Mentally Ill Health Care in America

Mental illnesses like bipolar disorder, depression, schizophrenia and substance abuse affect approximately 1 out of 5 families in the United States. These disorders result in significant economic costs and tremendous social hardships. Thanks to breakthroughs during the past century, many mental health conditions can now be effectively managed and treated with medications and psychological therapy. Yet despite decades of hard-earned progress, mentally ill health care in America still consists primarily of an uneven patchwork of programs that vary from one state to another.

History

• As urban areas took root in colonial America, state governments built institutions to house the mentally ill. Virginia opened the first state asylum in the mid-eighteenth century. The lack of effective treatments for chronically mentally ill patients and funding shortages caused conditions to deteriorate at overcrowded public institutions after the Civil War, a problem that persisted through the Depression and World War II. With the development of drugs to treat depression and psychosis, reformers launched a de-institutionalization movement in the 1950s based on the belief that many patients could be discharged from mental hospitals and reintegrated back into society. Current efforts are focusing on acute treatment and prevention of mental illnesses with an added emphasis on the roles that families, friends and other support networks play in promoting recovery.

Significance

• The National Alliance on Mental Illness reports that 1 in 4 adult Americans experiences a bout of mental illness each year. According to NAMI, 1 in 17 adults and 1 in 10 children have a serious mental illness such as alcohol or drug dependency, bipolar disorder, depression or schizophrenia. These disorders, which led to 4.3 million emergency room visits in 2006, have an estimated annual economic burden of $500 billion.

Effects

• Without adequate care, persons with mental illnesses tend to suffer more often from chronic medical conditions that can cut their lifespan by as much as 25 years, compared to the general population. These individuals also are prone to homelessness, social isolation and substance abuse. Mental illness is one of the top causes of suicide, which accounts for more than 30,000 deaths yearly in the U.S.

Shortcomings

• While advances have been achieved in treating psychological disorders, mentally ill health care in America continues to face substantial shortcomings. Estimates indicate that less than 1/3 of adults and half of children in the U.S. who are mentally ill receive treatment.

Progress

• After two decades of lobbying by mental health advocates, Congress recently approved legislation requiring insurers to provide fair and expanded coverage to mentally ill adults and children. This means insured individuals will be entitled to the same access for treatment of anxiety, depression and other serious disorders as they receive for physical conditions.