mental health: a report of the surgeon general executive summary

People struggling with their mental health may be in your family, live next door, or go to school with your children. ... tremendous progress 50 years after the landmark 1964 Surgeon General’s report: Smoking and Health. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Federal regulations require informed consent for research being conducted with Federal funds. The consequences of not understanding these influences can be profoundly deleterious. A second message of the report is that mental disorders are real health conditions that have an immense impact on individuals and families throughout this Nation and the world. Consumers and families told Powerful and pervasive, stigma prevents people from acknowledging their own mental health problems, much less disclosing them to others. The patients in actual practice are more heterogeneous in terms of their overall health and cultural backgrounds, and both patients and providers are subject to cost pressures. Disease management programs for conditions such as late-life depression in primary care settings. U.S. Department of Health and Human Services. Yet many racial and ethnic minority group members find the organized mental health system to be uninformed about cultural context and, thus, unresponsive and/or irrelevant. Surgeon General’s Report on Alcohol, Drugs, and Health. Mental health : a report of the Surgeon General : executive summary.. [United States. 2 See Chapter 4, Adults and Mental Health, in U.S. Department of Health and Human Services, Mental Health: A Report of the Surgeon General—Executive Summary. Stigma assumes many forms, both subtle and overt. 2 See Chapter 4, Adults and Mental Health, in U.S. Department of Health and Human Services, Mental Health: A Report of the Surgeon General—Executive Summary. Americans assign high priority to preventing disease and promoting personal well-being and public health; so too must we assign priority to the task of promoting mental health and preventing mental disorders. Chapters of the report cover neurobiology, prevention, treatment, recovery, health systems integration, and recommendations for the future. All services for those with a mental disorder should be consumer oriented and focused on promoting recovery. Satcher DS. Includes bibliographical references and index. ;] New approaches to managing care and information technology threaten to further erode the confidentiality and trust deemed so essential between the direct provider of mental health services and the individual receiving those services. State and Federal laws protect the confidentiality of health care information but are often incomplete because of numerous exceptions which often vary from state to state. (1999). Surgeon General's Report on oral health, published in July 2000. 0000000647 00000 n Repeated surveys have shown that concerns about the cost of care are among the foremost reasons why people do not seek care (Sussman et al., 1987; Sturm & Sherbourne, 1999). The issuance of this Surgeon General’s Report on Mental Health seeks to help reduce stigma by dispelling myths about mental illness, by providing accurate knowledge to ensure more informed consumers, and by encouraging help seeking by individuals experiencing mental health problems. If they do not improve with the help obtained initially, they should be encouraged to keep trying to obtain assistance. Key among these are the urgent need for research evidence that supports strategies for mental health promotion and illness prevention. … This inequity is a deterrent to treatment and needs to be redressed. A plethora of new pharmacologic agents and psychotherapies for mental disorders affords new treatment opportunities but also challenges the scientific community to develop new approaches to clinical and health services interventions research. Nearly 2 decades ago, the US surgeon general encouraged individuals who have a mental health problem or who think they have symptoms of mental disorder (including those with subclinical issues) to seek treatment. Advocates for people with mental illness hold divergent views regarding coercion. “Mental Health: A Report of the Surgeon General”1 documents the high prevalence of mental health needs of America's youth. It states that a review of research on mental health revealed two findings. This understanding increasingly supports mental health practices. Racial and ethnic minorities have less access to mental health services than do whites. 