General Mental Health Information

Mental health is sometimes thought of as simply the absence of a mental illness, but it is actually much broader. According to Healthy People 2010, mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity.¹ Mental health is indispensable to personal well-being, family and interpersonal relationships, and contribution to community and society.

Mental disorders generate an immense public health burden of disability. The World Health Organization’s Global Burden of Disease Study has found that the impact of mental illness on overall health and productivity in the United States and throughout the world is profoundly under-recognized. Mental illness is on par with heart disease and cancer as a cause of disability.¹

Approximately 20% of the U.S. population is affected by mental illness during any given year. No one is immune; mental disorders occur across the lifespan, affecting persons of all racial and ethnic groups, both genders, and all educational and socioeconomic groups. At least one in five children and adolescents aged 9-17 years will have a diagnosable mental disorder in a given year. Mental and behavioral disorders and serious emotional disturbances (SEDs) in children and adolescents can lead to school failure, alcohol or illicit drug use, violence, or suicide. In later life, the majority of people aged 65 years and older cope constructively with the changes associated with aging, and maintain mental health.  Yet an estimated 25% of older people (8.6 million) experience specific mental disorders, such as depression, anxiety, substance abuse, and dementia, that are not part of normal aging.¹

Mental disorders are health conditions that are characterized by alterations in thinking, mood, and/or behavior which are associated with distress and/or impaired functioning and may result in disability, pain, or death. Mental disorders include the following:¹

• Schizophrenia.
• Affective disorders, which encompass major depression and manic depressive illness.
• Anxiety disorders, which encompass panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and phobia.

Of all mental illnesses, depression is the most common disorder. About 6.5% of women and 3.3% of men will have major depression in any given year. Manic depressive illness affects arbout 1% of adults, with comparable rates of occurrence in men and women. A high rate of suicide is associated with such mood disorders. Major depression is the leading cause of disability and is the cause of more than two-thirds of suicides each year.

Although mental illnesses can affect anyone, there are some marked differences in how they present themselves by gender and age. Major depression affects approximately twice as many women as men. Anxiety, panic, and phobic disorders affect two to three times as many women as men. Women attempt suicide more often than men, but men’s risk of completed suicide is on average 4½ times higher than women’s. This suicide gender gap begins in adolescence and grows through middle and later life. Schizophrenia occurs more often in young men than in women and usually has its onset in the late teen and early adult years. Depression rates are much higher among older people who experience a physical health problem, and depression rates for older persons in nursing homes range from 15-25%. In contrast, rates of primary psychotic disorders drop with age; thus, schizophrenia and persistent paranoid disorders affect fewer than 0.5% of older adults.¹

Treatments for mental disorders are highly effective, with a variety of options available for most disorders.  There exists today a diverse array of treatment settings, and a person may have the option of selecting a setting based on health care coverage, the clinical needs associated with a particular type or stage of illness, and personal preference. Yet, despite the effectiveness of treatment and the many paths to obtaining a treatment of choice, only 25% of persons with a mental disorder obtain help for their illness in the health care system.¹

The co-occurrence of addictive disorders among persons with mental disorders is gaining increasing attention from mental health professionals. Having both mental and addictive disorders within the same year is a particularly significant clinical treatment issue, complicating treatment for each disorder. Every year, about 3% of the population aged 18 years and older has been identified as having co-occurring mental and addictive disorders. Of those with a serious mental illness, 15% have both types of disorder, and of those with a severe and persistent mental illness, 27% have both mental and addictive disorders. Co-occurring, or co-morbid mental and addictive disorders are estimated to affect 50-60% of homeless persons. Co-morbid mental and addictive disorders also are evident in children and adolescents.

Especially at risk for alcohol use problems are boys diagnosed with so-called externalizing disorders, such as conduct problems, oppositional-defiant disorder, and attention deficit/hyperactivity disorder (ADHD). From public health promotion and disease prevention perspectives, it is noteworthy that children and adolescents with mental illnesses often do not become substance abusers until after the mental illness becomes apparent. This time lag creates a window of opportunity when prevention of substance abuse in these children may be possible.¹

Implications for Prevention

As the life expectancy of individuals continues to grow longer, the sheer number—although not necessarily the proportion—of persons experiencing mental disorders in late life will expand. This trend will result in major challenges in organizing, financing, and delivering effective preventive and treatment services for this population.¹

Promising universal and targeted preventive interventions, implemented according to scientific recommendations, have great potential to reduce the risk for mental disorders and the burden of suffering in vulnerable populations. Also, social and behavioral research is beginning to explore the concept of resilience to identify strengths that may promote health and healing. With increased understanding of how to identify and promote resilience, it will be possible to design effective programs that draw on such internal capacity.¹

There is increasing awareness and concern in the public health sector regarding the impact of stress, its prevention and treatment, and the need for enhanced coping skills. Stress may be experienced by anyone and provides a clear demonstration of mind-body interaction. Coping skills, acquired throughout the lifespan, are positive adaptations that affect the ability to manage stressful events. Additional research can help quantify the public health burden of stress and identify ways to prevent or alleviate it through environmental or individual strategies.¹

Evidence that mental disorders are legitimate and highly responsive to appropriate treatment promises to be a potent antidote to stigma. Stigma creates barriers to providing and receiving competent and effective mental health treatment and can lead to inappropriate treatment, unemployment, and homelessness. The elimination of stigma associated with mental disorders will, in turn, encourage more individuals to seek needed mental health care.¹

¹ U.S. Department of Health and Human Services. Healthy People 2010. Washington, DC: January 2000.

For information on mental health services available in Boulder County, please contact the Mental Health Center of Boulder County, Inc., at 303-443-8500.