14.4 Treatment

Mental disorders are common, affecting tens of millions of people each year. Worldwide, more than one in three people in most countries report sufficient criteria for at least one at some point in their life. In the United States, 46% qualify for a mental illness within their lifetime, with less than 1 out of 5 receiving a diagnosis. An ongoing survey indicates that anxiety disorders are the most common in all but one country, followed by mood disorders in all but two countries, while substance disorders and impulse-control disorders were consistently less prevalent. Estimates suggest that less than half of people with mental illnesses in industrialized societies will receive treatment.

The World Health Organization (WHO, 2004) stated that “Prevention of these disorders is obviously one of the most effective ways to reduce the [disease] burden.”

Mental Illness and the Cost to Society

This leads us to consider the cost of mental illness to society. The National Alliance on Mental Illness (NAMI) indicates that depression is the number one cause of disability across the world “and is a major contributor to the global burden of disease.” Serious mental illness costs the United States an estimated $193 billion in lost earnings each year. They also point out that suicide is the tenth leading cause of death in the United States and 90% of those who die from suicide have an underlying mental illness.

Approximately, 37% of students with a mental disorder age 14 and older drop out of school which is the highest dropout rate of any disability group, and 70% of youth in state and local juvenile justice systems have at least one mental disorder. In terms of worldwide impact, the costs for mental illness are greater than the combined costs of cancer, diabetes, and respiratory disorders (Whiteford et al., 2013).

Negative societal responses to people with mental illnesses may be the single greatest barrier to the development of mental health programs worldwide Stigma happens when a personal with mental illness is viewed in a negative way because of their symptoms or behaviors associated with the condition. Unfortunately, negative attitudes and beliefs toward people who have a mental health condition are common.

Stigma can lead to discrimination, which can be experienced on a personal level (e.g., social isolation, exclusion or bullying) or it may be experienced at a structural or system level (e.g., employment, education, and housing). The stigma associated with mental illness makes most people reluctant to talk about their experiences of having strange thoughts or deep sadness. As a result of stigma, individuals are less likely to seek help or treatment for their mental illness. Discrimination may be obvious and direct, such as someone making a negative remark about a person with mental illness or someone getting treatment. Or it may be unintentional or subtle, such as someone avoiding a person with mental illness because they think people with mental illness unstable, violent or dangerous.

Several national and international organizations (National Alliance on Mental Health, World Health Organization, and European Commission) have provided several recommendations for reducing stigma surrounding mental illness:

• Know the facts about mental illness
• Educate others by challenging and correcting myths about mental illness
• Recognize personal biases
• Be conscious of language and power of words to perpetuate negative attitudes
• Support people with mental illness by offering encouragement