How many people in the United States have severe mental
illnesses?
Approximately 4.5 million individuals in the United States
have severe mental illness, either schizophrenia or manic-depressive
illness (bipolar disorder).
What is schizophrenia?
Schizophrenia is a neurological brain disorder that affects
2.2 million Americans today, or approximately one percent
of the population. Schizophrenia can affect anyone at any
age, but most cases develop between ages 16 and 30. Schizophrenia
interferes with a person's ability to think clearly, manage
emotions, make decisions, and relate to others.
Specific abnormalities that can be noted in individuals with
schizophrenia include delusions and hallucinations; alterations
of the senses; an inability to sort and interpret incoming
sensations, and an inability therefore to respond appropriately;
an altered sense of self; and changes in emotions, movements
and behavior.
What is bipolar disorder/manic depression?
Manic depressive illness (or bipolar disorder) is a neurological
brain disorder that affects 2.3 million Americans today,
or approximately one percent of the population. While manic-depressive
illness usually begins in adolescence or early adulthood,
it can sometimes start in early childhood or as late as
age 40 or 50. Individuals diagnosed with manic-depressive
illness, or bipolar disorder, have mood swings that alternate
from periods of severe highs (mania) to extreme lows (depression).
These mood swings, which are often out of proportion or
totally unrelated to events in a person's life, affect
thoughts, feelings, physical health, behavior, and functioning.
What is schizoaffective disorder?
Schizoaffective disorder is defined as having both severe
mood swings (mania and/or depression) and some of symptoms
of schizophrenia. Can mental illness really be treated?
Absolutely. While there is no cure for schizophrenia, it
is a highly treatable disorder. In fact, according to the
National Advisory Mental Health Council, the treatment
success rate for schizophrenia is comparable to the treatment
success rate for heart disease. People who experience acute
symptoms of schizophrenia may require intensive treatment,
sometimes including hospitalization. Hospitalization is
necessary to treat severe delusions or hallucinations,
serious suicidal inclinations, inability to care for oneself,
or severe problems with drugs or alcohol. It is critical
that people with schizophrenia stay in treatment even after
recovering from an acute episode. About 80 percent of those
who stop taking their medications after an acute episode
will have a relapse within one year, whereas only 30 percent
of those who continue their medications will experience
a relapse in the same time period. Medication appears to
improve the long-term prognosis for many people with schizophrenia.
Studies show that after 10 years of treatment, one-fourth
of those with schizophrenia have recovered completely,
one-fourth have improved considerably, and one-fourth have
improved
modestly. Fifteen percent have not improved, and 10 percent
are dead.
How many people with severe mental illnesses go untreated?
Current federal and state policies hinder treatment for psychiatrically
ill individuals who are most at risk for homelessness,
arrest, or suicide. As a result, 40% of the 4.5 million
individuals with schizophrenia and manic-depressive illness
(bipolar disorder), an estimated 1.6 million people, are
not being treated for their illness at
any given time.
Why would someone with a severe mental illness refuse treatment?
At least 40% of the 4.5 million people in the United States
who are diagnosed with either schizophrenia or manic-depression,
the two severest forms of mental illness, do not and cannot
realize they are sick because the illness affects their
brain's frontal-lobe function, which is necessary to make
that determination. Because they do not know they are sick,
they refuse medication and often deteriorate. The neurological
term
for this is "anosognosia," derived from the Greek
for "loss of knowledge”
How many homeless people have severe mental illnesses?
People with untreated psychiatric illnesses comprise one-third,
or 200,000 people, of the estimated 600,000 homeless population.
The quality of life for these individuals is abysmal. Many
are victimized regularly. A recent study has found that 28
percent of homeless people with previous psychiatric hospitalizations
obtained some food from garbage cans and eight percent used
garbage cans as a primary food source. These 200,000 individuals
comprise more than the entire population of many U.S. cities,
such as Hartford, Connecticut; Charleston, South Carolina;
Reno, Nevada; Boise, Idaho; Scottsdale, Arizona; Orlando,
Florida; Winston Salem, North Carolina; Ann Arbor, Michigan;
Abilene, Texas or Topeka, Kansas.
How many people in jails or prisons have severe mental illnesses?
People with untreated serious brain disorders comprise approximately
16 percent of the total jail and prison inmate population,
or nearly 300,000 individuals. These individuals are often
incarcerated with misdemeanor charges, but sometimes with
felony charges, caused by their psychotic thinking. People
with untreated psychiatric illnesses spend twice as much
time in jail than non-ill individuals and are more likely
to commit
suicide.
Are people with mental illness dangerous?
When undergoing treatment, people with severe mental illnesses
are no more dangerous than the general population. When
untreated, this is no longer the case. There are approximately
1,000 homicides - among the estimated 20,000 total homicides
in the U.S. - committed each year by people with untreated
schizophrenia and manic-depressive illness. According to
a 1994 Department of Justice, Bureau of Justice Statistics
Special Report, "Murder in Families," 4.3 percent
of homicides committed
in 1988 were by people with a history of untreated mental
illness (study based on 20,860 murders nationwide).
How often do people with mental illness commit suicide?
Suicide is the number one cause of premature death among
people with schizophrenia, with an estimated 10 percent
to 13 percent killing themselves. Suicide is even more
pervasive in individuals with bipolar disorder, with 15
percent to 17 percent taking their own lives. The extreme
depression and psychoses that can result due to lack of
treatment are the usual causes of death. These suicides
rates can be compared to
the general population, which is somewhere around 1 percent.
It is estimated that adequate psychiatric treatment could
save up to 5,000 lives per year.
Are severe mental illnesses expensive for society?
Schizophrenia and manic-depressive illness are expensive
diseases. The cost of schizophrenia alone is comparable
to the cost of arthritis or coronary artery disease (D.J.
Kupfer and F.E. Bloom, eds., Psychopharmacology: The Fourth
Generation of Progress, 1995): schizophrenia costs $33
billion per year; arthritis costs $38 billion per
year; and coronary artery disease costs $43 billion per year.
The costs included both direct costs of treatment as well
as indirect costs such as lost productivity. Severe psychiatric
disorders such as schizophrenia and manic-depressive illness
are costly three times over: Society must raise and educate
the individual destined to become afflicted; people with
the illnesses are often unable to contribute economically
to society; and many require costly services from society
for the rest of their lives.
Treatment Advocacy Center,3300 North Fairfax Drive, Suite
220, Arlington, Virginia 22201