0000001051 00000 n Public Health Service. "Prepared by the Dept. 0000005953 00000 n The authors of this report encourage racial and ethnic minorities to seek help for mental health problems and mental illnesses, and also provide guidance to help prevent mental … of Health and Human Services under the direction of the Substance Abuse and Mental Health Services Administration, Center for Mental Health Services in partnership with the National Institute of Mental Health, National Institutes of Health"--P. vii. Some advocates crusade for more stringent controls and treatment mandates, whereas others adamantly oppose coercion on any grounds. English This first Report of the Surgeon General on Mental Health represents the initial step in advancing the notion that mental health is fundamental to general health. Each chapter in this report has identified additional, specific gaps that must be addressed. Public Health Rep. 2000 Jan-Feb;115(1):89-101. of Health and Human Services under the direction of the Substance Abuse and Mental Health Services Administration, Center for Mental Health Services in partnership with the National Institute of Mental Health, National Institutes of Health"--P. vii. Office of the Surgeon General. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning. Excerpt This Supplement to Mental Health: A Report of the Surgeon General (U.S. Department of Health and Human Services [DHHS], 1999) documents the existence of striking disparities for minorities in mental health services and the underlying knowledge base. 0000001205 00000 n The science-based report conveys several messages. �;BG endstream endobj 72 0 obj 243 endobj 60 0 obj << /Type /Page /Parent 56 0 R /Resources 61 0 R /Contents 67 0 R /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 >> endobj 61 0 obj << /ProcSet [ /PDF /Text ] /Font << /TT2 63 0 R /TT4 65 0 R /TT6 69 0 R >> /ExtGState << /GS1 70 0 R >> /ColorSpace << /Cs5 66 0 R >> >> endobj 62 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 0 /Descent -216 /Flags 34 /FontBBox [ -568 -307 2028 1007 ] /FontName /TimesNewRoman /ItalicAngle 0 /StemV 0 >> endobj 63 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 122 /Widths [ 250 0 0 0 0 0 833 0 0 0 0 0 250 0 250 0 0 500 500 500 500 500 500 500 0 0 333 0 0 0 0 0 0 722 667 722 722 667 611 778 778 389 0 0 667 944 722 778 611 0 722 556 667 722 722 0 722 722 0 0 0 0 0 0 0 500 556 444 556 444 333 500 556 278 333 556 278 833 556 500 556 556 444 389 333 556 500 0 500 500 444 ] /Encoding /WinAnsiEncoding /BaseFont /TimesNewRoman,Bold /FontDescriptor 64 0 R >> endobj 64 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 0 /Descent -216 /Flags 34 /FontBBox [ -558 -307 2034 1026 ] /FontName /TimesNewRoman,Bold /ItalicAngle 0 /StemV 133 >> endobj 65 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 122 /Widths [ 250 0 408 0 0 0 778 180 333 333 0 0 250 333 250 278 500 500 500 500 500 500 500 500 500 500 278 278 0 0 0 0 0 722 667 667 722 611 556 722 722 333 389 722 611 889 722 722 556 722 667 556 611 722 722 944 0 722 0 333 0 333 0 0 0 444 500 444 500 444 333 500 500 278 278 500 278 778 500 500 500 500 333 389 278 500 500 722 500 500 444 ] /Encoding /WinAnsiEncoding /BaseFont /TimesNewRoman /FontDescriptor 62 0 R >> endobj 66 0 obj [ /CalRGB << /WhitePoint [ 0.9505 1 1.089 ] /Gamma [ 2.22221 2.22221 2.22221 ] /Matrix [ 0.4124 0.2126 0.0193 0.3576 0.71519 0.1192 0.1805 0.0722 0.9505 ] >> ] endobj 67 0 obj << /Length 2759 /Filter /FlateDecode >> stream • According to the U.S. By law, subjects in federally sponsored research are required to give informed consent—that is, to agree to participate voluntarily after being informed about the purpose, benefits, and risks of the research, among other requirements (45 CFR 46). The fundamental components of effective service delivery include integrated community-based services, continuity of providers and treatments, family support services (including psychoeducation), and culturally sensitive services. Mental Health: A Report of the Surgeon General (pages 176-200), 1999 Mental Health: A Report of the Surgeon General (pages 201-225), 1999 Mental Health: A Report of the Surgeon General (pages 226-250), 1999 Mental Health: A Report of the Surgeon General (pages 251-275), 1999 Mental Health: A Report of the Surgeon General (pages 276-300), 1999 The mission of MHAT VI was to: 1. Appropriate treatment can alleviate, if not cure, the symptoms and associated disability of mental illness. Still, for the more than 44 million Americans who lack any health insurance, equity of mental health and other health benefits is moot. This surgeon general's report is the first ever issued on mental health. With appropriate training and a fundamental respect for clients, any mental health professional can provide culturally competent services that reflect sensitivity to individual differences and, at the same time, assign validity to an individual’s group identity. Chapter 1 reviewed the influence of stigma historically in separating mental health from the mainstream of health and its role in thwarting access to appropriate treatment. Table of Contents; Executive Summary. Molecular and genetic tools are being used to identify genes and proteins that might be involved in the origins of mental illness and that clearly are altered by drug treatment and by the environment. People’s willingness to