Good mental health is an essential part of life. It is needed in order for a person to be productive and successful in every aspect of their life. Mental illnesses do not discriminate on race, religion, economic status, or gender. Several mental illnesses have interdependency on one another. For example, depression is usually accompanied by alcohol or drug abuse or schizophrenia is exhibited with a bipolar disorder.
It is important to examine the definitions of “disorder” and “disease” as use in the context of this paper. A “disorder” is diagnosed when symptoms or signs of distress are present. Disorders are diagnosed using clinical criteria. A “disease”, on the other hand, is the exhibition of conditions that can be detected physically (Shalala, ch 2).
Many people resort to suicide as a result of a mental illness or substance abuse. The statistics on suicides related to mental illnesses and substance abuse are staggering.
According to the National Institute of Mental Health, 30,535 Americans dies of suicide in 1998. Of the people who committed suicide 90 percent have a diagnosable mental disorder. Suicide is the 8th leading cause of death in the United States and the 3rd leading cause of death for ages 15 to 24. Research has shown that men are four times more likely to commit suicide, however, women are three times more likely to attempt suicide. Studies have found that suicide can be prevented by early detection and treatment for mental illnesses and/or substance abuse.
There are three main risk factors that are attributable to suicide.
They are depression and related mental illnesses, substance abuse, and aggressive or disruptive behavior. According to the Surgeon General’s report on mental health four of the ten leading causes of disability are mental disorders. These are major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder (OCD). Major depression is the leading cause of disability in the United States. Approximately 18.8 million people are affected by major depression each year.
The average age of onset is the mid-twenties. Depressive disorders usually coexist with substance abuse and anxiety disorders. Mood disorders are most commonly associated with depression. Symptoms of mood disorders are irritability, social withdrawal and the idealization of suicide. Bipolar disorder affects 2.3 million people each year in the United States.
The average age of the first manic episode is when the person is in their early twenties. Schizophrenia affects 2.2 million people each year. The earliest signs of schizophrenia are exhibited between the late teens and early thirties. Alterations in perception and thought processes are more commonly associated with schizophrenia. This can include disorganized thought and hallucinations.
Obsessive-compulsive disorder affects 3.3 million adults each year. However, it is more prevalent among adolescents. The first signs of OCD begin during childhood or adolescents. OCD is most commonly associated with anxiety disorders.
The diagnosis of mental disorders is very difficult.
There are very few tests that can be performed that give definitive results. For a symptom to be declared a mental illness must meet three criteria. These are “reports of the intensity and duration of symptoms, signs from their mental status examination, and clinician observation of their behavior including functional impairment.” (Shalala, ch 2). The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) is widely used in the United States to diagnose mental disorders. The manual organizes mental disorders into 16 different classes that are used for diagnosis.
Within each diagnostic class there are specific criteria that are used to make an appropriate diagnosis. One unique aspect of The Diagnostic and Statistical Manual of Mental Disorders is that is does not state causations for these disorders.
Since 1960, there have been several attempts to coordinate mental health care. The Community Mental Health Center (CMHC) program was initiated in 1963. The programs purpose was to consolidate community-based mental health services. However, CMHCs were highly ineffective with regards to the severely mentally ill and their ability to work with state mental health hospitals.
The Community Support Program (CSP) was then implemented. Its intent was to network mental health and human services agencies to aid in providing for the complex needs of people with severe mental illnesses. The fault of the CSP was that there were no incentives .