FOR IMMEDIATE RELEASE CONTACT: Mark Weber
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
www.MentalHealthCommission.gov.
