A Tragically Interwoven Web - Homelessness, Mental Illness and Substance Use Disorders
Homelessness and health care are deeply connected. We know that poor health - both physical and mental - is a cause and a result of homelessness. We cannot effectively address issues of homelessness without addressing access to health care for homeless persons. That is why we must continue to press for health care reform and remember the hope it holds for our most vulnerable populations.
It seems everyone is hoping for big changes in 2010. There is hope for the economy to improve, for the unemployed to find work, and for our brave servicemen and women to return home safely.
Next year, a decade after the Surgeon General's Report on mental health revealed that mental illnesses are as treatable as physical illnesses, there also appears to be hope for people with mental illnesses. The health care reform legislation currently being debated in Congress includes historic provisions to expand health coverage and significantly improve access to mental health and substance use disorder treatment services.
Health care reform in America is as much an economic issue as a moral one. The economic, social, and human costs of mental health and addiction disorders in the USA are enormous. In the USA, mental disorders collectively account for more than 15% of the overall burden of disease from all causes and slightly more than the burden associated with all forms of cancer. The USA spends upwards of $99 billion a year for the direct treatment of mental and substance abuse disorders, which is more than 8% of total annual health expenditures.
The promise of reform is arriving at a critical time in this country. Demand for mental health and substance use treatment has increased while state budgets for these types of services are being severely reduced. Due in part to the current economic turmoil, community mental health and substance use treatment centers nationwide are experiencing a 20% increase in demand for services, according to a 2009 survey by the National Council for Community Behavioral Healthcare. At the same time demand is increasing, at least 32 states are known to be enacting funding cuts, resulting in reduced services and closing programs.
One of the most crucial components of the health care reform legislation now being debated is the concept of parity. The bill includes the principles contained in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, the federal law passed last year which prohibits unequal treatment limits and financial requirements for mental health and substance use treatment. The parity provisions are essential, given that mental health and substance use treatment have traditionally been subject to discriminatory limits on coverage that restrict access to effective and, at times, lifesaving therapies.
Millions of Americans have mental health and substance use disorders and many still do not have access to treatment. Unlike most physical disorders these conditions start at an early age and often go untreated until the illness becomes debilitating. The delay in treatment often interferes with a young persons ability to succeed in school and in the workplace. As a result, many people with mental health and substance use disorders are unemployed or work in low-paying jobs without health insurance. They would greatly benefit from expanded mental health insurance coverage.
While health care reform is not a panacea for people with mental and substance use disorders, it takes groundbreaking steps in the right direction and may help stem the escalating death rates of people with serious mental illnesses. People in the USA with schizophrenia, bipolar disorder, and other serious mental illnesses die years sooner than other Americans. Three out of every five people with these types of mental illnesses die from preventable, co-occurring chronic diseases such as asthma, diabetes, cancer, heart disease, and cardiopulmonary conditions.
The tragic fact remains that in 2010, a majority of Americans with mental illnesses and addictions do not get treatment. Health care reform holds the promise of greatly increasing access to mental health and substance use services. Reform will finally open the treatment doors for some of the most vulnerable citizens in our society, and community behavioral health centers will be ready to help these individuals lead full and productive lives.
It seems everyone is hoping for big changes in 2010. There is hope for the economy to improve, for the unemployed to find work, and for our brave servicemen and women to return home safely.
Next year, a decade after the Surgeon General's Report on mental health revealed that mental illnesses are as treatable as physical illnesses, there also appears to be hope for people with mental illnesses. The health care reform legislation currently being debated in Congress includes historic provisions to expand health coverage and significantly improve access to mental health and substance use disorder treatment services.
Health care reform in America is as much an economic issue as a moral one. The economic, social, and human costs of mental health and addiction disorders in the USA are enormous. In the USA, mental disorders collectively account for more than 15% of the overall burden of disease from all causes and slightly more than the burden associated with all forms of cancer. The USA spends upwards of $99 billion a year for the direct treatment of mental and substance abuse disorders, which is more than 8% of total annual health expenditures.
The promise of reform is arriving at a critical time in this country. Demand for mental health and substance use treatment has increased while state budgets for these types of services are being severely reduced. Due in part to the current economic turmoil, community mental health and substance use treatment centers nationwide are experiencing a 20% increase in demand for services, according to a 2009 survey by the National Council for Community Behavioral Healthcare. At the same time demand is increasing, at least 32 states are known to be enacting funding cuts, resulting in reduced services and closing programs.
One of the most crucial components of the health care reform legislation now being debated is the concept of parity. The bill includes the principles contained in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, the federal law passed last year which prohibits unequal treatment limits and financial requirements for mental health and substance use treatment. The parity provisions are essential, given that mental health and substance use treatment have traditionally been subject to discriminatory limits on coverage that restrict access to effective and, at times, lifesaving therapies.
Millions of Americans have mental health and substance use disorders and many still do not have access to treatment. Unlike most physical disorders these conditions start at an early age and often go untreated until the illness becomes debilitating. The delay in treatment often interferes with a young persons ability to succeed in school and in the workplace. As a result, many people with mental health and substance use disorders are unemployed or work in low-paying jobs without health insurance. They would greatly benefit from expanded mental health insurance coverage.
While health care reform is not a panacea for people with mental and substance use disorders, it takes groundbreaking steps in the right direction and may help stem the escalating death rates of people with serious mental illnesses. People in the USA with schizophrenia, bipolar disorder, and other serious mental illnesses die years sooner than other Americans. Three out of every five people with these types of mental illnesses die from preventable, co-occurring chronic diseases such as asthma, diabetes, cancer, heart disease, and cardiopulmonary conditions.
The tragic fact remains that in 2010, a majority of Americans with mental illnesses and addictions do not get treatment. Health care reform holds the promise of greatly increasing access to mental health and substance use services. Reform will finally open the treatment doors for some of the most vulnerable citizens in our society, and community behavioral health centers will be ready to help these individuals lead full and productive lives.
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