs)? While it is immediately apparent that mental health issues are non-communicable, they nevertheless seem distinct from somatic NCDs such as cancer, diabetes, and hypertension. Do you think mental health should be promoted as its own domain, separate from those of communicable and non-communicable diseases, or should efforts instead be made to make it raise awareness about it within the realm of NCDs?
March 9, 2016 at 5:55 pm |
I completely agree that we need to have more attention to mental health care and services. There is still so much stigma around it and it is not well understood for sure among lay people and also police officers and law enforcement who sometimes arrest, shoot, jail, or put to death (capital punishment) people who are mentally ill and really need rehabilitation if possible or to be placed in an institution.
When it comes to less serious mental illness, we also need physicians to be more competent when talking to patients. You made an argument about including more mental health care within primary healthcare, but I just saw an article by PBS a few days ago (http://www.pbs.org/newshour/rundown/for-depression-primary-care-doctors-could-be-a-barrier-to-treatment/) that talks about how primary care physicians can be barriers to receiving treatment for depression. I think that we might also start talking about making sure that medical education or continuing medical education for physicians includes updates on mental health conditions (especially depression from the sound of this article) and treatments since so many people seem to seek treatment from primary care physicians instead of from mental health professionals. We might also need to address the reasons why people don’t go to mental health professionals (stigma, insurance not being taken, inaccessible).
In addition, this is not directly related to your post, but I have been studying climate change and physician education. One of the things I worked on was a CME (continuing education for physicians) about the mental health impacts of climate change. In the future, people may suffer more mental health impacts (e.g. anxiety, depression, ptsd) from natural disasters, potential displacement, and problems with security (food, wars over natural resources, environment, etc). We will need more mental health services in the future worldwide to accommodate climate change impacts.
March 11, 2016 at 5:53 pm |
Thank you so much for this informative post; mental health is a taboo issue, particularly in American culture, and it has so many negative connotations associated with it. The Mental Health Reform Act is an extremely important piece of legislation, as it is absolutely crucial to reduce the burden of mental health issues.
Additionally, I think this is a particularly important issue to discuss as mental health is consistently associated with large scale shootings. Despite the fact that the research is inconsistent on if mental health is associated with large scale shootings, addressing mental health issues could potentially allow for more discussion on what more can be done to reduce large-scale shootings.
March 11, 2016 at 8:08 pm |
This was a very interesting post. I have been wanting to learn more about mental health care and its changing landscape in the the face of healthcare reform in the Untied States.
I think it might be good if you included actionable points that individual citizens could take to help support the Mental Health Reform Act.
November 18, 2016 at 3:44 pm |
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The Mental Health Reform Act | SBFPHC Policy Advocacy