Editorial: A spotlight on mental disorders

Tuesday, Dec. 14, 1999 | 9:17 a.m.

Since taking office in 1997, Surgeon General David Satcher has used his bully pulpit to draw attention to mental health, dispelling myths and focusing on facts. Satcher's diligence culminated Monday in the release of a 500-page report, which found that shame and an inability to pay for treatment have prevented millions from getting mental health care so they can lead productive lives. "Mental disorders are not character flaws but are legitimate illnesses that respond to specific treatments, just as other health conditions respond to medical interventions," the report concluded. "Society no longer can afford to view mental health as separate and unequal to general health."

While this nation can do more, treatment today is better than it was decades ago when those with mental illnesses routinely were locked up in state institutions. In effect, they were consigned to prison-like settings for having illnesses that doctors were either unwilling to treat or didn't know how to address. In recent years this has changed, with many individuals being released who shouldn't have been institutionalized (it also should be noted, though, that mental health hospital budget cuts have forced patients to be released who clearly weren't ready to be on their own). Many of the people no longer in institutions aren't getting the treatment -- whether it's counseling or medication -- that they need to get better, however. Even those who are employed sometimes can find themselves in a downward spiral, losing their jobs and ending up homeless. "To a great extent, we are dumping our mental health problems on the streets of America," Satcher said in an interview with the Associated Press.

While no specific public policy recommendation was made by Satcher involving the contentious issue of whether insurance companies should be mandated to treat mental and physical health problems with the same weight, this report should create the foundation for an intelligent discussion of how to address mental health issues. While doctors know more about what causes some medical illnesses, the fact remains that some disorders still are medical mysteries that will require more funding to conduct additional research.

The key now is how the public -- including the business community, policymakers and other health professionals -- reacts to this report, which encourages those who believe they have a mental disorder to seek assistance. The 1964 surgeon general's report documenting the dangers of smoking proved to be a landmark study that helped change dramatically attitudes about tobacco. In his own way Satcher has made a significant contribution to creating a dialogue about another public health issue that affects so many -- it's estimated that almost one in every five Americans has a mental disorder, but two-thirds of them don't seek treatment. Public opinion only will change -- and create an environment fostering adequate care for mental disorders -- if people no longer avert their eyes and switch the topic when mental health comes up in conversation.