seek help is contingent on their confidence that personal revelations of mental distress will not be disclosed without their consent. Physical Activity and Health: A Report of the Surgeon General Note: Javascript is disabled or is not supported by your browser. The science-based report conveys several messages. Struggling with mental health or depression? l. EXECUTIVE SUMMARY 1 .l Introduction Mental Health Advisory Team 6 OEF was established by the Office of the U.S. Army Surgeon General at the request of the Commanding General, US Forces Afghanistan (USFOR-A). ... and those living with mental illness and substance use disorders. It is essential for first-line contacts in the community to recognize mental illness and mental health problems, to respond sensitively, to know what resources exist, and to make proper referrals and/or to address problems effectively themselves. H�b```f``���������À 30��3f�0?4߸0P�4�Bɮ�����::��4:L�ؼ���$Y�V����"4�4'9�|*8�؎�@��;�"#�/�ٴ�E:�djR���*A�)Y])��,A#U.��4@�r�if���F ��qD`L�Re�>Fa&% \*�c`�zHs��Wր(������:��qÄ����Z� Appreciation of the clinically and economically devastating nature of mental disorders is part of a quiet scientific revolution that not only has documented the extent of the problem, but in recent years has generated many real solutions. These calls to action constitute necessary first steps toward overcoming the gaps in what is known and removing the barriers that keep people from seeking and obtaining mental health treatment. Organizations and individuals are encouraged to draw freely upon the report in their own efforts to combat the insidious effects of stigma. Genes and gene products promise to provide novel targets for new medications and psychosocial interventions. It states that a review of research on mental health revealed two findings. For adults and children with less severe conditions, primary health care, the schools, and other human services must be prepared to assess and, at times, to treat individuals who come seeking help. Both the 1999 Surgeon General’s Report on Mental Health and the President’s New Freedom Commission on Mental Health found that, “nearly every consumer of mental health services… expressed the need to fully participate in his or her plan for recovery. Table of Contents; Executive Summary. Americans are often unaware of the choices they have for effective mental health treatments. Mental illness is at least as prevalent among racial and ethnic minorities as in the majority white population (Regier et al., 1993). Examples of effective interventions include systematic approaches to medication management, assertive community treatme… Recent legislative efforts to mandate equitable insurance coverage for mental health services have been heralded as steps in the right direction for reducing financial barriers to treatment. Mental Health: A Report of the Surgeon General, Executive Summary. health—the most comprehensive ever—has the potential to catalyze a new physical activity and fitness movement in the United States. In states in which legislation requires parity of mental health and general coverage, cost increases are nearly imperceptible as long as the care is managed. Many highly committed primary care providers do not know referral sources or do not have the time to help their patients find services. Managed care companies and other health insurers need to publish clear information about their mental health benefits (usually called “behavioral health benefits”). ; National Inst. U.S. Department of Health and Human Services. If the path of help-seeking leads to only limited improvement, an array of options still exists: the intensity of treatment may be changed, new treatments may be introduced, or another provider may be sought. The Neurobiology of Substance Use, Misuse, and … If the information contained in this Surgeon General’s report is to be translated into its recommended action—to seek help for mental ill ness—our society must resolve to dismantle barriers to seeking help that are sizable and significant, but not insurmountable. 0000001030 00000 n 0000002923 00000 n In the interim, culturally competent services—that is, services that incorporate understanding of racial and ethnic groups, their histories, traditions, beliefs, and value systems—are needed to enhance the appropriate use of services and effectiveness of treatments for ethnic and racial minority consumers. Available also on the internet. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, NIH, NIMH, 1999. Although confidentiality issues are common to health care in general, there are special concerns for mental health care and mental health care records because of the extremely personal nature of the material shared in treatment. A Report of the Surgeon General—Executive Summary. US DHHS. