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| Diminishing the Impact of Substance Abuse and Improving Mental Health in
the United States |
| Antony Fernandez1,3* and W. Victor R. Vieweg1,2 |
| 1Departments of Psychiatry, Virginia Commonwealth University, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA |
| 2Internal Medicine, Virginia Commonwealth University, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA |
| 3Psychiatry Service, Virginia Commonwealth University, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA |
| *Corresponding author: |
Antony Fernandez
Departments of Psychiatry
Virginia
Commonwealth University
Hunter Holmes McGuire Veterans Affairs Medical
Center
Richmond, Virginia, USA
E-mail: Antony.Fernandez@va.gov |
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| Received July 17, 2012; Accepted July 18, 2012; Published July 22, 2012 |
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| Citation: Fernandez A, Vieweg WVR (2012) Diminishing the Impact of Substance
Abuse and Improving Mental Health in the United States. J Addict Res Ther 3:e111.
doi:10.4172/2155-6105.1000e111 |
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| Copyright: © 2012 Fernandez A, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited. |
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| The Substance Abuse and Mental Health Services Administration
(SAMHSA), a division of the U.S. Department of Health and Human
Services (HHS), is charged with reducing the impact of substance
abuse and mental illness on America’s communities. We review recent
legislation and initiatives that move us in that direction. |
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| In March 2010, President Obama signed into law the Patient
Protection and Affordable Care Act and the Health Care and Education
Reconciliation Act of 2010 (together referred to as the Affordable Care
Act). This law makes health insurance coverage more affordable for
individuals, families, and the owners of small businesses. Broadening
health insurance for citizens particularly vulnerable to the adverse
effects of substance abuse and mental illness is a monumental step
in promoting overall good mental health in the United States. The
Affordable Care Act is just one aspect of a broader movement toward a
reformed behavioral health system. The evidence base behind behavioral
health prevention, treatment, and recovery services continues to grow
and promises better outcomes for people with and at risk for mental
and substance use disorders [1]. Health reform will have a dramatic
impact on the nation’s mental health system. It will increase access to
services and reduce physical and mental health disparities experienced
by socioeconomically disadvantaged groups, and racial and ethnic
minorities. |
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| Similar to physical illnesses, mental and substance use disorders lead
to diminished quality of life, impair both individuals and communities,
consume scare National resources, and shorten life expectancy if they
are not prevented, left untreated, or are poorly managed. Their presence
exacerbates the cost of treating co-morbid physical diseases resulting
in some of the highest disability burdens in the world for individuals,
families, businesses, and governments [2]. |
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| The impact of the Affordable Care Act on communities will be
enormous because this initiative will reduce the burden of substance
abuse and mental illness in the United States. The annual cost of
substance abuse in the United States is in the region of $510.8 billion
[3]. It is estimated that by 2020 mental health disorders will surpass all
physical diseases as a major cause of disability worldwide [4]. |
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| In 2008, an estimated 9.8 million adults aged 18 and older in the
United States had a serious mental illness. Two million youth aged 12 to
17 had a major depressive episode during the past year [5]. In 2009, an
estimated 23.5 million Americans aged 12 and older needed treatment
for substance use [6]. Half of all lifetime cases of mental and substance
use disorders begin by age 14 and three-fourths by age 24 [7]. |
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| Individuals, families, and communities will not achieve optimum
mental health without freedom from mental illness and addictions.
Preventive interventions and recovery oriented services for mental
illness are important aspects of health service systems. We need
communitywide strategies to improve health status and lower costs for
individuals, families, organizations, and governments. |
| |
| Promoting good mental health and the preventing substance
abuse and mental illness are key parts of SAMHSA’s mission to reduce the impact of substance abuse and mental illness on America’s
communities. The evidence base in this area continues to grow and was
recently summarized by the 2009 Institute of Medicine (IOM) report,
Preventing Mental, Emotional, and Behavioral Disorders among Young
People. The Affordable Care Act also emphasizes prevention and
promotional activities. Goals include primary prevention, building
emotional health, and preventing complications from substance abuse
and mental illness. |
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| Given the resource constraints faced at all levels of government, the
need for a system to track outcomes and improve the quality of services
cannot be overemphasized. This will ensure that adequate resources are
directed to effective approaches. Both outside and inside of government,
there is a demand for increased data. The GPRA Modernization Act
of 2010, which amends the Government Performance and Results Act
(GPRA) of 1993, requires SAMHSA to report information to HHS on a
quarterly basis. In addition, better coordination is needed around data
collection and evaluation at multiple levels. |
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| Finally, although accepting the importance of treating substance
abuse and mental illness is greater now than at any time in the past,
a great need exists for public awareness around mental and substance
use disorders. Serious gaps exist between the number of people who
need treatment for mental and substance use disorders and those who
seek that treatment. Prejudicial attitudes toward people with mental
and substance use disorders impede their recovery and create barriers
to their ability to lead full lives integrated within their communities.
Organizations such as SAMHSA are leading the way and will continue
to improve the Nation’s behavioral health, transform health care in
America, and achieve excellence in this important area. |
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| References |
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- Stein MB, Cox BJ, Afifi TO, Belik SL, Sareen J, et al. (2006). Does co-morbid depressive illness magnify the impact of chronic physical illness? A population based perspective. Psychol Med 36: 587–596.
- World Health Organization (WHO) (2004). Prevention of mental disorders: Effective interventions and policy options. Summary report. Geneva, Switzerland.
- Miller T, Hendrie D (2009). Substance abuse prevention dollars and cents: A cost-benefit analysis (DHHS Pub. No. SMA 07-4298). Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention.
- World Health Organization (WHO) (2004). Promoting mental health: Concepts, emerging evidence, practice. Summary report. Geneva, Switzerland
- Substance Abuse and Mental Health Services Administration (SAMHSA) (2009). Results from the 2008 National Survey on Drug Use and Health: National findings. (Office of Applied Studies, NSDUH Series H-36, DHHS Publication No. SMA 09-4434). Rockville, MD: SAMHSA.
- Substance Abuse and Mental Health Services Administration (SAMHSA) (2010). Results from the 2009 National Survey on Drug Use and Health: Vol. I. Summary of national findings. (Office of Applied Studies, NSDUH Series H-38A, DHHS Publication No. SMA 10-4856Findings). Rockville, MD: SAMHSA.
- Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR , et al. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62: 593–602.
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