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Co Ltura 1 Minorities, Childr 3N, Adolosoerts, and Older Adults

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Co Ltura 1 Minorities, Childr 3N, Adolosoerts, and Older Adults iC11 iItlIT 1 6 In 170 627 CG 013 TT imp. The Pr den Comm ins iott on tient -1Ileat h.Report -,to'he President. Volume 1. INSTITUTION Pr esiden COmtaizidlr. cr. Mental(teaith, Wasnort nt D. C. POE LATE 18 NOT 101p, AY MAU E PROM Su perin en en, of D- uaerts Governme nt Printihg Of ace) hin to C.20'402(040-000-00390-8 $2.75) ED FS RICE MF01(PC05 Plus posta ie. DF',SC PTORS Adults ; Children; 'C iviJ Riht *Community Healt h Se rvices ;Communityupport*Delivery Systems; Health Needs; *Mental Healh; *Mental Health Programs ;Poltoy Formation;Public Support IDENTIFIER S *Presidents Co mmissicr or Mntal Health 14E S IR A C T men* al health needs and servicesavailable in the United Sta tes in vesti ate-1 byt President' s commission on Mental Heal* h. Re ults indicat ed that :(1)mental health services are Primarily located in urban areas;(2) the needs cf racial and co ltura 1 minorities, childr 3n,adolosoerts, and older adults are not toeing [tilt;(3)na' ion al polici es and delivery systemsneed to be deve.loped to provide more compreh ens ive services; and(4) efforts oust be conduct eci to increase publicunderstanding and community support for men" al heal*services.(HL I) ***** *** * ****** ********* ****** Reproductions supplied by EDR the best that can be mach from the 07:1 document. ********************** 4 ************* ********* 19'78 U,S.DEPARTMENT OF HEALTH. cN) EDUCATION& WELFARE NATIONAL INSTITUTE OF EDUCATION THIS DOCUMENT HAS OE EN REPRO. OUCED EXACTLY AS RECEIVED FROM THE PERSON OR OROANIZATION ATING IT POINTS OF VIEW OR OPINIONS STATED DO NOT NECESSARILY REPRE. SENT OPP ICIAL NATIONAL INSTITUTE OF Volume EDUCATION POSITION OR POLICY For sale by the Superintendent of Documents. U.S. Government Printing Office Washington, D.C. 20402 Stock No 040-000-00390-8 /Catalog No. PR 39.8: M 52/R 29/V.I The President's Commission on Mental Health The Commission was established byExecutive Order No1 l973, signed by President Carter February 17, 1977, toreview the mental health needs of the Nation best and to make recommendations tothe President as to how the Nation might meet these needs. The Commission held publichearings across the country, and received the assistance of hundreds of individuals whocomprised special fact- finding task panels. These task panels, made up of the Nation'sforemost mental health authorities and other volunteers interested in mentalhealth, produced and submitted to the Commission the reports which arecontained in the Appendices to the Commission's Report. The Report to the Pres idens front the President's Commission r I Health consists of four volumes: Volume I contains the mission's Report and Recommendations to the President. Volumes II, III, and IV are Appendices to the Report. These contain the reports of task panels comprised of approximately 450 Individuals from throughout the country who volunteered their expertise, perceptions, and assessments of the Nation's mental health needs and resources in specific categories. Although the Commission has adopted certain of the options proposed by the task panels, the opinions and recommendations contained in the panel reports should be viewed as those of the panel members; they do not necessarily reflect the views of rho Commission. Rather, their publication is intended to share with the public the valuable information these individuals so generously contributed to the Commission. The President's Commission oncore Mena I Health Rosalynn Carter, Honorary Chairperson Thomas E. Bryant, Chairperson Florence Mahoney Ruth Ii, Love, Vice-Chairperson Martha L. Mitchell Priscilla Allen Mildred Mitchell-Bateman Allan Beige! Harold Richman Joso A. Cabranes Julius B. Richmond, Ex-Officio John J. Conger Reymunclo Rodriguez Thomas Conlan George Tarjan Virginia Dayton Franklin E. Vilas, Jr. LaOonna Harris Glenn E. Watts Beverly Long Charles V. Willie Acknowledgments The work of the President's Commission on Mental !leak!' could not havebeen accomplished without the voluntary contributions made by hundreds of individuals who served on various task panels created to provide data, information,and expertise. The Commission is grateful for their invaluable assistance. We also wish to acknowledge the contributions made by hundreds of others who comprised working groups or who individually assisted the task panels in their work, Testimony, both written and oral, given by many throughout the country at regional public hearings of the Commission was of great importance as we began our task, and to each person who took thetrouble to prepare Such testimony go our special thanks. The willing and full cooperation of many congressional committees, governmen- tal agencies, both Federal and State, which provided needed informationand advice, notably the Alcohol, Drug Abuse, and Mental Health Administration, theNational Institute of Mental Health and other agencies of the Department ofHealth, Education, and Welfare, and the Department of Housing and Development deserves special recognition. The