By Francis Koster, Ed.D.

In the early days of America, communities used to burn alive people with broken brains just for saying unusual or unpopular things.  They called these sick people "witches," and those people died terrible deaths at the hands of their neighbors because they had a brain that was not working correctly.

Three hundred years later, we have made progress - we no longer burn people whose brains are not working correctly. We just let them live under bridges, or thank them for their military service while underfunding their care, or consider it bad manners to talk to a parent when we pick up on troubling signals coming off their child.

We have moved away from thinking of a broken brain as the work of the devil. We do not yet act as if we think such malfunctions are almost "normal" - but they are.

According to the National Institute of Mental Health, one in four adults in the United States has a mental health issue each year [1] - most of the "serious cold" category. Around one in seventeen have a more serious lifelong condition. [2]

Mental illness disables more people in developed countries like the USA than heart disease or cancer! [3]

Like bones, brains break in little and big ways. We easily recognize that a fracture of the finger is less serious than a broken spine. A cough is likely to get better with a common medicine, and pneumonia may require hospitalization. Problems with the brain follow a similar pattern. Some illnesses (like depression or anxiety) may be short-term and can be treated simply and quickly. Others (like schizophrenia and bipolar disorder) require more intensive, long-term support.

Successful medical treatments exist for almost all of these conditions. Seventy to ninety percent of everyone who receives treatment is either cured or have a major improvement. [4]

A lot of brain malfunction is actually a form of birth defect. The brains ability to keep all the bodies chemicals flowing in the right amounts is largely shaped before birth. Breakdowns in that system can triggered by life events, like death of a loved one, drug use, trauma, infection, or combat. Signs that a brain is not working correctly tend to surface during the teen-aged or young adult years. [5] The odds are weighted slightly in favor of white females.[6] 

The good news is that, since the broken process is due to irregular or abnormal regulation of chemicals by other parts of the body, it is usually possible to add back some of the missing ingredients via prescription medicine, and help most patients get back in balance via therapy.  Medicine is the band-aid to stop the bleeding, while therapy and social support, such as individual or group therapy, is usually required for a cure.  

One patient I spoke to said that blaming sick people was a big issue - that no one would blame him if he was born with a cleft palette (another birth defect), but they were quick to blame him if his brain did not work in a normal fashion. This makes recovery more difficult, he said.

If one in four of our neighbors and family members are going to suffer from a brain related illness each year, and one in 17 are going to become seriously ill, you would think that we would have an efficient and effective system of treatment. We don't.

Annually, in America, fewer than one out of three adults with a diagnosed mental problem gets treatment. [7] Only one out of two of our fragile kids get some kind of help. Too bad about the other one.

Paying for heat is an expense. Putting in attic insulation is an investment. Making mental health services available to all is a form of social investment which pays huge dividends. Untreated mental illness costs the United States almost two hundred billion dollars in lost wages alone each year. [8]

To help, reach out to family and friends who have been living with this kind of issue, and let them know you care about them. Help them get to professional help, and above all support their taking of their medication. On an individual level patients can enjoy great success, and achieve normal, or close to normal, lives.

On the national level, we have a challenge. Each Optimistic Futurist column I write starts with an explanation of a challenge facing America, and ends with documented successful programs which can be implemented anywhere. In this case, I find I cannot do that. Laying out the challenge was easy. Identifying replicable systemic solutions was not. Indeed, a recent report [9] issued by the National Alliance on Mental Illness concluded that insufficient national standardized data is collected to even match and measure supply, demand and outcomes within the system.

We have a long way to go.



1. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, Md., U.S. Department of Health and Human Services, Substance Abuse and MentalHealth Services Administration, Center for Mental Health Services,1999, pp. 408409,

2. http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Mental_Illness.htm

3. http://www.cdc.gov/mentalhealthsurveillance/fact_sheet.html

4. Ibid


6. http://www.nimh.nih.gov/statistics/SMI_AASR.shtml

7. http://www.nami.org/Template.cfm?Section=About_Mental_Illness

8. http://content.time.com/time/health/article/0,8599,1738804,00.html

9. http://www.nami.org/Content/NavigationMenu/Grading_the_States_2009/Grading_the_States_2009_Documents.htm


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