Diminishing the Impact of Substance Abuse and Improving Mental Health in the United States

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

Received July 17, 2012; Accepted July 18, 2012; Published July 22, 2012

Citation: Fernandez A, Vieweg WVR (2012) Dim ealth in the United States. J Addict Res Ther 3:e111. doi:10.4172/2155-6105.1000e111

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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able border="0" cellspacing="0" cellpadding="0" class="table"> 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. 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. 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]. 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]. 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]. 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. 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. 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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