Secretary of the Department of Health, Education, and Welfare has been particularly supportive by making funds and staffavailable to the Commission during this year. The Institute of Medicine of the National Academy of Sciencesundertook a series of special studies at the request of the Commission. While the reportsof these studies will be published by the Institute, we wish to express ourparticular appreciation for them. To the hundreds of public and private professional and citizen organizations who gave us the benefit of their expertise, as well as the thousands of citizensand their families who shared with us their personal experiences keeping usalways mindful of the individual whose life has been affected by mental or emotional disability, our grateful thanks. Last, we wish to give special thanks to the dedicated and highlyprofessional staff of the Commission, the unstinting contributions of the support staff, and the help of the many volunteers who so generously assisted them. All contributions mentioned above are identified, insofar as possible, at the hack of the volume or in the Appendices. iii Contents of ittal 1' Health in America: 1978 Introduction _ Findings and Assessment Recommendations 12 Introduction _ 14 Community Supports 16 A Responsive Service System 29 Insurance for the Future _ _ 35 New Directions for Personnel 42 Protecting Basic Rights ___ 46 Expanding the Base of Knowledge _ 51 A Strategy for Prevention___ __ __ _ 55 Improving Public Understanding_ Annotations _ 60 Findings and Assessment 60 Community Supports 61 Services 67 Personnel 69 Basic Rights _ 73 Knowledge 76 Prevention 78 Public Understanding ___ _ _ 79 Staff 81 Task Panel i embers and Other Contributors Letter of Transmitta... THE WHITE HOUSE WASHINGTON The President The White Flouse Washington, D.C. Dear Mr, President: We present for your consideration the Final Report of the President's Commis- sion on Mental Health. The one-year study we undertook at your direction has convincer' us that a substantial number of Americans do not have access to mental health care of high quality and at reasonable cost. For many, this is because of where they live; for others,itis because of who they aretheir race, age, or sex; for still others, itis because of their particular disability or economic circumstances. Mental health services in this country are located predominantly in urban areas. For those who live in rural areas, small towns, and many of the poorer sections of the Nation's cities, specialized mental health facilities and personnel are frequently nonexistent, and the services available are rarely comprehensive. For many members of America's ethnic and racial minority populations, the mental health personnel and services that are available are either inadequate or fail to take into account their different cultural traditions. Many children, adolescents, and older Americans lo not have sufficient access to services or to personnel trained to respond to the special needs which are characteristic of their ages. While not enough is known about the causes and treatment of chronic mental illness, we do know that thousands who are so disabled receive deplorably inadequate assistance. Our study has also convinced us that, for the long run, the Nation will need to devote greater human and fiscal resources to mental health. We now devote only 12 percent of general health expenditures to mental health. This is not commensurate with the magnitude of mental health problems and does not address the interdepend- ent nature of physical and mental health. We must begin now to seek a realistic allocation of resources which reflects this interdependence. vii Further, since over half the dollars fur mental health cow are still spent Inlar State Institutions and mental health-related noising homes,thew is an urgent need for a national policy that will ,her the current balance of mental healthexpenditures In order to develop needed community-based services, Despite shortcomings and Inequities, the foundation existsfor teaching the goal of making high duality public and private mental health services available at able cost to all who need them, lu bring us nearer this goal, (luting the next decade we muse Develop networks of high duality, comprehensivemental health services throughout the country which are sufficiently flexible to respond tochanging circumstances and to the diverse racial and cultural backgroundsof Individuals, Wherever possible these services should he in local communities. Adequately finance mental health services with public and privatefunds so that care Is available at reasonable cost, Assure that appropriately trained I11ental healtht r rind will be available where they are needed. Make available where and when they arc tolcd servicos andpersonnel for populations with special needs, such as children, adolescents,and the elderly. Establish a national priority to meet the needs of people withchronic mental illness, Coordinate mental health services more closely with eachother, with general health and other human services, and with those personaland social support systems that strengthen our neighborhoods andcommunities.
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