Did you know that more than 43 million adults in our country struggled with mental illness in the past year? Half of us will meet the criteria for a diagnosable mental health condition at some point in our lives; one quarter by the age of 14. And more than 20 million [PDF 932 KB] adults have an alcohol or drug abuse problem. Yet, in spite of how common mental illness and addiction are in our families and in our communities, prejudice and barriers to accessing care still keep too many people from getting the treatment they need. Can you think of any other disease for which we would put up with that?
In 1999, my predecessor, Dr. David Satcher, issued a Surgeon General’s Report on Mental Health [PDF 52.9 MB]. In that landmark publication, he pointed out the enormous barriers to treatment created by prejudice against those with mental illness.
Given the important role my office has played in addressing such barriers, I was honored yesterday to address Mental Health America’s 2015 conference. I joined nearly 400 advocates, health professionals, educators and leaders from government, business and communities to discuss strategies for intervention and innovation in changing the way we think about mental health.
I share MHA’s goal of getting people the help they need before their issues advance too far. In treating diseases like cancer, we try to get to a patient before “stage 4.” That’s because we know it’s a lot better to treat people in the early stages when we can still stop or slow down the progression of disease. Well, the same is true for mental illness. We need to get to people #B4Stage4.
But, as a physician, I cannot begin to treat a problem until I can name the problem. The same is true on both the individual and community level. We cannot begin to address the challenges to achieving emotional well-being and good mental health until we get rid of the unacceptable stigma – be they cultural, religious or social – associated with mental illness and addiction.
Mental illness is not unique to our generation or to our nation. But how we deal with it – or fail to deal with it – is a byproduct of some unfortunate assumptions and wrong-headed beliefs. There is nothing weak or shameful about experiencing mental illness or seeking help for addiction. I say this not just because it is an important health issue, but also because it’s personal to me. When I was young, I had an uncle who committed suicide because of an undiagnosed mental illness.
The more I meet with and talk to folks, the more I realize how many of us are struggling with the very same challenges, but are afraid to tell anyone for fear of bringing shame to our families and ourselves. As First Lady Michelle Obama recently said, “There should be absolutely no stigma around mental health. None. Zero.” That is why I have called upon faith and civic leaders to use the power of their pulpits to save lives while saving souls, by igniting a conversation around mental health.
Positive mental and emotional well-being depends on many factors, including positive relationships with family and friends, the ability to participate in and contribute to the community, and the ability to access appropriate mental health services when needed. In a given year, fewer than half of the people diagnosed with mental illness receive treatment. Substance abuse also greatly impact the health and wellbeing of individuals, their families, and their communities and yet, only one in ten Americans receive needed treatment for these conditions.
Thanks to the Affordable Care Act, we now have one of the largest expansions of coverage for the screening and treatment of mental illness and substance abuse in a generation. This includes rehabilitative services that can help support people with behavioral health challenges. Because of the ACA, most health plans must now cover preventive services, like depression screening for adults and behavioral assessments for children, at no additional cost. As of 2014, most plans cannot deny coverage or charge more because of pre-existing health conditions, including mental illness. The ACA’s expansion of services works together with the provisions of the Mental Health Parity and Addiction Equity Act of 2008 to provide coverage and federal parity protections for tens of millions of people who live with mental illness and addiction.
To bring mental illness out of the shadows and deal with the challenge of drug and alcohol addiction, we need more than one voice. We need many voices. And we need to be intentional about making those voices – our voices – heard. Let’s talk about it, and let’s keep talking about it until no one is afraid to reach out for help. Let’s treat emotional well-being and mental health as part and parcel of overall health. Because they are. #MindBodySpirit
Dr. Vivek H. Murthy is the 19th Surgeon General of the United States and leads 6,700 Commissioned Corps officers of the U.S. Public Health Service.
Editor’s Note: Positive mental health is an important part of staying healthy when living with HIV. For more information, see our HIV Basics page Mental Health and HIV.