Mental Health Care

Report Outline
Pressures for Better Services
Changing Views of Mental Illness
Directions in Therapy and Research
Special Focus

Pressures for Better Services

Carter's Prescription for Federal Support

The mentally ill, it is said, have no constituency. Everyone seems to want them out of sight and out of mind. But when President Carter sent Congress his message on mental health care one key constituent was on hand to endorse his legislative proposals. Rosalynn Carter, who has had a long and abiding interest in mental health matters, was at her husband's side as he spoke with news reporters in the White House press room. She had served as honorary chairperson of the President's Commission on Mental Health whose report laid the groundword for the legislation he was that day (May 15) asking Congress to enact.

The commission report drew together many of the facts and enigmas surrounding the ill-defined but devastating cluster of disabilities grouped within the term mental illness. If the definitions are elusive, the problems are all too apparent. But the president's legislative prescription for mental health care has not evoked the optimism that infused the war on poverty, the missionary zeal aroused by civil rights, or the compassion inspired by the mentally retarded or physically handicapped.

There are a number of reasons why it is hard to mobilize public interest in the mentally ill. One is the nebulous nature of the population involved. The commission suggested that as many as 15 percent of the American people — some 32 million — may need mental health services at any one time. A figure of 10 percent had previously been used by federal health officials to project the need for services. It is not always clear how many of those persons are too severely ill to meet the everyday requirements of survival in society: to secure an education, hold a job, and relate in some satisfactory manner to others. To make any estimate requires arbitrary decisions about whom to include.