Mental Health Care System 'Beyond Repair'
By Ed Edelson
TUESDAY, July 22 (HealthDayNews) -- America's mental health
care system is "beyond simple repair," says a
presidential commission report that calls for a series of
basic changes in the way mental illness is diagnosed and
"Traditional reform measures are not enough," says
the President's New Freedom Commission on Mental Health's
final report, which was issued after a year-long study. It
describes a corrective effort that would involve every level
of government and citizens as well.
No extra money for mental health care is mentioned in the
report, because of the rules set up for the commission. The
board called for "policies that maximize the utilization
of existing resources," says Mark Weber, director of
communications for the federal Substance Abuse and Mental
Health Services Administration.
About $71 billion of the nation's $1 trillion annual health
care spending goes for mental illness, the commission
"But here's the rub," says Michael F. Hogan,
chairman of the commission and director of the Ohio Department
of Mental Health. "Mental health is the only category
where we spend more money not to treat it than to treat
He means that the bulk of the money is in the form of
disability payments to people, "most of whom could work
if they had a modicum of support. We spend too much on the
consequences of the illness and not enough on treating
Even the basic structure of the mental health care system
differs from that of other medical conditions, Hogan says.
"It is the only category where we have assigned much of
the treatment to state and county agencies," he adds.
"We don't do that for heart disease or cancer, but we do
it for disease of the brain."
And while the responsibility for mental health care mostly
rests with state and county agencies, "most of the money
is federal money, not in dedicated health programs but in
Social Security (news - web sites), Medicare, and
Medicaid," Hogan says.
At the root of the problem is an ingrained attitude toward
mental illnesses, he says.
"Prejudices persist that these are not real
illnesses," Hogan adds.
Yet 5 to 7 percent of American adults will experience a mental
illness in any given year, the report says. And "these
illnesses rank far ahead of cancer and heart disease in the
amount of disease in the world," Hogan says.
"Globally, suicide takes more lives than murder or
But current attitudes toward the mentally ill mean that there
is "a chasm between interventions that are known to be
effective and those that are used and paid for," Hogan
says. The report asks for more "evidence-based
treatment" of the kind routinely used for other diseases.
Achieving the report's goals will be difficult because
"the mental health system is so complicated and so
dispersed," Hogan says. "It is as much an issue in
state capitals and local governments as it is at the level of
the federal government. If we all come together over time, we
can make a significant difference. But that is a tall
Reaction to the much-anticipated report was quick to come from
private mental health organizations. More than a dozen of them
were ready with prepared statements, many hinting at the need
for more money.
For example, a statement by Dr. Marcia K. Goin, president of
the American Psychiatric Association, commends the commission
and asks Congress and the President "to provide real
solutions to fix the current fragmented mental health delivery
system, pass mental health parity legislation and provide
adequate funding in the public health system."
And Dr. Norman Anderson, president of the American
Psychological Association, says, "The challenge now
before us is to develop and finance a continuum of culturally
appropriate mental health and family support services, ranging
from prevention to acute and chronic care, across the
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