. th St 111111111111111111111 Se tt mg e age TCC00010009 for the Surgeon General's Report Fifteenth Annual Rosalynn Carter Symposium on Mental Health Policy r:r If/! * The Carter Center Fifteenth Annual Rosalynn Carter Symposium on Mental Health Policy Setting the Stage for the Surgeon General's Report In November 1999, shortly before release of the first Surgeon General's report to focus on mental illnesses, the Fifteenth Annual Rosalynn Carter Symposium on Mental Health Policy gathered experts from across the nation to discuss the momentous opportunity for the future presented by the report - an opportunity to improve services and the quality of life for thousands of people with mental illnesses. - John Gates Contents Clarity and Conviction ........... 4 New Hope for the Elderly ........ 44 Setting the Stage The Surgeon General's report offers exciting opportunities By increasing awareness, rhe repart can help reduce rhe for the Surgeon far ourreach and understanding. • Rosalynn Outer shame and isolation that burdens help-seeking behatior General's Report amtmg older adults. • Robert Bernstein At Issue: Public Awareness ......... 9 Produced by the The Surgeon General's repart presents opportunities far Advocates for Change ........... 50 Mental Health Program increased public discussion far a more comprehensit'C The report wiU protide substance for influencing public of The C'..arter Center nationaltoieu• of health. • David Satcher perceptions ahJut mental illnesses. • William Emmet Rosalynn Caner, Chanpmon An End and a Beginning ......... 11 Programs for the Least ........... 52 The Carter C'..enteT Menral The new report's science base can be a resource Ethnic populations are growing, and rhe report Health Task Force far banishing stigma and blame in mental illnesses. needs to speak to their special needs and missed • Kenneth MoritsUgu opportunities. • Gloria Rodriguez johnj. Gates, Ph.D., FC1rTIICT Director, Mmral Health Program The "Balanced Life" . 16 Issues of Compassion ............ 54 Let Ellingson, M.P.P.• 10 Mental health adtiOOltes must speak not only Americans respond messages rhtu stress rhe need far Assisranc Director, wholeness in mc.."'Ual and physiClll health; communication with science-based authority, but also u1th Menral Health Program should emphasize quality care for aU. • Celinda Lake a sense of passion. • Michael Faenza Everett Hullum, Process Begins .............. 24 Effective Alternatives ............ 56 Edicmg and Design health admcaces hatoe a great opportunity co define A nationwide study of consumer, sun·inJT-tlperaced E\'Cilt and portrait in the f~e/J. • Ho ....-:trd Goldman self-help programs reveals successes. • Laura Van Tosh t>hocography by Pt!l!EJ Cotttrl; ocher photographs from swck agencies. Prevention Is the Key ............ 57 in discriminanon and stigma, At Delw Air Lines, health and safety me~Xe The articles m this publica­ rhe report off the bookshelt-es and to create an atmosphere of care uon are adapted from addresses delin:red ac rhe Trottcr Betts and intenmtion. • Turn Wooldndge Ftfu:eruh Annual Rosal)nn Career Symposium on Opportunities and Actions ....... 64 Mental Hedclt Policy, Noo. 17-18, 1999. Symposium parcicifKmts suggest ways co use the Surgeon General's Report on Mental Health The Fifteenth Annual co infarm rhe public about mental health. Ros:tl)nn Carter Symposium on Mental Health is made possible A Chance for Change ........... 66 hy iunding from: Now, as lle\!CT befare, mental health • Anncnberg FounJation, advocaces need to "seize rhe day" for St. [}a\'ids, Pa. and reform. • Rosa lynn C'lrter • Charter Beha\'ioral Health LLC, Alpharetta, Ga. of the Big Picture ....... Representatives • The John D. and hope arc the essential ingredients Guests .............. 68 Ouhcrine T. MacArthur Foundation, presencatiml of adult mental Oucago Lis:\ Dixon • Merck & Company Inc., Whitehouse Station, N.J. • Pftzer Inc .. New York City • WXIA·Tv. II Ali\'c, Gannett Communications Fund, Atlanta AnEndanaa~ The new report may become a watershed event in mental health information, the aocument to begin the final stages of banishing stigma and blame in By Kenneth Morit'iugu ental health is critical to the overall health ofthe nation and we in the Surgeon General's office Mbelieve rt rs 'me we adopted a new approach to mental illne~ one is based on caring and nurtur- ing, one not clouded by the blame and the has characterized our toward this all too to mental ury America. Surgeon Gen­ Mental Health THE CARTER I 12 ~ Fifteenth Annual Rosalynn Caner Symposium CENTER JL on Mental Health Policy but good life is to be chiefly valued." We know that inherent in only one in four affected adults ever receives treatment. Only living a good life is good health, not just good physical health one-third of our young people who need mental health services but also good mental health. Throughout the ages, great sages get them. and philosophers have penned ideas