Mental Illness: Surprising, Disturbing Findings

By Marilyn Elias, USA TODAY

More Americans than ever with mental disorders are trying to get care, but only a third receive effective treatments, says a landmark government survey out Monday.Rates of mental illness have flattened in the past 15 years after steadily rising from the 1950s. "That's reassuring and a little surprising, given the economic slumps and 9/11," says survey director Ronald Kessler of Harvard Medical School.About one in four adults have the symptoms of at least one mental illness every year, and nearly half suffer disorders during their lifetimes, according to the study of 9,282 people published in the Archives of General Psychiatry. The study is a detailed update of large federal surveys done in the '80s and '90s.

On the positive side, 41% with a disorder went for treatment in the past year, up from 25% a decade ago and 19% two decades ago. The more severe the disorder, the more likely a person was to get good care.Most people with disorders — about four out of five — have mild to moderate mental illness. Overall, 6% of Americans have disorders that seriously impair their daily lives. Younger adults are most likely to seek prompt care, so the stigma of mental illness may be waning, Kessler says.

But positive signs in the survey may be overshadowed by two realities: Only about a third get effective care, and the most serious disorders begin at a young age, often going undetected and worsening for a decade or longer. Half of all mental illness begins by age 14, and three-fourths of adults have their symptoms by age 24, the survey shows.

But research has focused on adults. Much more research on the adolescent brain is needed, and large treatment studies not financed by drug companies must be done, says Thomas Insel, director of the National Institute of Mental Health, which paid for the survey.But there's a shortage of researchers focusing on treating children, "and most are working full time on drug-company-funded studies," Insel says.That only a third of adults get effective care "is pretty disturbing," Insel says. "We've got to figure out how to do this better. If I told you only a third of breast-cancer patients were getting adequate care, you'd wonder, how could that be?"

Patients got the most effective care from mental health experts, such as psychologists and psychiatrists, the survey shows. Yet even specialists gave adequate care to just under half of their patients. And 52% saw medical doctors for treatment of mental disorders, with 13% receiving adequate care.