Study suggests U.S. will rank No. 1 for mental illness

One-quarter of all Americans met the criteria for having a mental illness within the past year, and fully a quarter of those had a “serious” disorder that significantly disrupted their ability to function day-to-day, according to the largest and most detailed survey of the nation’s mental health, published Monday.

Although parallel studies in 27 countries are not yet complete, the new numbers suggest that the United States is poised to rank No. 1 for mental illness globally, researchers said.

“We lead the world in a lot of good things, but we’re also leaders in this one particular domain that we’d rather not be,” said Ronald Kessler, the Harvard professor of health care policy who led the effort, called the National Comorbidity Survey Replication.

The exhaustive government-sponsored effort, based on in-depth interviews with more than 9,000 randomly selected Americans, finds that the prevalence of U.S. mental illness has remained roughly flat in the past decade – a possible glimmer of hope given that previous decades had suggested the rates were gradually rising.

But the rest of the news from the survey – which did not include some of the most serious disorders, such as schizophrenia, for which patients are often institutionalized – is mostly discouraging.

Less than half of those in need get treated. Those who seek treatment typically do so after a decade or more of delays, during which time they are likely to develop additional problems. And the treatment they receive is usually inadequate.

Younger sufferers are especially overlooked, the survey found, even though mental illness is very much a disease of youth.

Half of those who will ever be diagnosed with a mental disorder show signs of the disease by age 14, and three quarters by age 24. But few get help.

Many factors contribute to these failings, the reports conclude, including inattention to early warning signs, inadequate health insurance and the lingering stigma that surrounds mental illness.

“The system has to get its act together to get its quality of care up,” Kessler said.

Thomas Insel – chief of the National Institute of Mental Health, which funded the $20 million study – said the nation needed to recognize that mental illness is a chronic condition that requires expert medical attention just as heart disease, Alzheimer’s and diabetes do.

He said he was disappointed to learn from the survey that despite the availability of effective treatments for many mental illnesses, including depression and anxiety, about a third of people in need rely solely on nonprofessional sources such as Internet support groups and spiritual advisers.

“You wouldn’t rely on your priest for treatment if you had breast cancer,” Insel said. “Why would you go to your priest for major depressive disorder? These are real medical and brain disorders, and they need to be treated that way.”