[Congressional Record Volume 149, Number 138 (Thursday, October 2, 2003)]
[Extensions of Remarks]
[Pages E1961-E1962]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   MENTAL HEALTH AWARENESS WEEK 2003

                                 ______
                                 

                          HON. DANNY K. DAVIS

                              of illinois

                    in the house of representatives

                       Thursday, October 2, 2003

  Mr. DAVIS of Illinois. Mr. Speaker, I rise today in honor of Mental 
Health Awareness Week. With the Census Bureau reporting yesterday that 
the number of people without health insurance shot up last year by 2.4 
million, the largest increase in a decade, raising the total to 43.6 
million, showing there is no hiding that our Nation is facing a health 
crisis. The reason behind this remarkable increase has been blamed on 
soaring health costs and many workers losing coverage provided by their 
employers. Although it is usually a misconception that those who are 
uninsured are also unemployed, the number of full-time workers without 
health insurance rose by 897,000 last year, to 19.9 million. Among 
people living in poverty, 49 percent of those worked full-time were 
uninsured. Beside a lack of information and education about mental 
illness, being uninsured plays a significant role on whether an 
individual reaches out for help or even receives treatment.
  In our Nation, one percent of the population has been diagnosed with 
schizophrenia, one percent has been diagnosed with manic depression and 
between 5-10 percent of Americans will experience at least one episode 
of major depression. This gives us a base number of about 14-24 million 
individuals. If you add in the millions who suffer with panic attacks 
or Obsessive-Compulsive Disorder, and include the more than four 
million who suffer with dementing illnesses, such as Alzheimer's 
Disease. Then if we include substance abuse and other addictive 
disorders, we reach a number that includes a quarter to a third of the 
American public who suffers with some form

[[Page E1962]]

of mental illness. During any one year period, up to 50 million 
Americans, more than 22 percent, will suffer from a clearly diagnosable 
mental disorder. These numbers demonstrate the need for mental health 
care and coverage. Yet, instead, services are disappearing and many, 
specifically minorities, are backing away from the services that still 
remain.
  Minorities in America face severe economic, cultural, linguistic and 
physical barriers for treatment of mental illness. According to a 
report from the U.S. Public Health Service, these difficulties prevent 
thousands from being properly treated. The study explains that 
minorities are no more likely than whites to suffer from mental 
illnesses. However factors often keep African Americans, Hispanics, 
American Indians, Native Hawaiians, and Asian Americans from getting 
the help they need and when they do, the treatment may be substandard 
or too late.
  For Asian Americans, studies have shown that they underutilize mental 
health services much more than other populations. The National Research 
Center found that Asians were underrepresented in the outpatient 
system, and they were more likely than African Americans, Whites, and 
Hispanics to have psychotic disorders. Although overall rates of mental 
illness among Hispanics roughly equal that of whites, young Hispanics 
have higher rates of depression, anxiety disorders, and suicide. The 
study also found that Hispanics born in the United States are more 
likely to suffer from mental illness than those born in Mexico or 
living in Puerto Rico. With African Americans being overrepresented in 
populations at high risk for developing mental illness--namely, 
the homeless, prisoners and children in foster care--the need for 
mental health treatment is generally higher. All three of these 
particular cultures have stigmas attached to mental illness along with 
social battles preventing treatment from being obtained. Even research 
on the mental health of minorities is sparse considering it was only in 
1994 when the National Institute of Health started to require that its 
funded studies include minorities and that studies indicate a subject's 
race.

  The research that does exist is startling. About 25% of African 
Americans do not have health insurance and many who do are more likely 
to receive care from a primary health provider rather than a mental 
health specialist or end up in the emergency room looking for help. As 
I mentioned, African Americans are over-represented in high-need 
populations that are particularly at risk for mental illnesses. One 
population group is the homeless, of which African Americans make up 
about 40% of the homeless population. Another is the prison population 
that is comprised of nearly half of all prisoners in State and Federal 
jurisdictions and almost 40% of juveniles in legal custody are African 
American. African American children and youth constitute about 45% of 
children in public foster care and more than half are waiting to be 
adopted. African Americans are also more likely to be victims of 
serious violent crime. One study reported that over 25% of African 
American youth exposed to violence met diagnostic criteria for post-
traumatic stress disorder. When compared to whites who exhibit the same 
symptoms, African Americans tend to be diagnosed more frequently with 
schizophrenia and less frequently with affective disorders. In 
addition, one study found that 27% of blacks compared to 44% of whites 
receive antidepressant medication. Moreover, the newer SSRI medications 
that have fewer side effects are prescribed less often to African 
Americans than to whites. And while the rate of bipolar disorder is the 
same among African Americans as it is among other Americans, African 
Americans are less likely to receive a diagnosis and, therefore, 
treatment for this illness.
  One of the high-risk populations that overly effect the African 
American population, the prison population, is of an extreme concern of 
mine. This year an estimated 600,000 exoffenders will be reentering 
communities across the nation. According to the U.S. Department of 
Justice, about 283,000 people who are incarcerated on any given day in 
the United States are known to have a mental illness, with almost 
550,000 others on probation. The rate of mental illness in the jailed 
population is four times greater than that in the general population. 
The Cook County Jail in Chicago has become, by default, the largest 
psychiatric facility in the state of Illinois. At least 10% of the 
Facility's 10,000 detainees are on psychiatric medications. Because the 
jail is overcrowded, prisoners must be released every day, whether they 
are ready or not, to make room for new arrivals. Unfortunately, our 
prison system's purpose is social control, not treatment. This means 
most of the detainees who have a mental illness are released with just 
a prescription and the address of a mental health facility and receive 
very little follow-up.
  Mr. Speaker, we have made much progress in mental health awareness--
we are talking about it today, which would have been unheard of 15 
years ago. But we have so much to do. In our recent budget crisis, 
states are cutting mental health funding first and not realizing the 
cost it will be on our society later. Education and breaking down 
misconceptions that many cultures face need to be improved. We need to 
ensure that our citizens are receiving the help they need by providing 
equal mental health services to all.

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