The most recent data on mental health illness and treatment have just been compiled by the National Council for Behavioral Healthcare, the national mental health trade association representing almost 2000 community mental health agencies across the country.
As a board member of that organization, I am continually impressed with the scope and quality of the services provided by this country’s community mental health organizations.
I am also struck by the scope of the problems we face and the lack of resources available to many people with mental illness in this country.
Mental illness is widespread, with 57.7 million children and adults, or 1 in 5 Americans suffering from it every year.
Although we spend $80 billion to care for mental illness every year, two-thirds of the people needing mental health treatment go without, mostly because of inability to access care and the stigma associated with seeking care. It is estimated that serious mental illness costs over $255 billion a year in lost earnings.
People with mental illness who do not receive treatment bear a heavy burden. More than 36,000 people commit suicide every year. Individuals with mental illness die on average 25 years sooner than the general population.
Untreated, mental illness disrupts a normal productive life. More than half of prison and jail inmates have mental health issues. Two-thirds of homeless adults suffer from alcoholism, drug addiction, mental illness or a combination of all three. Half of Medicaid beneficiaries with disabilities have a mental illness and 25 percent of all social security disability payments are for individuals with mental illness.
Yet, for people who receive treatment, the outlook is much better. Roughly 90 percent of people in treatment eventually recover. Mental health treatments work for 80 percent of people with bi-polar disorder, 70 percent of people with depression or panic disorders, and 60 percent of people with schizophrenia.
Mental health treatment success rates compare favorably to those for physical health care such as asthma (70 to 80 percent ), cardiovascular (60 to 70 percent ) and heart disease (41 to 52 percent ).
In Vermont things are somewhat better. Investments in community mental health agencies such as United Counseling Service (UCS) have been generally higher than in the rest of the country. We still struggle in Vermont, however, with access issues, stigma, the cost of healthcare, and other challenges.
Hurricane Irene has dramatically changed the landscape in Vermont in many ways, and especially for mental health. The Vermont State Hospital is no more, and it will be years before another state hospital is built. Vermont’s mental health agencies have been given the opportunity to provide alternative care for those individuals who would have been placed in the state hospital.
Over the next year, community mental health agencies will begin to roll out enhanced crisis response and residential services to address the needs of our most vulnerable citizens.
To prepare for the challenges to come and to meet the diverse needs of our clients, UCS and other agencies need to deliver best practice care and seek efficiencies.
As demands on our service systems increase, we will need to embrace an "episodic care" approach for many of our clients and their problems and acknowledge that clients should be able to access mental health services in the same way we tend to access our primary care physicians -- for strategic and immediate but brief help with an emergent issue.
In addition, it’s clear to me that community mental health centers will need to integrate services better with healthcare, partner proactively with housing and social service organizations, begin to offer treatment programs to those involved with Corrections and the legal system and make better use of technology and social media.
We know that some things haven’t changed and that good treatment comes from a good helping relationship. We also know that, to improve the quality of life of the people we serve, we will need to acknowledge and embrace the fact that "change is gonna come".