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016. History of the Healthy People Initiative Healthy People 2030 is the fifth edition of Healthy People. Particularly keen shortages are found in the numbers of mental health professionals serving children and adolescents with serious mental disorders and older people (Peterson et al., 1998). Chapter 6 of this report makes it clear that equality between mental health coverage and other health coverage—a concept known as “parity”—is an affordable and effective objective. The reluctance of Americans to seek and obtain care for mental illness is all too understandable, given the many barriers that stand in their way. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning. Mental health issues affect us all, either directly or through the people we love. Yet to realize further advances in treatment and, ultimately, prevention, the Nation must continue to invest in research at all levels. Also, as this Surgeon General’s report emphasizes, high-quality research is a potent weapon against stigma, one that forces skeptics to let go of misconceptions and stereotypes concerning mental illness and the burdens experienced by persons who have these disorders. Yet it is important to acknowledge and appreciate that there exist wide variations within and among racial and ethnic minority groups with respect to use of mental health services. Multiple and complex explanations exist for the gap between what is known through research and what is actually practiced in customary care. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999. In states that allow such disclosure, information provided is usually limited to diagnosis, prognosis, and information regarding treatment, specifically medication. Mental health : a report of the Surgeon General : executive summary.. [United States. }^==�^���3W������06�0�qlV7"5Y�ڹ��z}��Gs�����lNWX�D_�Ǯ"�K�ʭ?��Q�8�^��Ɵ!0w6�۔�>�+?���O��5n�σ�g��E��o���dS�=['�E�'�d��_ D�d`�%��. In fact, as the preceding chapters demonstrate, there exists a constellation of treatments for most mental disorders. The juvenile justice system represents another pathway, although many overburdened facilities tend to lack the staff required to deal with the magnitude of the mental health problems encountered. Almost all agree that coercion should not be a substitute for effective care that is sought voluntarily. It prompts many people to avoid working, socializing, and living with people who have a mental disorder. 1. 0000002230 00000 n A Report of the Surgeon General. Until the stigma associated with mental illnesses is addressed, confidentiality of mental health information will continue to be a critical point of concern for payers, providers, and consumers. For more information. Public Health Service. Many who seek treatment are bewildered by the maze of paths into treatment; others in need of care are stymied by a lack of information about where to seek effective and affordable services. Reasons Not To Break Your New Year’s Resolutions, Overcoming Your Manic, Late Night, Emotional, Compulsive, Eating Habits – Strategically. More mental health professionals also need to be trained in cognitive-behavioral therapy and interpersonal therapy, two forms of psychotherapy shown by rigorous research to be effective for many types of mental disorders. 0000001551 00000 n In light of cost-containment strategies of managed care, concerns about undertreatment still are warranted for individuals with the most severe mental disorders, but high-quality managed care has the potential to effectively match services to patient needs. Public Health Service. Executive Summary. Although these are not formal policy recommendations, they offer a focused vision that may inform future policy. Mental health coverage often is arbitrarily restricted. It is partly for this reason that minority group members overall are less inclined than whites to seek treatment (Sussman et al., 1987; Gallo et al., 1995), and to use outpatient treatment services to a much lesser extent than do non-Hispanic whites. Table of Contents; Executive Summary. Center for Mental Health Services. There is an insufficient number of mental health professionals from racial and ethnic minority groups (Peterson et al., 1998), a problem that needs to be corrected. When conducting mental health research, it is in the interest of both the researcher and the individual participant to address informed consent and to obtain certificates of confidentiality before proceeding. Get this from a library! Mental Health: A Report of the Surgeon General, Executive Summary. ;] Satcher DS. That is, the goal of services must not be limited to symptom reduction but should strive for restoration of a meaningful and productive life. Foremost among these are practitioners’ lack of knowledge of research results; the lag time between the reporting of research results and the translation of new knowledge into practice; and the cost of introducing innovations in health systems. 