"Mental disorders are not character flaws but are legitimate illnesses that respond to specific treatments, just as other health conditions respond to medical interventions," said the report. "Society no longer can afford to view mental health as separate and unequal to general health."
In the report, to be released Monday, U.S. Surgeon General David Satcher encourages Americans who suspect they have a mental disorder to seek help. It is nation's first-ever Surgeon General's report on treatment for mental illnesses.
The report is a scientific rather than political document and makes no specific policy recommendations. But mental health advocates said they would seize it in fighting for equal health insurance coverage of mental ailments, better treatments in prisons and more accountability in public spending.
All told, mental disorders affect nearly one in five Americans. Nearly half of those with a severe mental illness do not seek treatment.
"We've got a health crisis here and the surgeon general has documented it," said Laurie Flynn, executive director of the National Alliance for the Mentally Ill.
"Mental Health: A Report of the Surgeon General" reviews 3,000 academic studies on mental health and mental illness and has been in the works since Satcher took office in early 1997. The report's release comes at a session with Satcher and Tipper Gore, Vice President Al Gore's wife and a longtime advocate for the mentally ill.
Mrs. Gore noted that suicide is the third-leading cause of death among young people 18 to 24. When asked why they don't get help, she said on ABC's "Good Morning America," "The kids say to me, `Because they are afraid of being labeled.'
"Kids in particular need to know if they are in trouble and they know someone who is talking about violence or talking about suicide or is in a severe depression, they need to come forward and get the treatment they need because treatment works," Mrs. Gore said.
But even people who want treatment can't always afford it. Even those with health insurance often find sharp limits on what their health plans will pay for.
The report stops short of recommending that the law require insurance companies to treat mental and physical health problems equally as President Clinton and some in Congress have proposed. But it does call this coverage "an affordable and effective objective."
The nearly 500-page document examines both mental health and mental illness, calling them "points on a continum."
Mental health involves the ability to engage in productive activities, to fulfill relationships with others, adapt to change and cope with adversity. Metal illness includes a variety of disorders characterized by alterations in thinking, like Alzheimer's disease; in mood, like depression, or in behavior, like hyperactivity.
Satcher argues that people with mental health problems and mental illnesses can live happier, more productive lives with the help of therapy and medication.
Without help, someone who begins sad can become clinically depressed, and ultimately even suicidal. Untreated, the most severely ill can end up homeless or criminal.
"To a great extent, we are dumping our mental health problems on the streets of America," Satcher said in an interview. "We are dumping them into our jails and prisons; there's no question about that."
Satcher, who has also focused on racial disparities in health, noted that black Americans are less likely to get outpatient mental health services but more likely to end up institutionalized, suggesting they are missing opportunities for important early care.