THE MAJOR MENTAL-DISORDERS - NEW EVIDENCE REQUIRES NEW POLICY AND PRACTICE

This article argues that a new mental health policy and programmes are needed to deal with the major mental disorders (schizophrenia, major depression and bipolar disorder). Evidence has now accumulated to show that many of the persons who are afflicted with these disorders conti nue to suffer throughout their adult lives, despite treatment. In addi tion to their own suffering, their mental disorders lead to unmeasurab le suffering for their families which often include young children. No t only do these individuals present all of the symptoms and social imp airments usually associated with the major disorders, they are also at increased risk for premature death, substance abuse/dependence, crimi nality, violence, homelessness, and infectious disease. This situation cannot be left to continue. New policy and programmes designed to pre vent the major mental disorders are needed. Two consistent findings su ggest that prevention may be possible: 1) many of the children at risk for the major mental disorders can be identified by their family hist ory of mental disorder; and 2) non-genetic factors, biological and/or psychosocial, can limit the expression of the hereditary factors assoc iated with each of these disorders. Given what we know about the fate of children within these high risk families, it may be unethical to no t intervene.