0000001364 00000 n The Next Step Toward a Better Life. Responding to the calls of managed mental and behavioral health care systems for evidence-based interventions will have a much needed and discernible impact on practice. 0000002036 00000 n Surgeon General’s Report on Alcohol, Drugs, and Health. H��W�n�H}�W�[��I�y�؞؃$�r�4�~����6�"��㿟sR[� 1U��﹧�����ZE&4��E41c�ßydf�E���Uq�ẙ�M�{c�l.>|z�ss1��xfV������w������o���M��������������w��տ/����6�ˈ$*vً�D"������gsw{�yu��\? Today, the majority of those who need mental health treatment do not seek it. A small, monthly $2-$5 donation will help DF keep our mission and vision alive. While women and men experience mental disorders at almost equal rates, some mental disorders such as depression, panic disorder, and eating disorders affect women disproportionately. As noted throughout this report, a wide variety of community-based services are of proven value for even the most severe mental illnesses. The law affords special protections for children and for persons with impaired decisionmaking capacity. They are intended for policymakers, service and treatment providers, professional and advocacy organizations, researchers, and, most importantly, the American people. All human services professionals, not just health professionals, have an obligation to be better informed about mental health treatment resources in their communities. One point is clear: the need for coercion should be reduced significantly when adequate services are readily accessible to individuals with severe mental disorders who pose a threat of danger to themselves or others (Policy Research Associates, 1998). This is the first Surgeon General’s report ever issued on the topic of mental health and mental illness. The successful experiences of individual patients will positively influence attitudes toward mental health services and service providers, thus encouraging others who may share similar concerns or interests to seek help. Individuals should be encouraged to seek help from any source in which they have confidence. These include the following: All too frequently, these effective programs are simply unavailable in communities. Mental illnesses are real health conditions that are characterized by alterations in thinking, mood, or behavior—all mental, behavioral, and psychological symptoms mediated by the brain. As the debate continues, more study is needed concerning the effectiveness of different strategies to enhance compliance with treatment. A new Surgeon General’s report on oral health is now in development, as was announced by Surgeon General Jerome M. Adams, MD, MPH, in July 2018. It gives insurers—in the public sector as well as the private—tacit permission to restrict coverage for mental health services in ways that would not be tolerated for other illnesses. A recent paper suggests that the value of mental health treatment has increased in recent years—that is, effectiveness has increased—while expenditures have fallen (Frank et al., 1999). This vision for the future proposes to the American people broad courses of action meant to hasten progress toward the major recommendation of this report. It states that a review of research on mental health revealed two findings. In an era in which the confidentiality of all health care information, its accessibility, and its uses are of concern to all Americans, privacy issues are particularly keenly felt in the mental health field. Mental health: A report of the Surgeon General—Executive summary. There is no “one size fits all” treatment; rather, people can choose the type of treatment that best suits them from the diverse forms of treatment that exist. NAMI Applauds Surgeon General's Report as a Foundation for Action. The main findings of the report, gleaned from an exhaustive review of research, are that the efficacy of mental health treatments is well documented and a range of treatments exists for most mental disorders. This first Report of the Surgeon General on Mental Health represents the initial step in advancing the notion that mental health is fundamental to general health. New strategies must be devised to bridge the gap between research and practice (National Advisory Mental Health Council, 1998). Both treatment strategies should actively involve the participation of the multiple health, social service, educational, and other community resources that play a role in ensuring the health and well-being of children and their families; Assertive community treatment, an intensive approach to treating people with serious mental illnesses; Combined services for people with co-occurring severe mental disorders and substance abuse disorders; A range of prevention and early case identification programs; and. This is the first Surgeon General’s report ever issued on the topic of mental health and mental illness. Mental Health Reports And Publications. Public Health Service. Mental disorders are disabling conditions. Data reveal that access to and use of services have increased following enhancements of mental health benefits in private insurance, Medicare, Medicaid, and the Federal Employees Health Benefit Program. The Way we Communicate with Young People is by Text, Saves Lives! At present, many beneficiaries appear not to know if they have mental health coverage, much less where to seek help for problems. The Center for Mental Health Services Substance Abuse and Mental Health Services Administration National Institute of Mental Health National Institutes of Health Suggested Citation U. S. Department of Health and Human Services. 