Public Health, Mental Health and Substance Abuse


According to the WHO, a healthy person is a person in a state of complete physical and mental as well as social well-being. Hence, mental health is one of the major components of people’s health. It is necessary to note that substance abuse and mental health are regarded as closely related issues. These two health problems have a significant impact on public health in the US.

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First, the number of people suffering from these issues is significant. For instance, it has been estimated that one in five adult Americans has some kind of mental disorder (Lubotsky Levin, Hanson, Hennessy & Petrila, 2010). As for substance abuse, around 10% of Americans (aged 12 years old and older) have used illicit drugs at least once in their life (Buck, 2011). According to research, almost a quarter of Americans reported about their engagement in binge drinking during a month (Buck, 2011). Svrakic et al. (2012) state that the use of cannabis by the populations aged 12 and older is steadily increasing. These alarming data suggest that quite dramatic changes should be implemented in the system of public health to address this issue.

Mental disorders and substance abuse have a significant impact on public health. People at different developmental stages (teenagers, adults, and older adults) are affected differently. The most vulnerable group is the first one, and substance use and mental disorders are regarded as major causes of accidental traumas and death (including car accidents, overdose, suicides, and so on) (Schulte & Hser, 2014). Such outcomes are associated with the “maladaptive behavioral patterns” of this population as teenagers are often unprepared to handle the challenges related to substance abuse and mental disorders (Schulte & Hser, 2014, p. 7).

When it comes to adults, the outcomes of these health conditions are also quite serious. For instance, substance abuse and mental disorders are associated with the development of sexually transmitted diseases, overdose, liver damage, and so on. Furthermore, it is also associated with such psychological issues as anxiety and various mood disorders (including depression, phobias, and so on), and suicidal behaviors.

As far as older adults are concerned, mental disorders and substance abuse are associated with such health issues as cirrhosis, strokes, accidental injury. Psychological effects include suicidal behaviors, depression, anxiety, dementia, and so on. It is noteworthy that the system of public health still does not include a systemic approach to the two health issues mentioned above.

It involves several systems that respond to the needs of people suffering from mental disorders and substance abuse (Lubotsky Levin et al., 2010). These systems involve justice, social welfare as well educational system. It has been acknowledged that in the majority of cases people address outpatient clinics and non-governmental organizations that provide support to those suffering from mental disorders and substance abuse (Buck, 2011).

The government launches various programs aimed at the provision of high-quality services and support to such people. For instance, the Affordable Care Act mandates the provision of services to people suffering from mental disorders and substance abuse. Medicaid also covers these health issues to a certain extent. However, these efforts seem insufficient.

It is important to add that these health issues have various effects on economic, legal, and social systems. For instance, the expenditure for treatment of mental health and substance abuse in the USA exceeded $230 billion in 2014 (Lubotsky Levin et al., 2010). Apart from particular expenditures of the public health system, mental disorders and substance abuse have various negative effects on the economy of the country.

For instance, when it comes to employment, these health issues are associated with absenteeism, low productivity, poor performance, the unfavorable atmosphere in the working place (Buck, 2011). Organizations’ overall performance decreases and this may negatively affect the country’s economy. Of course, people having such problems may often lose their job and join the army of unemployed, which is another load for the country’s budget.

As for the legal system, it is also affected by substance abuse and mental disorders in several ways. For instance, the recent debate on marijuana legalization and its outcome shows that the legislature is influenced by public opinion and changes alongside society. At the same time, some laws are reinforced to address such dangerous behavior as drunk driving or domestic violence (Lubotsky Levin et al., 2010). Again, these measures seem insufficient as people (especially youth) display risky behaviors.

The social system is also influenced by the health issues in question. One of the most serious negative outcomes of substance abuse and mental disorders is the deterioration of social links (Schulte & Hser, 2014). Alienation, as well as social stigma, are the major reasons for this process. People suffering from the health conditions in question often try to avoid any contact. They tend to prefer being alone to participating in social events. They often find such social entities as schools, healthcare facility or workplaces as a hostile environment. At the same time, society can be rather hostile to the people who are regarded as potentially dangerous or simply other. The behavior of these people can often be risky for themselves as well as the people around them.

All these influences should be diminished but there are several challenges to the development of efficient treatment delivery systems. One of these challenges is the lack of funds. As has been mentioned above funding of programs aimed at assisting such people has increased but the number of such people has also grown significantly.

The government is unable to cover all the patients suffering from substance abuse and mental disorders (Buck, 2011). The government could (at least partially) address this issue by attracting investment from the private sector. The majority of facilities addressing the needs of people suffering from the health conditions mentioned are non-governmental and non-profit. Of course, many of these facilities also lack resources to address the needs of all patients or those who require assistance.

It is also important to note that the quality of services provided has to be corresponding. In many facilities, clients do not receive the assistance they need or services they expect to get (Buck, 2011). This is due to the lack of a qualified workforce. Nursing professionals, social workers, and other healthcare professionals are not numerous especially when it comes to facilities addressing the needs of people suffering from substance abuse and mental disorders. Those who are in the profession are often overloaded with tasks and the quality of services they provide deteriorates. These professionals also lack motivation as they are paid quite a little money and the profession is not prestigious.

Another problem is rooted in the lack of control and supervision. Many non-governmental facilities are operating in the country and it is difficult to supervise all of them. Besides, there is hardly any program aimed at the development of a specific approach to supervision and control of such facilities (Lubotsky Levin et al., 2010). Again development of this program and the agency responsible for its efficient implementation will need additional funds that are scarce.

Furthermore, many people do not address professionals and try to solve their health issues on their own, as they are afraid of the social stigma that is associated with these health conditions. When it comes to teenagers, they are often unable to understand that they need assistance, as they do not understand their state and the possible consequences of their health condition. As for adults, they can be afraid to lose their jobs if they address professionals and this will become known to their bosses or colleagues. Of course, many of these people are afraid of being stigmatized and prefer addressing their problems on their own.


In conclusion, it is necessary to note that mental disorders and substance abuse are serious health conditions that have various negative effects on the US economy and the country’s social development. These health issues have a significant impact on such systems as economic, social, and legal. They require the development of a complex approach. The public health system needs several changes, as it is now unable to address the issue. There are several challenges to address but the changes can be effectively implemented if the government, non-profit organizations, private sector as well as the public will make the necessary effort.


Buck, J.A. (2011). The looming expansion and transformation of public substance treatment under the Affordable Care Act. Health Affairs, 30(8), 1402-1410.

Lubotsky Levin, B., Hanson, A., Hennessy, K.D., & Petrila, J. (2010). A public health approach to mental health services. In B. Lubotsky Levin, K.D. Hennessy & J. Petrila, (Eds.), Mental health services: A public health perspective (pp. 5-13). New York, NY: Oxford University Press.

Schulte, M.T., & Hser, Y.I. (2014). Substance use and associated health conditions throughout the lifespan. Public Health Reviews, 35(2), 1-27.

Svrakic, D.M., Lustman, P.J., Mallya, A., Lynn, T.A., Finney, R., & Svrakic, N.M. (2012). Legalization, decriminalization & medicinal use of cannabis: A scientific and public health perspective. Missouri Medicine, 109(2), 90-98.