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Health :: Prevention and treatment are leading contributors to mental health crisis

One in four U.S. adults suffer from a diagnosable mental disorder, yet they face barriers to equal access to treatment and preventive health services, public health experts said today at a forum releasing new research examining the impact of mental illness on the nation’s health from the October 2006 issue of the American Journal of Public Health.

In one study, researchers found that unmarried parents reported poorer mental health and more behavioral problems than married parents, but not all unmarried parents were alike. Those whose relationships ended before the birth of a child reported significantly more impairment than any other group. This pattern was especially true for partner violence and fathers’ history of incarceration.

“The percentage of births to unmarried parents has tripled in the past three decades,” said Michelle DeKlyen, Ph.D., of the Center for Research on Child Wellbeing at Princeton University and lead author of the study. “Since the children of parents with poor mental health are themselves at risk for multiple problems, addressing the mental health needs of these parents will have long-term benefits for public health.”

In another new study, researchers found that racial and ethnic discrimination is associated with poor mental health status, and the association between discrimination and mental health may be stronger for immigrants who have lived in the United States longer than for more recent arrivals.

Another study examining trends in suicide rates showed that among adolescents and young adults aged 15 to 24 suicide rates increased steadily until 1994 and then began a steady decline to levels not seen since the early 1970s. Among adults aged 65 and older, data show an overall decline in suicide rates dating back more than 15 years.

Public health experts discussed these and other new findings and the increasingly broad impact mental illness has on the nation, where mental disorders are the leading cause of disability for people ages 15 to 44, and among children, nearly 5 percent – or 2.7 million – are reported by their parents to suffer from behavioral or emotional difficulties. Mental illness not only affects the health status of the individual, but also has profound effects on the community at large.

“Barriers to mental health care include stigma as well as discrimination in access,” said David Satcher, M.D., Ph.D., former U.S. surgeon general, director of the Center of Excellence on Health Disparities, and the Poussaint-Satcher-Cosby Chair in Mental Health at the Morehouse School of Medicine in Atlanta. “Because of these barriers persons with mental disorders often do not receive the care they need and many end up on the street or in the criminal justice system.”

Experts here pointed to these and other obstacles to prevention and care, including lack of adequate insurance coverage for mental health, poor coordination of mental health services with primary care and high costs of medication, as leading contributors to this health crisis.

“It is tragic that Americans who suffer from mental illness are denied access to the same health services that are provided for other debilitating conditions,” said Georges Benjamin, M.D., F.A.C.P., executive director of the American Public Health Association. “Our nation’s economy has lost more than $150 billion in productivity because of unmet mental health needs, and as many as 8 million Americans, including children, who have serious mental illnesses do not receive adequate treatment each year. Mental illness is a treatable disease, and Americans deserve access to the services that will help improve their lives and productivity.”

The release of this special themed issue of the Journal, which contains 17 articles on mental health, was sponsored by the Community Voices Initiative of the National Center for Primary Care, Morehouse School of Medicine and the American Public Health Association. The National Mental Health Association (NMHA) co-sponsored the event. Other studies found:

— Individuals with at least one current psychiatric disorder were 2.7 times more likely to be persistent smokers than those without a disorder;

— The South has the highest proportion of suicides by firearms in the United States, followed by the West, the Midwest and the Northeast;

— Between 1998 and 2003, the number of patients with a mental health or substance abuse diagnosis in the nation’s health centers rose from 210,000 to 800,000, indicating the increasingly central role of health centers in providing mental health services across the United States; and

— Adolescents who consume large quantities of soft drinks containing sugar, tend to report more mental health problems than adolescents with a low or moderate consumption of such soft drinks.

Experts participating in the forum included Henrie M. Treadwell, Ph.D, senior social scientist and associate director of development, National Center for Primary Care, Morehouse School of Medicine; Georges C. Benjamin, M.D., F.A.C.P., executive director, American Public Health Association; David Satcher, M.D., Ph.D., former U.S. surgeon general, director of the Center of Excellence on Health Disparities; Michelle DeKlyen, Ph.D., research associate, Center for Research on Child Wellbeing, Princeton University; Robert E. McKeown, Ph.D, associate dean for research and professor of epidemiology, Arnold School of Public Health, University of South Carolina; Gilbert C. Gee, Ph.D, assistant professor of health behavior and health education, University of Michigan School of Public Health; and David Shern, Ph.D., president and chief executive officer, National Mental Health Association, http://www.nmha.org.

A webcast of this event will be provided by the Kaiser Family Foundation and available after 5 p.m. ET, on Friday, Sept. 29, at http://www.kaisernetwork.org/healthcast/apha/28sep06. Along with the webcast, a transcript and related resources will also be available.

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