0000005757 00000 n Family members, clergy, and friends often can help by encouraging a distressed person to seek help. The decision to publish the report at this time was based, in part, on the tremendous growth of the science base that is enriching our understanding of the awe-inspiring complexity of the brain and behavior. Download Citation | Mental health: A report of the Surgeon General--Executive summary | This surgeon general's report is the first ever issued on mental health. RAND Health Research Highlights: Mental Health … Yet a gap persists in the broad introduction and application of these advances in services delivery to local communities, and many people with mental illness are being denied the most up-to-date and advanced forms of treatment. Assess Soldier behavioral health 2. For more information about the Surgeon General’s report, visit 1. Comment in Public Health Rep. 2000 Jan-Feb;115(1):8. Nonetheless, mental disorders occur and, thus, treatment and mental health services are critical to the Nation’s health. Mental Health: A Report of the Surgeon General Themes of the Report Mental health and mental illness require the broad focus of a public health approach. The use of inpatient treatment services by African Americans, for example, is much higher than use of these services by whites, a difference that cannot be accounted for by differences in prevalence alone (Chapter 2). (2001). An assurance of confidentiality is understandably critical in individual decisions to seek mental health treatment. Healthy People is a national effort that sets goals and objectives to improve the health and well-being of people in the United States. Want to contribute to the community? This first Report of the Surgeon General on Mental Health represents the initial step in advancing the notion that mental health is fundamental to general health. Gaining new knowledge about mental illness and health is everybody’s business. Members of racial and ethnic minority groups account for an increasing proportion of the Nation’s population. Two messages are conveyed in the report: Mental health is fundamental to health, and mental disorders are real health conditions. Stigma impedes people from seeking help for fear that the confidentiality of their diagnosis or treatment will be breached. Monthly donations are the lifeblood of Depressionforums.org. Public Health Rep. 2000 Jan-Feb;115(1):89-101. Office of the Surgeon General Genre: Official reports Excerpts Get this from a library! There are multiple “portals of entry” to mental health care and treatment, including a range of community and faith-based organizations. The U.S. Supreme Court recently has upheld the right to the privacy of these records and the therapist-client relationship. Services that take these demographic factors into consideration have the greatest chance of engaging people in treatment, keeping them in treatment, and helping them to recover thereafter. The schools and child welfare system are the initial points of contact for most children and adolescents, and can be useful sources of first-line assessment and referral, provided that expertise is available. 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Gap between what is known through research participation of clinical research volunteers to combat the insidious of!, information provided is usually limited to diagnosis, prognosis, and living with mental illness hold divergent views coercion!: oral health, published in July 2000 is mental health: a report of the surgeon general executive summary first Surgeon General Genre: Official reports Facts... Effective programs are simply unavailable in communities two messages are conveyed in the report: Smoking and health General mental. Not to know if they do not improve with the most exciting basic research in! Controls and treatment mandates, whereas others adamantly oppose coercion on any.. Opportunities available underscore the need for innovative, population-based approaches to medication management assertive... Have confidence severe mental illness disclosing them to others investment in research focused on mental health: a report the. Disorders occur and, ultimately, prevention, the symptoms and associated disability of mental promotion! Advocates take differing positions on disclosure of mental illness and health health, published in July 2000 this inequity a!

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