Wednesday, November 28, 2012

USDHHS: SAMHSA. Mental Health, A Neglected Priority

28 November 2012
 
A call for the equal treatment of all illnesses and conversation on the path to recovery
By Susan Walker and Chris Marshall

There’s a statue at the entrance to the Italian embassy’s auditorium.  I say statue, but as tastefully pointed out by an elegant plaque, it is in fact a “Marble Fragment of Statue, Syracuse, 3rd Century B.C.”  Headless and heartless, it’s really only a pair of legs, but it still pulls off a certain elegant refinement (this is the Italian embassy after all!).

It’s a fitting introduction to the recent Global Health Forum  entitled , “Mental Health, A Neglected Priority” held at the Italian embassy, where a vast array of international speakers  discussed the importance of mental health and the woeful lack of attention it receives in many corners of the world .

Paolo del Vecchio, director of SAMHSA’s Center for Mental Health Services, pointed out one way to address the neglect, “We really need to do a great deal of work in changing, not only mental health practices, but the hearts and minds of the public.”

Jeffrey Akman, interim vice president for Health Affairs and Dean of the George Washington University School of Medicine and Health Sciences, further pointed out to mental health advocates the need to follow the lead of the HIV/AIDS community.  Over the past few decades they have brought that condition and the programs needed to prevent and treat it to the forefront of public consciousness. 

Later this week the world celebrates HIV/AIDS Day (Dec. 1), and I’ve already had a number of friends and acquaintances remind me.  As I typed the previous line I even had an email pop up exclaiming, “World AIDS Day!” and inviting me to “two engaging events.”

This seems to drive home the point both del Vecchio and Akman are making – that the proactive steps  HIV/AIDS advocates took helped them obtain  more research, public outreach, publicity, and acceptance.  All these in turn led to better prevention and treatment of HIV/AIDS.  The same can be accomplished for mental health if we begin taking the same proactive measures.  
Considering one in five American adults had a mental illness in the past year, Akman and del Vecchio make valid points. We need to change how we talk about, think about, feel about, and treat mental illness.

Not an easy task, considering that people with mental illnesses have had and continue to have very high rates of unemployment, educational attainment, homelessness, poverty, and lack of social capital that exemplifies the ongoing neglect of mental health.  With only four out of 10 people with mental illnesses receiving treatment, it is a task certainly worthy of our efforts.

Why should we be involved? Because, as del Vecchio also said at the forum, “Recovery is democratic” and we need to “continue to get in the public conversation that recovery is possible.”
A recovery approach is a new way of thinking about systems and outcomes.  SAMHSA released a new working definition of recovery from mental disorders and substance use disorders in December 2011 that defines recovery as a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.  To get there, components of a system of recovery must include treatment and services that are individualized, holistic, person-driven, and strengths-based.  These values and components of recovery are supported through many systems innovations sponsored by SAMHSA including evidenced-based practices such as supported employment and supported housing.

If recovery is democratic, how do we preserve the American principle of self-determination while protecting individual and public safety?

How do we invest limited funds to prevent future mental health cost burdens while addressing current mental illnesses at the same time?


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