Although the terms are often used interchangeably, poor mental health and mental illness are not the same. A person can experience poor mental health and not be diagnosed with a mental illness. Likewise, a person diagnosed with a mental illness can experience periods of physical, mental, and social well-being.
Mental Illness Is Not…
Mental and physical health are equally important components of overall health. For example, depression increases the risk for many types of physical health problems, particularly long-lasting conditions like diabetes, heart disease, and stroke. Similarly, the presence of chronic conditions can increase the risk for mental illness.2
Suicide is a leading cause of death in the United States. In fact, it was the 2nd leading cause of death for people ages 10-24. It accounted for the loss of more than 45,979 American lives in 2020, nearly double the number of lives lost to homicide. Learn more about mental health problems.
Fact: Even very young children may show early warning signs of mental health concerns. These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors.
Unfortunately, only half of children and adolescents with diagnosable mental health problems receive the treatment they need. Early mental health support can help a child before problems interfere with other developmental needs.
Fact: People with mental health problems are just as productive as other employees. Employers who hire people with mental health problems report good attendance and punctuality as well as motivation, good work, and job tenure on par with or greater than other employees.
Fact: Studies show that people with mental health problems get better and many recover completely. Recovery refers to the process in which people are able to live, work, learn, and participate fully in their communities. There are more treatments, services, and community support systems than ever before, and they work.
Fact: Treatment for mental health problems varies depending on the individual and could include medication, therapy, or both. Many individuals work with a support system during the healing and recovery process.
Fact: Friends and loved ones can make a big difference. In 2020, only 20% of adults received any mental health treatment in the past year, which included 10% who received counseling or therapy from a professional. Friends and family can be important influences to help someone get the treatment and services they need by:
Fact: Prevention of mental, emotional, and behavioral disorders focuses on addressing known risk factors such as exposure to trauma that can affect the chances that children, youth, and young adults will develop mental health problems. Promoting the social-emotional well-being of children and youth leads to:
The Division of Intramural Research Programs (IRP) is the internal research division of the NIMH. Over 40 research groups conduct basic neuroscience research and clinical investigations of mental illnesses, brain function, and behavior at the NIH campus in Bethesda, Maryland. Learn more about research conducted at NIMH.
Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe. Two broad categories can be used to describe these conditions: Any Mental Illness (AMI) and Serious Mental Illness (SMI). AMI encompasses all recognized mental illnesses. SMI is a smaller and more severe subset of AMI. Additional information on mental illnesses can be found on the NIMH Health Topics Pages.
The data presented here are from the 2020 National Survey on Drug Use and Health (NSDUH) by the Substance Abuse and Mental Health Services Administration (SAMHSA). For inclusion in NSDUH prevalence estimates, mental illnesses include those that are diagnosable currently or within the past year; of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); and, exclude developmental and substance use disorders.
Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and for their family and friends. The symptoms of schizophrenia can make it difficult to participate in usual, everyday activities, but effective treatments are available. Many people who receive treatment can engage in school or work, achieve independence, and enjoy personal relationships.
Most people with schizophrenia are not violent. Overall, people with schizophrenia are more likely than those without the illness to be harmed by others. For people with schizophrenia, the risk of self-harm and of violence to others is greatest when the illness is untreated. It is important to help people who are showing symptoms to get treatment as quickly as possible.
Educational programs can help family and friends learn about symptoms of schizophrenia, treatment options, and strategies for helping loved ones with the illness. These programs can help friends and family manage their distress, boost their own coping skills, and strengthen their ability to provide support. For more information about family-based services in your area, you can visit the family education and support groups page on the National Alliance on Mental Illness website.
A growing body of research is helping to tease apart why some people with serious mental illness are prone to violence while others are not, and how clinicians and others can help through improved treatment and informed myth-busting
Many health service psychologists will, at some point in their careers, evaluate, treat, or study the relatively small number of people with serious mental illness who have committed or have the potential to commit violence toward others. Most often they see these individuals in psychiatric inpatient or forensic settings, but occasionally in private practice as well. Many more psychologists have also treated clients who have contemplated or even completed suicide, considered by some to be violence against the self.
While perpetrating violence is relatively uncommon among those with serious mental illness, when it does occur, in many cases it is intertwined with other issues such as co-occurring substance use, adverse childhood experiences, and environmental factors, says Eric B. Elbogen, PhD, a psychologist and professor of psychiatry and behavioral science at the Duke University School of Medicine who studies violence and mental illness.
It is important to learn about these issues not only to better treat these individuals and to aid their families and communities but to combat the misperception that most people with serious mental illness are violent, adds Jeffrey Swanson, PhD, a medical sociologist at the Duke University School of Medicine and a prominent researcher of the topic. For example, people often believe that people with mental illness are largely responsible for incidents of mass violence and that people with mental illness are responsible for a large share of community violence. Yet both views have been roundly debunked by research, says Swanson.
As important, a growing body of research shows that when people with serious mental illness commit violent or aggressive acts, other factors besides the illness itself are often at play, says Kimberly Brown, PhD, ABPP, an associate professor of clinical psychiatry and behavioral sciences at Vanderbilt University Medical Center and host of an APA 2020 convention workshop (available on demand) on the topic.
One of the most striking findings from the original MacArthur Violence Risk Assessment Study is an environmental one: When the team compared discharged psychiatric patients without substance use disorder with people from their same neighborhoods, their rates of violence were about the same, says Paul Appelbaum, MD, Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law at Columbia University and a site principal investigator on the MacArthur Study. In other words, when neighborhoods are unsafe, poor, and high in crime, violence is an equally likely outcome whether a person has a mental illness or not.
Despite significant advances in knowledge, however, research in the area is still mixed, says Brown. Some studies find larger links between violence and mental illness than others, and others find no relationship at all. Several reasons help to explain such differences, including that researchers use different population samples in their studies, as well as different definitions and variables to measure violence and mental illness. With violence, for instance, some studies include relatively minor acts of aggression, while others focus exclusively on serious acts of harm toward others. The same is true with mental illness, with some studies of schizophrenia and violence, for example, including only so-called positive symptoms like hallucinations, which are associated with high rates of violence. But other studies find that negative symptoms, such as apathy and loss of motivation, are associated with lower violence rates (Archives of General Psychiatry, Vol. 64, No. 5, 2006).
In an editorial in The American Journal of Psychiatry (Vol. 176, No. 9, 2019), Appelbaum also points out that many of the current studies, reviews, and meta-analyses in the field rely on data originally collected for other studies, not for the specific purpose of studying the relationship between mental illness and violence. To help move the field forward, he suggests that researchers conduct more prospective studies that use violence as the primary outcome measure and have sufficient power to identify the range of risk-related variables and integrate them into sound theoretical models. Also helpful, he says, would be developing uniform research methods when studying the topic. 2ff7e9595c