The present system of care for people with severe mental illnesses was developed when mental disorders were conceptualized as different from other bodily disorders. Consequently, the mental health delivery system does not routinely minister to other health needs. As a result, people with severe mental illnesses are more likely to die at an early age. In addition to a very high suicide rate, people with severe mental illnesses also have more accidents and suffer more heart disease, infections, and type II (adult onset) diabetes.

The Unrecognized and Untreated
There are indications that unrecognized and untreated mental illnesses are associated with very high physical health care utilization and can be a significant factor in homelessness, unemployment, intractable poverty, and crime. People with unrecognized or untreated mental illnesses interact with care providers who address their physical health, food, shelter, and employment needs. But just as the mental health system is not accustomed to addressing the physical health needs of patients, the primary care and social service systems are not accustomed to identifying or addressing many mental disorders. By coordinating identification services with emergency rooms, primary care offices, welfare offices, food banks, homeless shelters, the judicial system, and other community organizations, mental health treatment providers can help identify and treat people who would otherwise slip through the cracks.

Community Support
As new therapies permit higher levels of functioning, many mental health systems are not positioned to help consumers take advantage of their full potential. For example, many people with severe mental illness are underemployed for their current level of functioning and do not have access to services that would help them become appropriately employed. Also, engagement in community social life is often limited. People with mental illness may feel unwelcome in social settings, causing a need for supportive programs that help them transition into society.

Treating the Whole Person
As the Foundation helps providers develop systems to treat the whole person, we will fund activities such as the following:

• The creation and development of partnerships between mental health and primary care providers
• The development of supportive community services, such as vocational education, employment support, volunteer opportunities, religious participation, transitional and independent housing, and family support programs
• Demonstration projects that identify and treat mental disabilities and substance abuse as factors in over-utilization of health services, poverty, homelessness, unemployment, and crime