Division of Mental Hygiene

What is Mental Illness?

Mental illness refers to certain medical/biological conditions that can cause changes in one’s thinking, feeling, mood, behaviors, ability to relate to others and daily functioning that often result in a decreased capacity to cope with life’s ordinary demands.   

With the right treatments and support services, however, people with mental illness can live productive, fulfilling lives, and, in many cases, recover.

Mental illnesses, sometimes called mental disorders, are a serious public health concern that too often go undetected and/or untreated. Regrettably, mental illnesses take a serious toll on many aspects of an individual’s personal, family and work life.

Even though we do not know for certain, there are many possible causes of mental illness, including genetics, trauma, biological or psychological factors.

Symptoms of mental illness vary depending on the specific disorder, but may include mild to chronic or even severe forms of depression, anxiety, attention deficits, memory impairments, drinking and drug use, and even the presence of hallucinations or delusions.

Some common symptoms of mental illnesses include:

• Confused thinking;
• Long-lasting sadness or irritability;
• Extreme highs or lows in mood;
• Excessive fear, worrying or anxiety;
• Social withdrawal;
• Changes in eating or sleeping habits;
• Feelings of anger or hostility;
• Difficulties with attention/concentration;
• Delusions or hallucinations;
• Increasing inability to cope with daily problems and activities;
• Denial of obvious problems;
• Many unexplained physical problems;
• Abuse of drugs and/or alcohol; and
• Suicidal thoughts and in severe cases, even suicide attempts

The treatment of mental illness can include the use of medication (such as antidepressants, anxiety medications, mood stabilizers and antipsychotics), psychotherapy, support and self-help or other methods/interventions. Among the major psychotherapy treatment options are cognitive-behavioral, psychodynamic and interpersonal therapies. These methods have different techniques, but they are all based on helping the person with mental illness function better and, hopefully, recover.

According to one study, individuals with serious mental illness die 25 years earlier than the general population. Healthier lifestyle choices and supportive measures, such as eating healthier foods, exercising, quitting smoking and engaging in stress-reduction methods, are vital to recovery; all of these help increase a person’s quality of life, and lengthen their life span.

Mental Illness in NYC

Depression and anxiety are among the most widespread mental illnesses, affecting an estimated 54 million adults in the United States each year. In New York City, a 2004 Department of Health and Mental Hygiene-conducted survey, the Health and Nutrition Examination Survey, found that 430,000 (7.5%) of NYC residents suffered from a major depressive disorder and 200,000 (3.5%) from a generalized anxiety disorder in the previous 12 months.

In the 2005 NYC Community Health Survey also conducted by DOHMH, 6.3%, or 378,000 City residents, reported nonspecific psychological distress. Psychotic disorders, eating disorders, developmental disorders, substance-use disorders and personality disorders also affect many New Yorkers.

Mental illness is also a problem among teenagers; in the 2005 Youth Risk Behavior Survey, conducted by the New York City Department of Health and Mental Hygiene (DOHMH), 9.6% of respondents said they had attempted suicide in the previous 12 months. Depression is one of the leading underlying causes of suicide attempts and among those youth who reported a suicide attempt in the past year, more than 67% also had reported symptoms of depression.

You can access these and other statistics about the health of City residents on the Web at https://a816-health3ssl.nyc.gov/.

DOHMH wants New Yorkers to know that treatment works and that recovery is possible. Early screening and detection, medication, therapy and peer support can make a big difference. Recovery refers to a process through which individuals are able to live, work, learn and participate fully in their communities. Recovery is based upon empowerment, respect, responsibility and peer support, and it makes use of individualized, culturally competent, holistic and person-centered, strength-based strategies to promote progress toward a healthier life.

DOHMH partners with consumers, families, advocates and providers to ensure access to high-quality services and to improve the lives of New Yorkers. In this way, we help support recovery, eradicate stigma, increase awareness and promote accessibility and equity in treatment and other opportunities for people with psychiatric disabilities.

There are also support organizations for consumers who are learning how to cope with mental illness and their families. More information is available at http://www.naminycmetro.org/, the Web site of the New York affiliate of the National Alliance on Mental Illness.

What DOHMH Is Doing

The New York City Department of Health and Mental Hygiene contracts with hundreds of agencies throughout the 5 boroughs to help people of all ages with mental illness. Most consumers are served in outpatient treatment programs, although some consumers occasionally require a higher level of care (such as inpatient) during times of crisis. There are separate programs targeting children, ranging from young children to adolescents, and DOHMH also funds programs tailored for older adults.

As part of the Take Care New York program, DOHMH is committed to combating depression by making depression screening and management available as a routine part of primary care in New York City. DOHMH promotes the use of the PHQ-9, a simple set of nine questions that tells a primary care doctor whether his or her patient is likely to be depressed. The goal is to give primary care physicians a simple, numerical measure to detect depression, similar to measuring blood pressure or cholesterol. If the measurement is too high, then the doctor, patient and family know that something needs to be done. DOHMH also currently oversees, in collaboration with the NYC Department for the Aging and the Mental Health Association of New York City, the Geriatric Depression Screening Initiative, which provides detection and treatment of depression among New Yorkers over 55.

Individuals who suffer from mental illness are more likely to abuse alcohol and drugs – and abusing these substances can trigger or exacerbate mental illness. During the past several years, also as part of Take Care New York, DOHMH has promoted the use of buprenorphine, a new treatment for heroin and other opioids. These efforts resulted in a steady increase in New Yorkers prescribed buprenorphine, from near zero in January 2003 to more than 1,300 in January 2007.

DOHMH focuses on helping consumers recover from their illness and lead productive lives. The Department realizes that recovery from mental illness is more difficult without a stable home environment. As a result, getting homeless mentally ill consumers off the streets and into permanent housing is one of the Department’s goals.

The City also funds over 40 other types of programs that serve people with mental illnesses, helping them to lead full productive lives within their communities and to recover. These include clubhouses, employment programs and case management as well as other housing programs,

Consumer Support

Furthering our mission of supporting recovery, the Department’s Office of Consumer Affairs ensures that the systems serving New Yorkers with mental hygiene conditions are aware of the practical needs consumers face. The Office of Consumer Affairs achieves this mission by making sure that the Department understands, listens to and integrates the voices of consumers in service delivery, policy and planning. The Office of Consumer Affairs directly serves the community through the provision of an information and referral line; library and Internet access; scholarships to pertinent conferences and seminars; promoting leadership development; and by advocating at public speaking events, among other activities.

What To Do

If you have questions, call 311, New York City’s phone number for government and non-emergency services or directly to the Office of Consumer Affairs at 212-219-5393.

For mental health or treatment referrals call LIFENET: 1-800-LIFENET (1-800-543-3638; 1-877-AYUDESE en Español; 1-800-543-3638 for Asian-speaking populations) is a toll-free, confidential help line that provides callers with information and referrals for those seeking services to mental health and substance abuse resources throughout the New York City area. LIFENET operates 24 hours per day/seven days per week.