Breakthrough Patient Recruitment

: A System Crying Out for Help: Mental Health Care in the United States

A System Crying Out for Help: Mental Health Care in the United States

Managing Editor

The United States is failing to provide even basic mental health care. Seriously, we're failing. We got a "D" on the National Alliance on Mental Health (NAMI) Grading the States report, a national report on the public mental health care system that features individual grades for each state and an overall assessment for the country. The 2009 report is the most recent report, and it was the second time NAMI provided grades for provision of mental health services. The first was in 2006, and we got a "D" that time, too.


The grades are based on 65 specific criteria in four categories: health promotion and management, financing and core treatment/recovery services, consumer and family empowerment, and community integration and social inclusion. Overall, 6 states earned a "B," 18 states earned a "C," 21 states received a "D," and 6 states received an "F."


Mental Health Care Suffers from too Little Funding, Too Much Stigma


Discussions about mental health care resurfaced-in earnest this time-following the mass shooting at Sandy Hook Elementary School in December 2012. Although that tragedy sparked a debate about gun control, it also brought into light gaps in the country's mental health care services and mental health care policies


Too often, mental health care budgets are overrun by in-patient hospital care for the most extreme mental health patients. But we could be helping people long before they ever get to that stage. And experts say that public stigma often leads to many people not seeking treatment before things get really bad. Shame, embarrassment, and fear often prevent people them from seeking professional help for mental illness. Some people also offer suffer from a condition called anosognosia (or lack of insight), meaning they are unable to understand that they have a mental health disorder.


There's a lot we don't know about mental illness. But here's what we do know.


  • One in four adults experiences a mental health disorder in a given year
  • One in 17 adults lives with a serious mental illness, such as schizophrenia, major depressive disorder, or bipolar
  • One in 10 children live with a serious mental or emotional disorder
  • One-half of all lifetime cases of mental illness begin by age 14 and three-quarters by age 24
  • Fewer than one-third of adults and one-half of children with a diagnosable mental disorder receive mental health services in a given year
  • 24 percent of state prisoners and 21 percent of local jail prisoners have a recent history of a mental health disorder, and 70 percent of youth in juvenile justice systems have a least one mental disorder
  • More than 50 percent of students with a mental disorder age 14 and older drop out of high school-which is the highest dropout rate of any disability group


Wraparound Program Seeks to Treat Children Before they Become Headlines


We deserve better. And in some places, we do better. A program in Milwaukee, WI, Wraparound Milwaukee, has won awards for its comprehensive, cost-effective care for children with mental health needs. The program provides coordinated services for children with mental health disorders who have been placed in foster care or caught up in the juvenile justice system. But the program doesn't just keep tabs on children in the "system." Wraparound Milwaukee also provides preventive services to several hundred children not tracked through the court system-with the goal of keeping them out of it.


While Wraparound has won awards and was featured in a PBS documentary, Wisconsin as a state received a "C" from NAMI on its 2009 report-a drop from a "B" grade in 2006. Such parity from within a single state suggests that there is much more work to be done to improve provision of mental health care services.


Excellence in Mental Health Act will Strengthen System


Recognizing the need to strengthen our mental health care system, a bipartisan group of senators in February introduced the Excellence in Mental Health Act. The Act establishes standards for Federally Qualified Community Behavioral Health Centers that will require them to provide mental health services that span from 24-hour crisis care to integrated physical, mental, and substance abuse treatments. The Act also seeks to expand access to mental health services by supporting renovation of existing centers and construction of new ones.


The point here is not that we're struggling to provide adequate mental health care services; the point is that we need to do something about it. No one should suffer in silence with a mental illness. No voice is too small to speak up. And we all deserve to be heard.

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