Breaking the Silence

Website for the American Mental Health Counselors Association's Breaking the Silence initiative to address mental health stigma.

Addressing the Mental Health Crisis Affecting Our Country

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By contributing blogger Joel E. Miller

One critically important issue stands out for consideration in the next presidential debate: the mental health crisis facing our country. It’s the crisis we aren’t talking about enough and Americans need to know where their candidates stand on the topic. As you can see, the following numbers are alarming, and many are only getting worse. What plans do the candidates have to address this crisis?

The U.S. suicide rate is the highest it’s been in 30 years.

The suicide rate continues to grow and is a crisis that affects Americans of all ages.[i] The suicide rate jumped 24 percent from 1999-2014[ii]–among middle-aged women (45-64 years old), the suicide rate skyrocketed by 63 percent during this time period.[iii] Suicide is the second leading cause of death for 15-24 year olds.[iv] An average of 20 veterans die by suicide every day—a rate far higher than the U.S. average.[v] About 2.5 times more people die by suicide than by homicide.

One in five people live with mental illness. More than half don’t get mental health care.

Mental health care is unavailable or unaffordable for many Americans. About 17 million children experience mental health problems[vi] and more than 43 million adults live with a mental health condition,[vii] yet 50 percent of people do not receive mental health treatment.[viii] Not being able to afford the cost is the top reason,[ix] which is compounded by a national shortage of mental health providers. This shortage is most pronounced in low-income communities and in rural areas.[x] Stigma associated with mental illness plays a large role in discrimination against people who have a mental health condition, who feel shamed into not seeking needed treatments. We must challenge stigma. We all have a role in creating a mentally healthy community that supports recovery and social inclusion and reduces discrimination.

Mental health conditions are the second most common reason teens are hospitalized.[xi]

Not only are our youth and young adults committing suicide at high rates, they are also experiencing mental health conditions that are serious enough to require a hospital stay. In 2012, more than 162,000 hospital stays among 13-18 year olds were for mental health conditions—the second leading cause of teen hospitalizations.[xii] We know that 50 percent of all mental illness begins by age 14; 75 percent by age 24[xiii], and that early treatment leads to better outcomes. However, in the U.S., there is an average delay of 74 weeks from first symptoms of psychosis to when a person receives care.[xiv]

Two million people with mental illness are admitted to jails each year.[xv]

Our criminal justice system is becoming our default mental health system. Today, people with serious mental illness are overrepresented among people who are incarcerated, especially women.[xvi] Most are in jail for non-violent offenses, and most receive no treatment after admission.[xvii] Many people with mental illness leave jail in worse health than when they entered, and we currently don’t have a system that effectively addresses their needs in the community. All of this comes at a tremendous cost to individuals, families, communities and taxpayers.

People with mental illness are dying about 10 years earlier than those without mental illness, largely of treatable health conditions.
Nearly 70 percent of adults with mental health conditions have one or more medical conditions. Co-occurring mental health and medical conditions affect treatment outcomes, health care costs and mortality rates. Xix Co-occurring conditions can impair a person’s self-care and management of a chronic disease, like diabetes, which can then lead to complications, such as blindness.

We need to be talking about mental health. Our country can do better.

Mental health research, services and supports lag far behind that devoted to other chronic conditions, despite the economic impact of mental illness of nearly $200 billion per year in lost earnings[xviii] and an untold toll on individuals, families and communities. Meaningful reform of our mental health system will require both leadership from the next President and the commitment and ability to work effectively with Congress and with the many federal agencies that touch Americans who live with mental illness. We are calling on you to raise the issue of the candidates’ plans for addressing this life-threatening and life-saving topic during the October 9th Presidential Town Hall debates.


[i] Drapeau, C. W., & McIntosh, J. L. (for the American Association of Suicidology). (2015). U.S.A. suicide 2014: Official final data. Washington, DC: American Association of Suicidology, dated December 22, 2015, downloaded from
[ii] Curtin SC, Warner M, Hedegaard H. Increase in suicide in the United States, 1999–2014. NCHS data brief, no 241. Hyattsville, MD: National Center for Health Statistics. 2016.
[iii] Ibid.
[iv] Ibid.
[v] U.S. Department of Veterans Affairs. Office of Suicide Prevention. Suicide Among Veterans and Other Americans 2001-2014. August 3, 2016.
[vi] Child Mind Institute (2015). Children’s Mental Health Report. Retrieved from
[vii] Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50).
[viii] Beth Han, Sarra L. Hedden, and Rachel Lipari; RTI International: Elizabeth A. P. Copello and Larry A. Kroutil. (2015). Receipt of Services for Behavioral Health Problems: Results from the 2014 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration.
[ix] Ibid.

[x] Ibid
[xi] Heslin KC (AHRQ), Elixhauser A (AHRQ). Mental and Substance Use Disorders Among Hospitalized Teenagers, 2012. HCUP Statistical Brief #202. March 2016. Agency for Healthcare Research and Quality, Rockville, MD.
[xii] Ibid.
[xiii] National Institute of Mental Health (2005). Mental Illness Exacts Heavy Toll, Beginning in Youth. Press release.
[xiv] Addington J. et al. (2015). Duration of untreated psychosis in community treatment settings in the United States. Psychiatric Services, 66(7), 753-756.
[xv] Steadman, H. J., Osher, F. C., Robbins, P. C., Case, B. & Samuels, S. (2009). Prevalence of serious mental illness among jail inmates. Psychiatric Services, 60(6), 761-765. Retrieved February 5, 2016 from
[xvi] Ibid.
[xvii] Subramanian R., Delaney R. Roberts S., Fishman N., McGarry P. (2015). “Incarceration’s Front Door: The Misuse of Jails in America” Vera Institute of Justice 4..Retrieved April 9, 2015 from
[xviii] Insel, T.R. (2008). “Assessing the Economic Costs of Serious Mental Illness. American Journal of Psychiatry.” 165(6), 663-665.


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