Surgeon General David Satcher, M.D., proclaimed that treatment for mental disorders and mental health services are critical to the nation’s health as he released a landmark report last month. APA and mental health advocacy groups applauded Satcher for increasing national awareness of effective treatments and barriers to treatment.

Commented APA President Allan Tasman, M.D., "This 1999 Surgeon General’s report can do for mental illness what the Surgeon General’s 1964 report did for smoking and health. APA believes it will bring about a sea change in public attitudes and understanding of mental illnesses and set the stage for a major assault on the myths and stigma that continue to block access to care for millions."

A powerful antidote to stigma is research that generates more effective treatments, according to Satcher at last month’s press briefing at the Old Executive Office Building. The 500-page report documents the effectiveness of a range of treatments for most mental disorders based on an extensive review of the scientific literature. The report also covers mental health and mental illness in children, adults, and the elderly, as well as the organization and financing of mental health services.

Tipper Gore, the President’s advisor on mental health, said at the briefing, "The Surgeon General’s Report on Mental Health provides a historic opportunity to deepen America’s understanding of mental health."

Satcher’s key messages were that mental illnesses are real and biologically based and that effective treatments are available. "I urge Americans to seek help for yourselves or your loved ones experiencing symptoms of mental illness," he said.

Stigma and a lack of mental health parity, however, are major barriers to getting needed treatment, said Satcher. "The lack of access to mental health care has driven far too many vulnerable people into homelessness and our jails and prisons."

Satcher called for real parity between benefits for mental illness and benefits for "physical" illness, noting that only about 27 states have enacted laws mandating some form of limited parity. Satcher supports a public health orientation to mental health that emphasizes epidemiological data, prevention, early diagnosis, and promotion. "This perspective involves people in the entire community sharing the responsibility for mental health," he observed.

Tasman commended Satcher’s report for calling for continued research and recognizing "the need to train additional psychiatrists and other mental health professionals, especially in the care of children with mental illnesses."

APA applauded the Surgeon General’s report for devoting a chapter to confidentiality and recognizing that it is a necessary component of mental health treatment and a therapeutic patient-doctor relationship.

Satcher called for these broad actions to improve mental health in the new millennium:

• Overcome stigma by disseminating accurate information

• Improve public awareness of effective treatments

• Ensure an adequate supply of mental health services and providers

• Ensure delivery of state-of-the art treatments

• Tailor treatment for each patient in terms of the patient’s age, gender, race, and culture

• Facilitate entry into treatment

• Reduce financial barriers to treatment.

The Surgeon General credited the Substance Abuse and Mental Health Services Administration, in particular the Center for Mental Health Services and the National Institute of Mental Health, for its work in preparing the report. Howard Goldman, M.D., a professor of psychiatry at the University of Maryland School of Medicine, was the report’s senior scientific editor.

Satcher also announced that in-depth supplements to the report would be released this year. The first supplement will address the implications of race, culture, and gender for mental health. The second supplement will examine mental health issues specific to the elderly.

Satcher said he wanted to be remembered as the Surgeon General who listened to the American people and responded effectively. "I hope this report released today is a meaningful response to the nation’s unmet mental health needs," he said.

The full report, "Mental Health: A Report of the Surgeon General," is available on the Web at <www.surgeongeneral.gov/library/mentalhealth/index.html>