Few Get the Care They Need for Mental Illness

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Photo by E. Wagele

In his article, The Treatment Gap, Thomas Insel, head of the National Institute of Mental Health, listed some important facts about mental illness:

  • Fewer than half the people with a serious mental disorder like depression get treated. About half of those who receive treatment will get adequate or evidence-based care. And with our current options, only about half of those who get such care will recover completely. This means that only about 12.5 percent of people with a serious disorder are recovering.
  • Mental disorders are associated with higher levels of disability than nearly all other medical disorders.
  • Unlike most forms of heart disease and cancer, mental disorders often begin before age 30 and interrupt early careers. They are the chronic, disabling disorders of young people, and they’re too often fatal.
  • The approach to treating mental disorders has changed radically over the decades. Once seen as psychic conflicts requiring psychoanalysis, they were later seen as chemical imbalances requiring medication, a result of abnormal electrical activity in specific circuits of the brain, analogous to an arrhythmia in the heart. Devices that deliver deep brain stimulation or transcranial magnetic stimulation are used to modulate this arrhythmia.
  • Psychotherapy, meds, and devices all work to one degree or another, but not everyone responds to all of these approaches, and some respond to none. We still don’t know how to identify the best treatment for any individual. Some people with depression respond to cognitive behavior therapy, some to antidepressant medication, and some to deep brain stimulation. Some respond best to a combination of the three.

In addition, according to the World Health Organization:

  • Mental health disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide.
  • Suicide is now among the three leading causes of death among those aged 15 to 44 (male and female). Suicide attempts are up to 20 times more frequent than completed suicides. Globally each year approximately one million people die from suicide. Although suicide rates have traditionally been highest amongst elderly males, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of all countries.
  • There are more than 40,000 suicides a year in this country—more than twice the number of homicides. They are nearly always associated with a mental disorder and kill more people than breast cancer or AIDS.
  • Over 350 million people around the world have depression, a treatable disease, yet less than 50% of those with depression are currently receiving treatment.

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