Our Mission About the Commission Return to the Home Page Background Information Contact Information Presidential Address New Freedom Commission on Mental Health


President's New Freedom
Commission on Mental Health

Achieving the Promise: Transforming Mental Health Care in America

Goal 1: Americans Understand that Mental Health Is Essential to Overall Health


    1.1 Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention.

    1.2 Address mental health with the same urgency as physical health.

Understanding the Goal

Many People with Mental Illnesses Go Untreated

"Our country must make a commitment: Americans with mental illness deserve our understanding, and they deserve excellent care. They deserve a health system that treats their illness with the same urgency as a physical illness."

* Causes of disability for all ages combined. Measures of disability are based on the number of years of "healthy" life lost with less than full health (i.e., YLD: years lost due to disability) for each incidence of disease, illness, or condition. All data shown add up to 100%.

Stigma Impedes People from Getting the Care They Need

Suicide Presents Serious Challenges

Figure 1.2. Suicide is the Leading Cause of Violent Deaths Worldwide shows a pie chart divided into three sectors: suicide, 49.1%; homicide, 31.3%, and war-related deaths, 18.6%.

Better Coordination Is Needed Between Mental Health Care and Primary Health Care

Mental Health Financing Poses Challenges

Figure 1.3.
Distribution of Public and Private Mental Health Expenditures, 1997

Figure 1.3. Distribution of Public and Private Mental Health Expenditures, 1997 shows a pie chart divided into two shaded areas, All Private (43%) and All Public (57%).  The All Private sector is further divided into three sectors: Out of Pocket (17%), Private Insurance (24%), and Other Private (2%).  The All Public sector is further divided into four sectors: Medicaid (20%), State and Local (20%), Medicare (13%), and Other Federal (4%).

Also, many older adults and disabled individuals may rely on Medicare for their health care. However, in this program, coverage is an issue - with the most obvious example being the lack of a prescription drug benefit. As important as Medicaid and Medicare have been, they have not always grown along with the dramatic improvements in health care, such as prescription drugs, preventive care, and coordination of care. Action is needed now to remedy this problem.

Services and Funding Are Fragmented Across Several Programs

While each program provides essential assistance, together they create a financing approach that is complex, fragmented, and inconsistent in its coverage.

Financing Sources Can Be Restrictive

Achieving the Goal


1.1 Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention.

Public Education Activities Can Help Encourage People to Seek Treatment

Swift Action Is Needed to Prevent Suicide

Figure 1.4. Model Program: Suicide Prevention and Changing Attitudes About Mental Health Care


Air Force Initiative to Prevent Suicide


To reduce the alarming rate of suicide. Between 1990 and 1994, one in every four deaths among active duty U.S. Air Force personnel was from suicide. After unintentional injuries, suicide was the second leading cause of death in the Air Force.


In 1996, the Air Force Chief of Staff initiated a community-wide approach to prevent suicide through hard-hitting messages to all active duty personnel. The messages recognized the courage of those confronting life's stresses and encouraged them to seek help from mental health clinics - actions that were once regarded as career hindering, but were now deemed "career-enhancing." Other features of the program: education and training, improved surveillance, critical incident stress management, and integrated delivery systems of care.


From 1994 to 1998, the suicide rate dropped from 16.4 to 9.4 suicides per 100,000. By 2002, the overall decline from 1994 was about 50%. Researchers also found significant declines in violent crime, family violence, and deaths that resulted from unintentional injuries.38 Air Force leaders have emphasized community-wide involvement in every aspect of the project.

Biggest challenge

Sustaining the enthusiasm by service providers as the program has become more established.

How other organizations can adopt

The program can be transferred to any community that has identified leaders and organization, especially other military services, large corporations, police forces, firefighters, schools, and universities.


All U.S. Air Force locations throughout the world

Further, the Commission recommends forming a national level public-private partnership to advance the goals and objectives of the NSSP that proposes local projects in every State. This public-private partnership would emphasize building voluntary coalitions to address suicide prevention in communities and would include local leaders, business and school personnel, and representatives of the faith community.


1.2 Address mental health with the same urgency as physical health.

Recognize the Connection Between Mental Health and Physical Health

Address Unique Needs of Mental Health Financing

To be effective and comprehensive, mental health care must rely on many sources of financing. Flexible, accountable financing that pays for treatments and services that work and result in recovery is an essential aspect of transforming mental health care in America.


Previous Page Table Of ContentsNext Page


Commission on Mental Health Logo

Mental Health Resources / Home