This year marks the 25th anniversary of the American Disabilities Act, which is rightfully hailed as one of the greatest pieces of civil rights legislation in our nation’s history. The ADA was the first comprehensive national law in the world to safeguard the rights of people living with disabilities, and its purpose was clear from the very first line: “The Congress finds that physical or mental disabilities in no way diminish a person’s right to fully participate in all aspects of society, yet many people with physical or mental disabilities have been precluded from doing so because of discrimination.”In honor of this anniversary, my husband, Mayor Bill de Blasio, has designated July as “Disability Pride Month.” And indeed, New Yorkers have many reasons to be proud. The first organization focused on helping people with disabilities thrive in mainstream society was founded here in the late 1800s, and the modern disability rights movement can be traced back to a small but committed group of New Yorkers.
But as far as we’ve come in the last quarter century, the work begun by previous generations of New Yorkers is far from complete. It now falls to us to take the baton and address the largest source of disability in the world: mental illness.
As a society, when we think about disability we most often think about impairments that limit our physical mobility. But in fact, we should be thinking much more broadly. The ADA defines disability in part as “a physical or mental impairment that substantially limits one or more major life activities.” When you consider things in that light, isn’t it obvious that serious mental illnesses like schizophrenia, bipolar disorder, and major depressive disorder are disabilities? For people struggling with these conditions, basic life activities like going to school, being productive at work and building strong and healthy personal relationships can be profoundly challenging.
The statistics bear this out. Researchers have developed a metric called the Disability-Adjusted Life Year (DALY), which measures the overall burden of a given disease. Here in New York City, the five disorders with the greatest disability burden are 1) heart disease, 2) major depressive disorder, 3) other musculoskeletal disorders, 4) substance use disorders, and 5) anxiety disorders.
In other words, three of the five disorders that cause the greatest turmoil in the lives of New Yorkers are mental illnesses. But tragically, far too many people are not getting the help they need. In a 2012 survey, four in 10 New York City adults with a serious mental illness reported needing treatment in the past year, but said they did not receive it or delayed getting it.
Can you imagine how we would react if nearly half of all New Yorkers who were suffering from heart disease weren’t getting treatment? We would quickly label the situation a crisis and mobilize a five-borough public health campaign to connect people with the resources they need to get well. But because mental health conditions are still saddled with a stigma rooted in ignorance, we have done our best to ignore the vast suffering in our midst—until now.
This fall, the de Blasio administration will release a mental health Roadmap. The Roadmap is a plan of action that will lay out a series of steps we must take to create the kind of mental health system we need. Over the past seven months, I’ve been traveling throughout the city, asking New Yorkers to share their stories and advice. While everyone’s experience is unique, their advice for us has been remarkably consistent.
They want to work with us to build a real mental health system – one that reaches into every community, with services that are sensitive to the language and culture of the people it serves and recognizes a fundamental truth: there is no health without mental health.
In order to build this system we need your help, and we need it now. The next time you encounter someone struggling with a mental health condition, offer the courtesy and respect you would extend to someone in a wheelchair. Such small acts of kindness are the foundation on which we will build a mental health system that does justice to both the American Disabilities Act and New York City’s hard-earned reputation as a place where everyone has the opportunity to live their fullest life.
Chirlane McCray is First Lady of New York City. This year, she has committed herself to the creation of a mental health roadmap, which will set a citywide agenda to address the gaps and disparities in mental healthcare. In addition to mental health, she has lent her voice and position to furthering the administration’s efforts to expand early childhood development and support the survivors of domestic violence.