New Freedom Commission on Mental Health


President's New Freedom
Commission on Mental Health

Press Release

    November 1, 2002 Phone: 301-443-8956

    Commission Reports to the President "Mental Health System is in Disarray"

    Exemplary Programs Offer Hope for the Future

    Calling the mental health system an inefficient maze of private, federal, state and local government programs with scattered responsibility for services that frustrates both people with mental illness and providers of care, the President's New Freedom Commission on Mental Health Chairman Michael F. Hogan, Ph.D., released an interim report to the President today.

    Citing the need for dramatic reform at all levels of service delivery, Hogan said, "the Commission's challenge now is to identify realistic solutions to help people with mental illness get the quality care that research has shown to be effective."

    "Today, people diagnosed with cancer or heart disease benefit from a broad array of effective treatments. People with mental illness deserve no less. Undetected, untreated and poorly-treated mental disorders interrupt lives, leading many to disability, poverty and long-term dependence." Hogan continued. "The good news is that recovery from mental illness is a reality; a range of safe and effective treatments, services and supports exist for men, women and children with mental illness. We know that when mental illness is diagnosed early and treated appropriately, quality of life is tremendously improved. Yet, half of all people who need treatment for mental illness do not receive it. The rate is even lower for racial and ethnic minorities and the quality of care they receive is poorer."

    In its report, the Commission identified barriers to quality care and recovery. Some relate directly to the service delivery system itself, such as fragmentation and gaps in care for children, adults and older adults. Others reward dependency such as through a mix of inadequate rehabilitation, and disincentives to work. Still others reflect a failure to make mental health a national priority. In its next phase of work, the Commission will be addressing ways to break down these barriers to recovery.

    Hogan said, "We need to answer the question, 'Why are 90 percent of adults with serious mental illness unemployed?' After all, studies show that a majority want to work and can work. Instead, our Nation's largest 'program' for people with mental illness is the disability system. Our mental health, rehabilitation and disability programs unintentionally trap millions of individuals - who want to work - into expensive long-term dependency."

    Hogan continued, "The barriers that keeps adults with mental illness from productive work and children with serious emotional disturbance from school success are a tragedy from both human and economic perspectives. Although most adults with mental illness want to work, they are the largest and fastest growing group of people with disabilities receiving Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) payments. An estimated $25 billion is spent annually for this population. Many people with mental illness find that they cannot afford to go back to work because they would lose their Medicaid coverage and disability benefits, and despite a job, could not afford private health insurance coverage. Too many people with mental illness are trapped in a 'disability welfare system' that badly serves them and needs reform. And although many children with emotional disorders are very bright, fewer than half ever graduate from high school. Our failure to support employment and school success is a disgrace."

    To help identify what works best to break down the barriers to care for people with mental illness, the Commission has already identified some creative, community-based programs that blend the promise of modern science with the compassion of skilled professionals. These exemplary programs often achieve the best results, despite bureaucracies that frequently create fragmentation instead of focus, and that 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 their child's life, to suicide prevention by the United States Air Force, and effective treatment for late-life depression.

    "These models," Hogan said, "can inspire communities nationwide, and provide realistic examples of how quality, coordinated care is possible for the millions of Americans with mental illness."

    Overall, the Commission's interim report found 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 effective treatments tailored to their needs, to supports and to services in their communities. State-of-the-art treatments, based on decades of scientific inquiry, are not being transferred from research to community settings. At the same time, many outdated and ineffective treatments are still used.

    The President's New Freedom Commission on Mental Health was established by Executive Order 13263 on April 29, 2002. The Commission=s work is essential to the President=s commitment B embodied in the New Freedom Initiative B to eliminate inequality for Americans with disabilities.

    The President tasked the Commission to recommend improvements in the U.S. mental health service system for adults with serious mental illness and for children with serious emotional disturbances. He requested a review of both public and private sectors to identify policies that could be implemented by federal, state and local governments to maximize the utility of existing resources, to improve coordination of treatments and services, and to promote a full life in the community for people with mental illness. The Commission's recommendations will be presented in its final report. The document released today responds to the legal requirement for an interim report. 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