Severe Mental Illness: The Ignored Public Health Crisis

 "I'm afraid to die." "What happens to my son when I die?" Treatment Advocacy Center Executive Director Lisa Dailey says she will never forget that testimony from a Virginia mother in her 80s who had spent much of her life caring for her son, now in his 50s, with severe mental illness.

In 1963, President John F. Kennedy signed the Community Mental Health Act, which was supposed to decrease the number of institutionalized individuals in psychiatric hospitals by creating local mental health care centers.

"Our entire medical system for people with severe mental illness is predicated on the idea that family is responsible for providing the majority of the care, in their homes, at their own expense, without any support, and without any of the tools they would need to be able to make that actually work," Ms. Dailey said.

The laws governing mental health are different in each state, but there are some common problems nationwide, including limited psychiatric bed space in hospitals, a shortage of psychiatrists, a high bar toward getting into a hospital for treatment, and often the release of patients with a chronic mental health condition with no plan after release.

About half of the population of people with severe mental illness are untreated because of a lack of insight into their condition, according to TAC. About 30 percent of the chronically homeless population is estimated to have severe mental illness.

More than 1.8 million people with severe mental illness are booked into jails every year, and they account for 20 percent of jail and prison inmates.

Some 29 percent of family homicides are committed by someone with severe mental illness; 7 percent of all homicides, 20 percent of all law enforcement officer fatalities, and up to 50 percent of mass homicides are associated with severe mental illness, according to TAC. "Our policies about this, especially within the medical system, are not based on what we actually know about the trajectory of what works in an illness like this; it is based on wishful thinking," Ms. Dailey said. 

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