As I suspected, the report about the SAMHSA study which found that 1 in 5 Americans are mentally ill wasn't reported with complete accuracy. It turns out our American media folks failed to recognize or failed to tell us that there are actually two definitions of "mental illness" as used by SAMHSA.
The first thing that was not made clear in the reports I read is that it was a survey, not a study. Doctors were not asked to report numbers. A random sample of current patients was not studied. This means that, while scientific methods were followed, the people in the study were simply asked questions, not diagnosed.
An important piece of information left out of the media reports I saw is that only people 18 and older were considered in this survey. Developmental disorders, such as autism and mental retardation, were not included. Only diagnosable mental, behavioral, and emotional disorders were included in the study, though it was unclear to me whether or not conditions that are primarily or substantially physical in nature were included. Those illnesses present in people who also had a drug addiction problem were excluded from the survey.
People who are part of a subgroup expected to have an unusually high rate of mental illness, such as those in mental institutions and prisons, were excluded from the survey.
As to the definition of mental illness, SAMHSA deferred to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association [APA], 1994). Their definition is divided into two levels of mental illness; Severely Mentally Ill and "any mental illness." This is where our media reports did us the greatest injustice. They did not specify which group they were reporting on.
What qualifies a person as having a Severe Mental Illness (SMI)? They must have or have had a "diagnosable mental, behavioral, or emotional disorder…of sufficient duration to meet diagnostic criteria…that has resulted in serious functional impairment, which substantially interferes with or limits one or more major life activities. The DSM-IV site lists about 160 of these ranging from various levels of bipolar disorders to a variety of fetishes.
So, if the media had more accurately reported the results of this survey, the results would have been a little different. Those with Severe Mental Illness, as determined by questionnaires and interviews, amounted to only 4.8% of American adults not in any of the types of institutions mentioned above. That means only 1 of every 20 of us, not 1 in 5.
The other major category, "any mental illness" was defined similarly to SMI except for this sentence, "Adults who had a diagnosable mental, behavioral, or emotional disorder in the past year, regardless of their level of functional impairment, were defined as having any mental illness." (Italics mine). This is the group that represents about 1 in 5 American adults. Again, these conditions include all levels of bipolar disorders, anxiety disorders, adjustment disorders, and so forth. If you have claustrophobia, agoraphobia, or any other phobia, you are the 1 in 5. If you are more anxious is certain situations that most people, you are the 1 in 5. If you have a compulsion that is more pronounced that most people, you are the 1 in 5.
Do you feel any better now? Do you feel worse?
There is one thing that a better understanding of this report doesn't change. There are still plenty of people living among us who need our understanding and our help. Don't underestimate the power of one person's smile, touch or friendship to affect a needy person's life. Show the love of Jesus to all.
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