Mental Health Theme Issue: Title and subTitle BreakCall for Papers

In 1990, then-President George H. W. Bush issued a proclamation designating the 1990s as the Decade of the Brain to encourage brain research and also to enhance public awareness of the benefits to be derived from brain research.¹ This formal recognition of the importance of increasing both scientific knowledge and public understanding about the organ that is the site of emotion and cognition and the controller of most bodily functions was a fitting way to end the 20th century, and few would question that knowledge about brain structure and function has increased remarkably.

However, at the end of the first decade of the 21st century, mental disorders continue to be a major public health problem throughout the world, making a substantial independent contribution to the burden of disease worldwide.² Mental disorders are a major cause of long-term disability and also interact with other health conditions as risk factors and sources of additional morbidity and mortality.³ Of course, mental disorders are also a direct cause of mortality, with approximately 800 000 individuals committing suicide every year worldwide³ —usually related to mood disorders, alcohol and other drug abuse, or schizophrenia and other psychoses. In the United States, the latest statistics available (2006) indicate more than 33 000 annual deaths from suicide, a rate of 11.1 suicide deaths per 100 000 population per year, and 594 000 annual emergency department visits for self-inflicted injuries.⁴

The overall burden from mental disorders is striking, with an estimated 14% of the global burden of disease attributed to mental disorders.⁵ A recent assessment of mental disorders and treatment in the United States, using multiple data sources (1996-2006), led to mixed conclusions.⁶ Particularly concerning were the findings that access to care appeared to decline among individuals with mental health impairments and that at least 7% of the population with serious and persistent mental illnesses was incarcerated in jail or prison each year.

In recognition of the public health importance of mental disorders, JAMA will publish a theme issue on mental health in May 2010. The use of the term mental health in this regard merits comment, since most of the content will undoubtedly be about mental disorders. This is analogous to the fact that mental health centers are usually centers of mental illness. The explanation, of course, is that mental disorders are the problem and mental health is the goal. The World Health Organization has made the point that “there is no health without mental health” since “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,”⁷ obviously a lofty goal.

For the theme issue, we encourage submission of high-quality, evidence-based studies pertaining to all aspects of mental health and mental disorders. Articles of interest and relevance for JAMA's broad medical readership will be of particular interest, and studies reporting original data or systematic reviews, including meta-analyses, will generally receive higher priority.

In view of the plan to publish a fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders(DSM-V) in 2012, the first revision of the diagnostic criteria for mental disorders since 1994, data-based articles on psychiatric diagnosis will certainly be of interest.⁸ Another very timely issue is the current effort to achieve health care system reform in the United States.⁹ Submissions providing evidence about how access to care, quality of care, and cost efficiency can be optimized in the diagnosis and treatment of mental disorders will merit careful consideration. As always, multicenter randomized clinical trials addressing important issues with the potential to change and improve clinical practice will be of the greatest interest for JAMA readers and editors. Controlled trials assessing preventive interventions^{10 - 11} are of particular importance. We also plan to publish a small number of scholarly articles of opinion as Commentaries, meeting the strict JAMA criteria for concision.¹²

Manuscripts received by December 1, 2009, will have the best chance of consideration for the mental health theme issue. All submitted manuscripts will undergo JAMA's usual rigorous editorial evaluation and review. High-quality submissions not selected for the theme issue may be considered for other JAMA issues or may be referred for consideration by the appropriate Archives specialty journal. Authors should consult JAMA Instructions for Authors¹² for guidelines on manuscript preparation and submission.

Although the statistics noted herein regarding mental disorders provide an overview of the magnitude and importance of the problem, mental illness and mental health are experienced by individuals, families, and communities. As a psychiatrist, I have seen the pain, frustration, and despair caused by mental disorders. I have also been privileged to share in the relief and possibilities attained when mental illness is overcome. The goal for the JAMA theme issue on mental health is that it will be of assistance to clinicians and policy makers in helping patients, families, and communities move in that positive direction.