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Mental Health: A Report of the Surgeon General
Preface
from the Surgeon General
U.S. Public Health Service
The past century has witnessed extraordinary progress in our improvement of the
public health through medical science and ambitious, often innovative,
approaches to health care services. Previous Surgeons General reports have
saluted our gains while continuing to set ever higher benchmarks for the public
health. Through much of this era of great challenge and greater achievement,
however, concerns regarding mental illness and mental health too often were
relegated to the rear of our national consciousness. Tragic and devastating
disorders such as schizophrenia, depression and bipolar disorder, Alzheimer’s
disease, the mental and behavioral disorders suffered by children, and a range
of other mental disorders affect nearly one in five Americans in any year, yet
continue too frequently to be spoken of in whispers and shame. Fortunately,
leaders in the mental health field – fiercely dedicated advocates, scientists,
government officials, and consumers – have been insistent that mental health
flow in the mainstream of health. I agree and issue this report in that spirit.
This report makes evident that the neuroscience of mental health—a term that
enconipasses studies extending from molecular events to psychological,
behavioral, and societal phenomena – has emerged as one of the most exciting
arenas of scientific activity and human inquiry. We recognize that the brain is
the integrator of thought, emotion, behavior, and health. Indeed, one of the
foremost contributions of contemporary mental health research is the extent to
which it has mended the destructive split between “mental” and “physical”
health.
We know more today about how to treat mental illness effectively and
appropriately than know with certainty about how to prevent mental illness and
promote mental health. Common sense and respect for our fellow humans tells us
that a focus on the positive aspects of mental health demands our immediate
attention.
Even more than other areas of health and medicine, the mental health field is
plagued by disparities in the availability of and access to its services. These
disparities are viewed readily through the lenses of racial and cultural
diversity, age, and gender. A key disparity often hinges on a person’s financial
status; formidable financial barriers block off needed mental health care from
too many people regardless of whether one has health insurance with inadequate
mental health benefits, or is one of the 44 million Americans who lack any
insurance. We have allowed stigma and a now unwarranted sense of hopelessness
about the opportunities for recovery from mental illness to erect these
barriers. It is time to take them down.
Promoting mental health for all Americans will require scientific know-how but,
even more importantly, a societal resolve that we will make the needed
investment. The investment does not call for massive budgets; rather, it calls
for the willingness of each of us to educate ourselves and others about menial
health and mental illness, and thus to confront the attitudes, fear, and
misunderstanding that remain as barriers before us. It is my intent that this
report will usher in a healthy era of mind and body for the Nation.
David Satcher, MD,PhD
Surgeon General
Chapter 1: Introduction and Themes
Chapter 2: The Fundamentals of Mental Health and Mental
Illness
Chapter 3: Children and Mental Health
Chapter 4: Adults and Mental Health
Chapter 5: Older Adults and Mental Health
Chapter 6: Organizing and Financing Mental Health
Services
Chapter 7: Confidentiality of Mental Health
Information: Ethical, Legal, and Policy Issues
Chapter 8: A Vision for the Future
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FEDERATION
OF TEXAS PSYCHIATRY