These [mental] disorders are highly prevalent in all societies, across all national boundaries, they’re non-discriminatory; they’re non-political. People of all races, all ethnic groups, all income groups may experience mental illnesses and almost every family has experiences with mental illness. 

Over these 40-50 years, we’ve had major advances where we’ve begun to move people out of hospitals and into communities. But I think we got a little ahead of ourselves 50 years ago and we moved people out of hospitals where community facilities weren’t ready for them. So we ended up with a series of problems that we have spent these last 50 years trying to clean up, such as homelessness, the lack of psycho-social services and supports that are necessary, particularly for people with more severe mental illnesses.  So I think that’s probably been the greatest failing that we did not earlier recognize: the changing needs of people when they’re no longer in institutions, and creating the opportunities for success for them. We know a lot about that now; we know how to do it reasonably well. Unfortunately the kind of services that we need are not available broadly to people around the country. 

If I had to identify the greatest change in these last 50 years, it is the fact that families and consumers [of mental health care services] now have a very, very vibrant voice in determining what happens to them. This typically will empower a family, to be more informed persons, to learn the system. You need to know the system if you have a person in your family in it. It’s a fragmented system, as the President’s report found, and it’s uneven care, nationwide. So it behooves the person, the consumer, and the family member to be a very informed consumer.

There is a considerable body of knowledge now that tells us that even full, robust parity will probably cost less than 1-4% to implement nationwide. The absence of doing that can only be described as discriminatory. We have effective treatments available, we have a lot of people who need these treatments, and unfortunately they can’t get them often because of a financial barrier. 

I think that the message of recovery is a message that occurs on many levels. The most important message that that communicates is hopefulness. And hope is a great antidote to all sorts of ills. And I think it also communicates a message of empowerment to consumers and family members, that this is not a hole from which I can’t get out of, this is not a death sentence. This is an illness, a challenge that I have to meet, and I’m going to have to work hard at it. But there is hope at the other end.