Let's take a close look at mental health issues.

Byline: Jackman Wilson Register-Guard Editorial Page Editor

BEFORE THIS NEW year gets stale, I'd like to launch a new project for The Register-Guard's editorial department: a sustained examination of mental health.

Our mental health project is modeled on our "Arts in our community" series. In collaboration with the City Club of Eugene, we resolved last year to pay special attention to the arts and their role in people's lives.

The arts series was an experiment for us; we'd never tried anything like it before. The idea was that by declaring an intention to pay special attention to the arts, we'd oblige ourselves to be on the lookout for arts-related topics to write about. Equally important, we'd make it clear that people who had something to say about any aspect of the arts, broadly defined, would be welcome to contribute guest columns or articles for our Commentary section.

The results of this experiment were mixed. The project sputtered at times; weeks would pass without an editorial or guest column bearing the "Arts in our community" logo.

But there were successes as well. We prepared an early editorial endorsement of legislation to create the Oregon Cultural Trust, and we followed the bill through to its approval. The trust is the most significant arts-related public policy initiative in the state's history, and joins the Beach Bill and land-use planning as an example of Oregon's willingness to innovate. Our support of the trust would not have been argued in such detail, well before the issue came to the attention of other newspapers in the state, if we hadn't committed ourselves to search for opportunities to write about the arts. It's possible that our editorials kicked the trust up a few notches on the legislative agenda.

Another success came late last year, when we published architect Otto Poticha's remarks to the City Club about the banality of Eugene's architecture. His comments prompted a vigorous, if one-sided, discussion - hardly anyone took serious issue with Poticha's contention that Eugene is architecturally ugly. A strong constituency in favor of more distinctive architecture has been revealed. This was an example of how a collaboration with the City Club can prove fruitful, and we hope for more of the same as we begin our examination of mental health.

Why mental health? Partly because mental health is a topic that can't possibly be addressed in a single editorial or guest column. Only through a sustained examination can we hope to bring ourselves and our readers to an understanding of mental health and mental illness - what it is, how it's treated, how it affects people's lives. It will take far more than a single editorial or column to explain how the mental health system works, with its bewildering array of programs and funding streams.

Nearly every public institution is affected. The public schools are cutting counselors who deal with young people who are suicidal or using drugs, both of which are often symptoms of mental health problems. By default, the county jail and hospital emergency rooms have become institutions for the mentally ill. Much of the work of the courts and the police involves dealing with problems that can be traced to mental illness. Substance abuse, a primary contributor to crime, abuse and family breakups, is coming to be seen as a mental health issue. Governments at every level, along with private organizations such as the United Way, devote a significant share of their resources to addressing mental illness and its consequences.

Behind the institutions that respond to mental health problems are the mentally ill themselves. We'd like to describe who they are and find out what types of treatment are most effective. It's clear from the outset that many mentally ill people aren't getting the treatment they need, and sometimes get no treatment at all - with consequences ranging from suicide and hospitalization to lives of quiet misery.

The scope of the problem was described in the 1999 Surgeon General's Report on Mental Health, which said that during the course of a year 20 percent of adults suffer some form of mental disorder. Nine percent experience "significant functional impairment," affecting family life, social relations and employment. Severe and persistent mental illness - schizophrenia, bipolar disorders, panic disorders, depression, obsessive-compulsive disorders - affect 2.6 percent of adults.

The surgeon general's report estimated that the direct costs of mental illness totaled $69 billion in 1996, accounting for 7.3 percent of all medical spending. This estimate is absurdly low. Many expenses counted as ordinary health-care costs are indirect results of mental health problems, and other costs ripple throughout society.

The problem is not only big and complicated - mental health is also a field where profound changes are taking place. The surgeon general's report noted four of them: Scientific understanding of the human brain and behavior is advancing rapidly. The range of treatments for mental illness is expanding. The financing and organization of the mental health system is being transformed. Powerful groups have emerged to advocate for the rights of the mentally ill and their families. All of these changes are clearly visible in Lane County.

So there's a lot to learn. We will rely on people with knowledge and expertise in the field - program administrators, case workers, academics, advocates and others - for advice, suggestions and, especially, written contributions to our pages. We also hope to hear from the real experts, people who have struggled with mental illness themselves or in their families. We plan to explore the deficiencies of the existing mental health system, and see some visions of what a better system would be like. The City Club will do the same.

Turning our attention to mental health doesn't mean we'll stop writing about the arts and welcoming guest columns on arts-related topics. Our hope is that over the course of the past year we've gotten into the habit of recognizing the importance of the arts, and that we'll continue to give them the prominence they deserve. Mental health is another issue, or set of issues, that deserves to be pushed higher on the agenda of public discussion. Let's see what we can do to make that happen.

Jackman Wilson is editorial page editor of The Register-Guard. He can be reached at jwilson@ guardnet.com.