The Mental Illness Epidemic

There is an epidemic of mental illness in America.  It’s time policy leaders did something about it.

They could start by acknowledging just how widespread this epidemic is.  According to the National Institute on Mental Health, it affects one-fourth of our population – over 57 million adults and over 15 million children. 

Why are the numbers so staggering?

No one knows for sure, but the bad economy, wars, and abuse are all probable factors.

According to a Gallup Poll released last year, the bad economy led to an increase in emotional illness among all adults.  Especially hard hit were those between the ages of 30 and 55, the family breadwinners.

CNN reported in 2007 that one-third of all veterans returning from Iraq or Afghanistan were treated for mental illnesses.  Their children were also affected.  According to a survey of health records released this past month and reported in the New York Times, children between the ages of 3 and 8 with parents in the military had 10% more visits to mental health providers than their peers.

Also in 2007, 5.8 million child neglect or abuse allegations were reported to state child protection agencies.  Almost 800,000 of these were confirmed.

Simply blaming economic and environmental factors isn’t enough, however. 

Researchers have achieved some breakthroughs, but they still don’t know why 17 million adults have serious mental illnesses like schizophrenia, bipolar disorder, and major depression.  These are not caused by economic or environmental factors, and they have devastating consequences.

Homelessness and incarceration are two of them.  According to the National Coalition for the Homeless, 25% of homeless people have severe mental illness, and mental illness is a leading cause of homelessness in our country. 

County jails, where inmates usually stay for under six months either awaiting trial or serving time for minor offenses, are teeming with people affected by mental illness.  Some officials report that up to 85% of jail inmates have mental illness.  They are also three times more likely to have serious mental illness than someone not in jail, and a 2009 study found that nearly one in three female jail inmates had serious mental illness – five times the prevalence in the population as a whole. 

This isn’t acceptable.

Policy leaders need to take this epidemic seriously.

First, they need to do more to identify and treat serious mental illness in children.  The Mental Health Association of Palm Beach County (FL) has offered a creative idea.  It suggests adding periodic mental health screening to pediatric care for all children, to identify and treat mental illness in children at the earliest possible age.  All state legislatures, not just Florida’s, should look closely at this.

Second, they need to decriminalize mental illness.  Simply exhibiting symptoms of mental illness in public can sometimes be cause for arrest, wasting precious resources.  A few years ago, a schizophrenic homeless person was arrested for “sitting or lying on a public sidewalk.”  He missed his court hearing because he was in jail for violating his probation on an earlier offense by being arrested again.  When he finally got to court, no one except the homeless person could keep track of what time he was actually serving for which offense, so he was released. 

People with mental illness don’t belong in jail.  If policy leaders changed the laws that send them there, as a side benefit jail overcrowding would end overnight.

Third, they need to create an emergency mental health response system that looks more like the rest of our emergency response system.  In a health emergency, an ambulance responds.  In a mental health emergency, a law enforcement officer responds.

They should be sainted for taking on this role.  They have diverted many people in crisis away from jails.  But it is no more reasonable to ask law enforcement professionals to evaluate mental illnesses than it would be to ask them to evaluate diabetes, heart disease, or cancer emergencies.

Local and county emergency mental health services systems should be staffed by mental health professionals.  Policy makers should use the new federal insurance parity laws to assure that insurance covers the cost.

Fourth, they need to rebuild our safety net system of care for people with mental illness.  When we emptied our large state institutions beginning in the 1970s, we were supposed to replace them with community mental health centers. But we stopped building these new centers before we were finished. 

It’s time to start building them again, and to pass laws giving them preferred Medicare and Medicaid rates, discounted drug pricing, and access to ongoing federal grants like the ones supporting community health centers.  Then policy leaders should integrate safety net health and mental health care.

These are just four ways policy leaders could start dealing with the epidemic of mental illness.  There are more.  75 million Americans in crisis are waiting patiently.