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President's New Freedom
Commission on Mental Health

Press Release

    November 1, 2002 Phone: 301-443-8956

    Mental Health Commission Releases Interim Report

    The President's New Freedom Commission on Mental Health is charged with conducting a comprehensive study of the United States mental health service delivery system and advising the President on methods of improving the system to enable adults with serious mental illness and children with serious emotional disturbances to live, work, learn and participate fully in their communities. As part of that goal, the President's April 29 Executive Order creating the Commission requires this interim report to describe barriers to the delivery of effective mental health care. The report also provides examples of community-based care models with success in coordinating services and providing desired outcomes. The Commission will further examine these barriers and models as it develops its final recommendations.

    After several months of hearing from the public, experts in mental health care and people with mental illness and their family members, the interim report finds:

    Mental Illness Affects Millions of Men, Women and Children. About 5-7 percent of adults, in a given year, have a serious mental illness. "Serious mental illness" is a term used in federal regulations for any diagnosable mental disorder that affects work, home, or other areas of social functioning. A similar percentage of children, about 5-9 percent, have a "serious emotional disturbance." This term also comes from federal regulations, and it refers to any diagnosable mental disorder, in a child under age 18, that severely disrupts social, academic and emotional functioning. When compared to all other diseases, such as cancer and heart disease, mental illness including depression, bipolar disorder and schizophrenia, ranks first in terms of causing disability in the United States.

    Effective Treatments for Mental Illness Exist. A range of safe and effective options are available to treat mental illnesses - including medications and short term psychotherapy, and community-based supportive services. When mental illness is diagnosed early and treated appropriately, quality of life is tremendously improved. Quality care for children with serious emotional disturbances can improve their social functioning, school attendance and grades, and of equal significance, reduce severe behavioral and emotional problems, and contact with law enforcement. Quality treatment and flexible supports for adults with a serious mental illness lead to employment and recovery, reduced substance abuse and incarceration, and greatly improved quality of life.

    Multiple Barriers Impede Access to Effective Treatments, Services and Supports. The array of programs that deliver or pay for treatments, services and supports are offered by multiple levels of government and the private sector. The varying missions, settings and financing of these health, housing, disability and employment programs create a mental health maze instead of a coordinated system. Navigating this maze is left to the people with the mental illness and their families, who are least equipped to deal with the complexities of the system. As a result, it is often impossible for families and consumers to find the care that they urgently need. Overall, one in two people who need mental health treatment do not receive it. For ethnic and racial minorities, the rate of treatment is even lower than that for the general population and the quality of care is poorer.

    The Commission has identified five barriers in the interim report that needlessly impede access to care: "Fragmentation and Gaps in Care for Children, Fragmentation and Gaps in Care for Adults, High Unemployment and Disability for People with Serious Mental Illness, Insufficient Attention to Older Adults, and Mental Health and Suicide Prevention are not yet National Priorities."

    Incentives Reward Dependency Instead of Recovery. Approximately 90 percent of adults with serious mental illness are unemployed. Studies show that many of them want to work and many can work. Instead, our nation's largest 'program' for people with mental illness is disability payments. The situation is similar in many ways to the pre-reform welfare system. Mental health, rehabilitation and disability programs unintentionally trap millions of individuals - who want to work - into expensive long-term dependency, the costs of which are staggering. People with mental illness are both the largest and fastest growing group of people with disabilities receiving Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) disability payments. An estimated $25 billion is spent annually for this population.

    Excellent Care and Recovery Is Possible. Creative, community-based programs that blend the promise of modern science with the compassion of skilled professionals are breaking down the barriers to effective treatments, services and supports. These exemplary programs often achieve the best results despite - not because of - bureaucracies that often create fragmentation instead of focus and reward dependency instead of recovery. They range from school-based mental health care in Dallas; to home visits by trained nurses for high-risk women during pregnancy and the first year of the child's life; to suicide prevention by Air Force generals; and treatment for late-life depression in primary care.

    Overall, the Commission's interim report finds that the system is not oriented to the single most important goal of the people it serves - the hope of recovery. Many more individuals could recover from even the most serious mental illnesses, if they had access to treatments tailored to their needs, to supports and to services in their communities. State-of-the-art treatments, based on decades of research, are not being transferred from research to community settings. Meanwhile, many outdated and ineffective treatments are currently being actively supported. The barriers to effective mental health care can and must be overcome, and the Commission will continue its task of developing ways to do so.

    Additional information about the Commission and the Interim Report are available on the Internet at


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This page was last updated on July 22, 2002