Mental illness presents great challenges for individuals, families and communities. From stress disorders and depression among an over-stressed military, to incidents of school violence, to the $193 billion in wages lost annually in the United States because of mental illness, mental health issues affect us all. But despite this significance—and the fact that mental illness is a major driver of school failure, health care costs and suicide—many are not aware of its impact until mental health problems strike to home.
How are we doing in New York State on these challenges? We are a leader! From services to children to treatment for state prison inmates, we have approaches that are the envy of other states. Under Governor David Paterson’s leadership, the Office of Mental Health is partnering with other agencies, such as collaboration with the Office of Alcoholism and Substance Abuse to better address the needs of those with both mental health and substance abuse issues.
It is a sad irony that even though mental health issues are so prevalent and their effects so far-reaching, at the national level mental health care is often an afterthought. Too many health settings don’t screen for or treat mental illnesses, and many insurance plans don’t fully cover mental health care. In too many schools, emotional disturbance is a neglected driver of dropouts and failure. And as a result of this neglect, mental illness disability is the nation’s largest and costliest category of disability payments.
This historic pattern of neglect is especially significant and especially troubling in health care. Mental illness is unique among all major categories of illness in that we must maintain a separate, government run, illness-specific “mental health system” instead of providing early care within mainstream health care programs, covered like care for other illnesses by mainstream health insurance.
The good news is that the times are changing. In 1999, the first Surgeon General’s report on Mental Health was issued, concluding that “there is no overall health without good mental health.” In 2002-2003, I was privileged to chair the first President’s mental health commission since the Carter administration, recommending sweeping changes in mental health care—such as earlier detection and family-centered care for children, which are now being pioneered in New York.
These signs of national attention follow what people with mental illness are teaching us. With early identification, appropriate treatment and suitable supports, people with mental illnesses can live full, productive and meaningful lives in their communities.
Now, the U.S. Congress is in the final stages of considering legislation that would put care for brain disorders on a par with care for other illnesses within health care plans. Through the enactment of “Timothy’s Law,” New York State has already taken this important step. In 2002, President Bush called for such legislation nationally. Congress must enact it and the President must sign it this year. Equal medical care for the brain is common sense and is long overdue. As a nation, we should expect no less.
