ABSTRACT
It has been reported by the National Institute of Mental Health (NIMH) that 22% of the population is affected by mental disorders each year. It has also been estimated that 5 million American adults experience the most severe of these illnesses, including major depression, manic-depressive disorder, schizophrenia, panic disorder, and obsessive-compulsive disorder. However, these severe illnesses represent only a small portion of a much broader problem, and a large number of individuals are affected by various mental and behavioral disorders that occur independent of age, gender, race, and socioeconomic status. These mental disorders result in a cost of $148 billion each year for treatment and indirect costs, and the cost of depression alone is estimated at $53 billion a year in the United States (NIMH, 1995). Serious depression affects approximately 15% of the U.S. population at least once in a lifetime, but it is estimated that only 1 person in 10 with such disorders gets adequate treatment. The solution to this pandemic public health problem is prevention, and a theoretical rationale for prevention has been addressed in chapter 2. One concern is that two thirds of the people suffering from depression never get treated for this disorder, and half of this group never even seeks treatment. Furthermore, a national advisory panel on depression has reported that even when patients seek treatment insurance and managed care companies actively discourage them from seeking mental health care services (Hirschfeld, 1996).
