• The Substance Use and Mental Health Landscape
• Understanding the Need for Prevention and Treatment
• Expanded Access to Treatment
• Encouraging Recovery in Communities Across America
• Recovery Benefits Everyone
• Additional Recovery Resources
• Sources

For 22 years, National Recovery Month:  Prevention Works, Treatment is Effective, People Recover (Recovery Month), sponsored by the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center for Substance Abuse Treatment (CSAT), within the U.S. Department of Health and Human Services (HHS), has celebrated people in recovery and lauded the work of treatment providers. Recovery Month highlights that all individuals have the fundamental and inherent value to be accepted and treated with respect, dignity, and worth. In addition, Recovery Month spreads the message that behavioral health is an essential part of health and one's overall wellness, and that prevention works, treatment is effective, and recovery from substance use and mental disorders is possible.

This year's Recovery Month theme, "Join the Voices for Recovery:  Recovery Benefits Everyone," emphasizes that:

• All American's have the opportunity to access provisions within the Affordable Care Act and Mental Health Parity and Addictions Equity Act (MHPAEA), aimed to improve physical and emotional health while ensuring people will receive the care they need at a more reasonable cost.
• Public awareness will increase access for those in need of essential substance use and mental health treatment and recovery support services, including behavioral health treatment.
• These legislative changes will improve the overall health and well-being of people in the United States.

The passage of the MHPAEA provides parity, or the recognition by insurance services—both public and private—that substance use and mental disorders are treated comparably to other physical health and medical conditions.¹

This overview will discuss health reform's impact on access to treatment and recovery services, the overall need for these services in today's society, and groups that can raise awareness about these services.

The Substance Use and Mental Health Landscape

Substance use and mental disorders touch everyone one way or another—regardless of race, age, gender, workplace, geography, or socioeconomic level. While the conditions are widespread, treatment services are effective, and recovery is possible. In fact, millions of Americans are in recovery today.²

Substance use disorders—which include misuse, dependence, or addiction to alcohol and/or legal or illegal drugs—and mental health problems—which include depression, anxiety disorder, mood disorder, post-traumatic stress disorder (PTSD), and others—are major public health concerns in the United States, but prevention and treatment services are available and effective. Studies have shown that substance use disorders include both physical and mental dependences,³ and have characteristics similar to other chronic diseases, such as asthma, hypertension, and diabetes.⁴ Like substance use disorders, mental health problems are common, yet treatable, and the realities are often misunderstood. The most common mental health problems are anxiety and mood disorders, ranging from phobias to major depression and bipolar disorder.⁵

As with other chronic illnesses, individuals who seek treatment and recovery support services for substance use and mental disorders learn new life skills and go on to live healthy, empowered, and productive lives, giving back to their communities.

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Understanding the Need for Prevention and Treatment

Effective and cost-efficient strategies for preventing and reducing the severity of some substance use and mental disorders exist. For example, school-based prevention programs for children, teens, and young adults that talk about the dangers of alcohol and/or drug use can reduce the development of substance use disorders.⁶ Despite numerous successful prevention efforts, in 2009, 20.9 million people aged 12 or older still needed treatment for substance use disorders but did not receive it at a specialty substance use facility in the past year,⁷ and 6.1 million adults in the United States aged 18 or older who reported an unmet need for mental health care didn't receive services.⁸ Fortunately, recovery is possible, and so common that half of all adults over age 18 know someone in recovery from addiction to commonly used substances such as alcohol, illicit drugs, or prescription drugs.⁹

A number of risk factors are associated with substance use and mental disorders. Research suggests that genetic factors account for between 40 to 60 percent of a person's risk of developing a substance use disorder.¹⁰ However, just because a substance use or mental disorder runs in a family, it doesn't mean that others in the family or their children will be affected.¹¹ In fact, more than one-half of all children of people with alcohol dependence don't develop the disease.¹² Likewise, while some mental health problems—such as bipolar disorder—tend to run in families, most children with a family history will not develop the condition.¹³ If parents are worried that they or their children may be at risk for a substance use or mental disorder, consider the following tips: don't drink illegally or use illicit drugs,¹⁴ don't misuse prescription medication,¹⁵ address traumatic events,¹⁶ communicate any concerns with a health care provider or a trusted person,¹⁷ and stay physically and mentally healthy.¹⁸

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Expanded Access to Treatment

In 2009, approximately 22 percent of adults with substance use and/or mental disorders were uninsured. Of these uninsured adults, one in three had incomes below the Federal Poverty Level.¹⁹ There is a great need to help people who suffer from substance use and/or mental disorders gain access to treatment and recovery support services. Now, with the passage of the Affordable Care Act in 2010, health care coverage will expand to approximately 32 million Americans who were not previously insured.²⁰ This Federal law includes many new provisions aimed at improving coverage for and access to substance use and mental disorder prevention, treatment, and recovery support services.

Through the implementation of the MHPAEA, employer health plans with more than 50 employees enrolled that choose to include coverage for substance use and mental health services must provide those benefits in the same way as all other medical and surgical services covered by their plan. Therefore, for plans that choose to offer coverage, co-payments, deductibles, and annual and lifetime caps on substance use and mental disorder treatment benefits must be equal to benefits for other medical conditions.²¹ Behavioral health is essential to health and this expanded access to treatment can provide thousands of Americans the opportunity to live happy, healthy, and productive lives in long-term recovery.

