Many Americans Experience Mental Illness

A landmark survey of the mental health of Americans has found that mental disorders strike early in life. The results, reported recently in the Archives of General Psychiatry, showed that half of all mental illness starts by age 14, and three fourths of patients with mental illness exhibit symptoms by age 24.

Although many cases begin with mild symptoms, if left untreated they can escalate into severe problems. Individuals with more serious cases, however, tend to put off treatment, and when they do seek professional help they tend to receive inadequate treatment, according to the researchers.

"Mental disorders are highly prevalent and chronic," said Thomas R. Insel, MD, director of the National Institute of Mental Health (NIMH), during a recent press conference on the results of 4 studies. "These disorders cause a high degree of disability, with nearly 6% of the population showing serious disability. That is really extraordinary. Those are the kinds of numbers we didn't have before," Dr. Insel stated.

The researchers divided the mental disorders into 4 classes: anxiety disorders, mood disorders, impulse-control disorders, and substance abuse disorders. Here is a snapshot of the studies' key findings:

• The majority of Americans will meet the diagnostic criteria for 1 or more mental health disorders at some point in their life
• Anxiety disorders are the most common (experienced by 28.8% of Americans at some time in their life), followed by impulse-control disorders (24.8%), mood disorders (20.8%), and substance abuse disorders (14.6%)
• In any given year, 18.1% of adults experience anxiety disorders, 9.5% experience mood disorders, 8.9% experience impulse-control disorders, and 3.8% experience substance abuse disorders
• In nearly all the mental disorders, individuals delay getting treatment (for anxiety disorders, delays range from 9 to 23 years; for mood disorders, from 6 to 8 years; for impulse-control disorders, from 4 to 13 years; and for substance abuse disorders, from 5 to 9 years)
• The survey found that mental health service remains low, with a significant number of cases not receiving treatment in the prior year; only 12.3% of patients with mental illnesses are treated by a psychiatrist, compared with 22.8% treated by a general medical provider

The lead author of the study, Philip S. Wang, MD, DrPH, said the good news is that "treatment rates are somewhat higher than a decade ago." He pointed out, however, "We need new programs to improve the adequacy of care."

The survey, known as the National Comorbidity Survey Replication, is taken every 10 years to evaluate the mental health of the United States. The study was funded by the NIMH.