NAMI Annual ConventionJune 19, 2005
“Promoting Mental Health & Recovery from Mental Illness”
Eduardo J. Sanchez, M.D., MPHCommissioner, Texas Department of State Health Services
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Depression Panic Disorder Schizophrina Heart Disease
Treatment Success Rates
80%
75%
60%45-50%
Disease Burden by Illness Categories in Market Economies
All cardiovascular conditions 18.6
All mental illness 15.4All malignant diseases (cancer) 15.0
All respiratory conditions 4.8
All alcohol use 4.7
All infectious and parasitic diseases 2.8
All drug use 1.5
Global Burden of Disease study,1 conducted by World Health Organization
WHO Rankings:Years of life lost to premature death
and years lived with a disability 1. Unipolar major depression 10.7%2. Iron deficiency anemia 4.73. Falls 4.64. Alcohol use 3.35. Chronic obstructive pulmonary disease 3.16. Bipolar disorder 3.07. Congenital anomalies 2.98. Osteoarthritis 2.89. Schizophrenia 2.610. Obsessive compulsive disorders 2.2
*Disability-adjusted life year (DALY)
Mental Illnesses are IllnessesWhy Treat Them Differently?
• Mental illness is the 2nd largest cause of disability, ahead of cancer (in established market economies)
• By 2020, clinical depression is expected to rank as the 2nd leading cause of disability worldwide.
• Mental illnesses are regarded as diseases of the brain by medical science, yet 45% of those surveyed consider mental illness a matter of moral failure.
“. . . the criminal justice system is the largest provider of mental health and substance abuse services for Texas
children and adults.”— Eduardo Sanchez
Mental Illness Strikes More Americans Each Year Than Other Serious Illnesses
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Mental Illness
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CVD Diabetes Cancer Asthma
CDC BRFSS, SEER Cancer Statistics Review, 1975-2002, “Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders” Arch Gen Psychiatry. Vol. 62, June 2005
People With Multiple Healthcare Needs May Choose 1 of 4
Doorways into Care
Substance Abuse Mental Illness Physical Illness Jail
“The work ahead requires that we effectively integrate primary health care
with behavioral health care.”— Eduardo Sanchez
Prevention & Early Intervention: Adolescent Health Screening
• Half of all mental illness begins by age 14
• ¾ of adults have their symptoms of mental illness by age 24
• Our goal is to ensure adolescent behavioral health screening in every primary care setting in Texas
“In the whole history of medicine, it’s never been possible to overcome an
epidemic simply by treatment. You need to have prevention.”
“At risk teens who received 15 sessions of talk therapy had 1/3 the rate of depression of a
similar group of kids who received no therapy”