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Encouraging Recovery in Communities Across America

Barriers to the treatment of substance use and mental disorders—including discrimination, lack of access, and denial—still exist. The following groups can be instrumental in raising awareness about the importance of accessing treatment and recovery support services and their effectiveness, to help erase barriers. Additionally, they can educate people nationwide on the physical, emotional, economical, and social benefits of recovery.

• Policymakers – Local, State, and Federal policymakers need to inform their constituents about the benefit of treatment for and recovery from substance use and mental disorders, and how recovery positively affects communities both socially and economically. For example, after individuals receive treatment in an integrated primary care and substance use setting, total medical costs per patient per month are more than halved.²² With treatment, one's overall health improves, community crime decreases, and employment increases.²³
• Individuals Affected by Substance Use and Mental Disorders, Families, and People in Recovery – Millions of people in the United States are directly or indirectly affected by substance use and mental disorders. It is essential to recognize the signs and symptoms of substance use and mental disorders and how to access treatment and recovery support services. Additionally, people already on a path of recovery can help others achieve recovery to live a healthy, productive life and participate fully in their community.
• Health Care Providers – Primary care providers, community health centers, and Federally Qualified Health Centers (FQHC) screen, diagnose, and treat people with substance use and mental disorders or work with specialty care providers to help people recover. Specialty treatment providers need to know how health reform will affect the delivery of services. They also need to reevaluate the services they offer and how they collaborate with general health care providers to serve the broader populations needing treatment.²⁴
• Workforce – Substance use disorders cost employers more than $100 billion annually through absenteeism, increased health claims, increased accidents, and lost productivity.²⁵ In addition, the annual economic cost of mental health problems is estimated to be at least $79 billion, of which $63 billion is due to lost productivity.²⁶ To combat these issues, employee assistance programs (EAPs), which can range from telephone-based to on-site programs, can be easily implemented. EAPs can benefit companies in many ways, such as improving productivity by more than 50 percent.²⁷ Furthermore, the return on investment in EAP services for mental health problems is about a $2 to $4 savings for every dollar invested.²⁸

Recovery Benefits Everyone

The recovery process is different for everyone. SAMHSA supports a recovery-oriented system of care, which recognizes that each person must be the central participant in his or her own recovery. While service types may vary, all services should offer choice, honor each person's potential for growth, focus on a person's strengths, and attend to overall health and well-being.²⁹ For resources that can aid in one's recovery journey and improve overall well-being, refer to the resources available at the end of this document.

Investing in prevention, treatment, and recovery support services benefits everyone by reducing the social and economic burdens that substance use and mental disorders have on society. Specifically, it is possible to decrease the Nation's substance misuse costs, which exceed half a trillion dollars,³⁰ as well as costs related to mental health problems, which amount to approximately $79 billion, annually.³¹ SAMHSA encourages community leaders, clergy, health care providers, and employers to inform all individuals that in the wake of health reform, coverage for substance use and mental health treatment and recovery support services (if provided) will be equal to the medical and surgical benefits provided for other health conditions. Through access to treatment, complete recovery is possible, ultimately improving one's entire well-being, including mental, physical, spiritual, and emotional health.

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Additional Recovery Resources

A variety of resources provide additional information on Recovery Month, substance use and mental disorders, and prevention, treatment, and recovery support services.

• Substance Abuse and Mental Health Services Administration (SAMHSA) Website – Leads efforts to reduce the impact of substance use and mental disorders on communities nationwide.
• SAMHSA's National Helpline, 1-800-662-HELP (4357) or 1-800-487-4889 (TDD) – Provides 24-hour free and confidential information about substance use and mental disorders, prevention, treatment, and recovery referrals in English or Spanish.
• SAMHSA's "Find Substance Abuse and Mental Health Treatment" Website – Contains information about treatment options and special services located in your area.
• SAMHSA's "Considerations for the Provision of E-Therapy" Report – Shares extensive information on the benefits, issues, and success of e-therapy.
• SAMHSA's ADS Center – Provides information and assistance to develop successful efforts to counteract prejudice and discrimination and promote social inclusion.
• National Suicide Prevention Lifeline, 1-800-273-TALK (8255) – Provides a free, 24-hour hotline available to anyone in a suicidal crisis or emotional distress.
• Alcoholics Anonymous and Narcotics Anonymous – Contains an array of resources for individuals suffering from alcohol or drug dependence, respectively, and allows them to find and join a local chapter.
• Al-Anon/Alateen and Nar-anon – Provides community and support networks for family members of all ages who have been affected by substance use disorders.
• Narconon – Provides prevention, education, and rehabilitation programs for drug misuse and dependence.
• SMART Recovery® – Offers free, self-empowering, science-based mutual-help groups for all types of addictive behaviors.

As health reform continues to be implemented, use the following resources to learn how to access treatment and recovery support services:

• HealthCare.gov – Managed by HHS; provides information to the general public on how the new law affects access to health care.
• The Kaiser Family Foundation – Provides a summary of the comprehensive health reform law.
• The Parity Implementation Coalition's Parity Toolkit – Aids individuals in seeking recovery, and their families, providers, and advocates, in understanding their rights under the MHPAEA law.

Click here for a longer version of this guide. Information about treatment options and special services in your area can be found by calling 1-800-662-HELP (4357) or 1-800-487-4889 (TDD), as well as at http://www.samhsa.gov/treatment.

Inclusion of websites and resources in this document and on the Recovery Month website does not constitute official endorsement by the U.S. Department of Health and Human Services or the Substance Abuse and Mental Health Services Administration.

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Sources

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