Abstract
Objective: To show that mental illness affects everyone in society, describe some of the main obstacles to better outcomes, and build confidence that they can be overcome.
Methods: A review and analysis of relevant evidence and experience combined with personal advocacy.
Results: Mental illnesses are common and seriously under-treated, reform of the system of care has completely stalled, and insidious reinstitutionalization of the modernized system is occurring. A number of contributing factors and possible solutions are identified, including mental health literacy and advocacy campaigns, a focus on young people and early intervention, and functional reintegration of the treatment of mental and substance use disorders.
Conclusions: A new wave of reform and major financial investment in the treatment of mental and substance use disorders is overdue. This can be best achieved by combining the evidence-based health care (EBHC) paradigm with a direct appeal to the self-interest of members of the general community. A National Institute of Mental Health and Addiction should be a key element of such reform, which must be a continuing process with substantially increased federal and State funding.