pertaining to the impor­ We must ensure that we leave nobody behind in our tance of a sound mind and a sound body. Even parables in the approach to mental health, from the child with attention deficit Bible document evidence of mental illnesses, although they may hyperactivity disorder to the young adult combating depression not refer to them as such. So, this concept of mental health is to the senior struggling with Alzheimer's disease. Mental health/ not a new one. Neither are mental illnesses new, but one has to mental illness spans the full continuum of life. We need a wonder why it has taken us so long to address mental health at system that responds appropriately throughout that entire this level. continuum. In 1964, just 35 years ago, then Surgeon General Leonard But age is only one factor. Mental illnesses transcend all Shealey released the landmark Surgeon General's Report on Smok­ walks and avenues of life, all races, and all levels of socioeco­ ing and Health. Since then, Surgeon Generals have published 52 nomic status. That is why we must ensure that mental health reports in all, 28 of them on tobacco. But as important as all 52 services are as widely available as other services within the reports are, we believe this one, Mental Health: A Report of the health care delivery system, services that are also culturally Surgeon General, holds special significance for several reasons. appropriate. One of the basic tenets of public health is that, to the extent D cason number one is that mental illnesses are a public we care for the needs of the most vulnerable amongst us, we do ~ealth problem that we must all address. As Dr. Satcher has the most to protect the health of our nation. In addressing men­ mentioned, this represents the first time ever that a Surgeon tal health as a public health issue, we protect and improve the General's report has undertaken the topic of mental health. But health of our nation. beyond that, the report is significant because mental health is a The second reason the report is important is because mental critical public health problem crying out for a national response. illnesses are real. We are witnessing a scientific revolution in our This report, coupled with the Surgeon General's Call co Action co understanding of mental health and mental illnesses. Over the Prevent Suicide, released this past summer, answers that cry. It i past 25 years, our understanding of brain behavior has improved an opportunity to engage the American people in a manner that markedly. This scientific revolution has brought with it the can truly make a difference, a difference that can change the knowledge that mental illnesses impair thinking, feeling, and way we consider mental health, a difference in the way we talk behavior; interfere with a person's capacity to be productive and about mental illnesses, a difference in the way we help individu­ enjoy fulfilling relationships; and that mental illnesses can als with mental diseases. include schizophrenia, manic depressive or bipolar illnesses, Every year, more than 51 million Americans experience diag­ panic disorders, and other anxiety disorders. nosable mental disorders. They strike close to home. Many of us The good news is that mental illnesses can be treated, but know someone who has been affected by mental illness. Of not until they are acknowledged. To maintain good mental these, more than 6.5 million are disabled by health, we have to be willing to acknowl­ severe mental illnesses, including as many as edge that psychological and emotional prob­ 4 million children and adolescents. Major ' ' Mental health is critical lems exist. Left untreated, mental illnesses to the overall health of the nation, depression, schizophrenia, bipolar illness, can result in a host of other problems, and we believe it is time we eating disorders, anxiety disorders, and other including violence, substance abuse, home­ adopted a new approach to men­ mental illnesses frequently impair normal lessness, or imprisonment. By increasing tal illnesses, one that is based on daily activities such as working, sleeping, awareness of mental illnesses and by reassur­ caring and nurturing and not and caring for oneself and others. And yet, clouded by the blame and the ing people that mental illnesses are real, we, stigmatization that has character­ ized our society's attitude toward this all too prevalent malady. )) Kenneth Moritsugu: THEg::[ 13 1An End and a Beginning As deputy surgeon general, Rear Admiral health servtce career in 1968 and completed Kenneth Moritsugu ass1sts the Surgeon Gen­ three tours of duty while in med1cal school. He eral in addressmg national health poltcy 1ssues. has served as medical d1rector of the Depart­ A career officer in the Commissioned Corps of ment of Justice's Federal Bureau of Pr1sons, a the U.S. Public Health SeNice smce 1988, he position responsible for the health care of nearly was born and ra1sed m Honolulu, Hawaii.