In Brief

U.S. Surgeon General Richard Carmona, MD, pledged his commitment to achieving parity for mental health and stressed the pivotal role psychologists can play in emergency preparedness during a speech at APA's 2003 Annual Convention in Toronto.

"Until we can say the words 'public health' and everybody thinks of that as including mental health, we will not have a complete health-care system," Carmona told the crowd of psychologists. "I won't be satisfied until we achieve parity."

Carmona said that mental health needs to be put on the radar screen, especially since the public's psyche continues to be tested by acts of terrorism--such as the anthrax terrorist attacks in 2001 that generated uneasiness throughout the country.

"A dozen envelopes sent out from an anonymous person paralyzed the greatest country in the world," he said. "We were not prepared to deal with the mental health consequences of this threat, and we still aren't."

The potential long-lasting mental health effects of such acts can sometimes far outweigh any physical component, Carmona said.

He stressed the importance of building an infrastructure that fosters the public resilience necessary to cope with terrorist events. He pointed to Israeli models of resilience instituted following suicide bombings--such as people being encouraged to continue shopping at a mall that had been attacked a day before.

By comparison, Carmona said, "If a mall is bombed here, there will be no activity there for years, children won't go to school, dads won't go to work and the economy will plunge further--even if there were no deaths from the event."

Carmona emphasized that the country must turn from merely responding to mental health needs following an attack to targeting prevention as a pathway to building resilience. Carmona asked for psychologists' help in building such resilience and raising the public's mental health literacy.

"The next terrorist event, we might lose 100 or 1,000 people from a physical injury, but we will lose millions by the psychological devastation," Carmona said. "We cannot allow that to happen."

To keep with his vow to support mental health, Carmona announced plans to publish a Surgeon General's report on mental health preparedness to help raise awareness of mental health and keep it in the forefront.

"Together, we can and we must build resilience into American society while keeping the mental health needs of the country on the forefront and in parity with other health needs of the United States," Carmona told the audience. "I'm making a pledge that I'm willing to do that. But I need a big team behind me."

APA CEO Norman B. Anderson, PhD, said he was pleased by Carmona's support of mental health and called his speech inspiring.

"We are extremely fortunate to have a surgeon general who understands that no discussion of health can exclude mental health," Anderson said.