How much has our country avoided truly addressing the issue of mental health in recent decades?
So much so that when former U.S. Surgeon General David Satcher released a report on mental health in 1999, it was the first ever issued on that topic by the federal office.
"By the time I had become surgeon general (in 1998), there had already been 30 reports on smoking but not one on mental health," Satcher said recently.
"That's a reflection of the challenges we've faced over the years in addressing mental health," he added.
"But the reality is that if you don't have mental health, you don't have good health at all."
It's a fact that African-American men have been traditionally slow to accept, a crippling hesitancy that causes many black males to silently suffer from mental illness rather than seek care that could effectively treat them.
And it is an issue that continues to put huge numbers of Americans at risk, especially black men.
It's estimated that at least 1.3 million African-American men will develop depression during their lifetimes.
And in one much-noted study, the death rate from suicide for black men was found to be almost four times that for black females.
Such grim statistics made Satcher, the first black man to serve as surgeon general, the perfect keynote speaker for "Brother, You're On My Mind: Changing the National Dialogue Regarding Mental Health Among African-American Men" - an insightful discussion hosted by Omega Psi Phi, one of America's largest black fraternities, during its recent national conference in Jacksonville.
Addressing a packed audience, Satcher made a powerful plea for black men to drop fears of being negatively labeled for suffering from mental illness and reach out for assistance rather than continuing to live in needless pain.
"We are less likely to seek care because of the stigma associated with mental illness in our community," Satcher said regarding African-American men.
"(But) you shouldn't be embarrassed about having a mental disorder. You should be embarrassed if you don't seek care for it. That's really what should be embarrassing to you."CHANGING CULTURE, REMOVING STIGMA
Satcher said it was vital to change a cultural perception among black men that having an issue with mental health is a sign of weakness or a lack of masculinity - or even a failure of spiritual faith.
"Too many (black men) still think this is about being possessed by the devil," Satcher said of mental illness.
"But just as things go wrong with our hearts, our lungs and our livers, they can go wrong with our brains. You would seek help if there was something wrong with those other body parts. Why wouldn't you seek help for your brain?"
Satcher noted that while overall fewer than 25 percent of African- Americans get care for suspected mental disorders, it's even lower for black men.
That has produced tragic ripple effects, Satcher added.
They range from some mentally ill black males ending up in jail for actions that could have been prevented through early treatment to others refusing to address their disorders until severe and lasting damage has been done to their lives.
"Too often, we wait until we have a mental health crisis and then run for help," Satcher said of black males.
"It's keeping us from having productive lives and successful relationships with others."
Satcher's speech was sobering.
But it was also encouraging.
It represented another step forward in developing the candid dialogue that black men must be willing to have about mental health.
"None of us can take our mental health for granted," Satcher said.
And African-American men can't take talking about mental health as a sign of weakness.DEFINING MENTAL HEALTHHere is how former U.S. Surgeon General David Satcher, who issued the first-ever Surgeon General's report on mental health in 1999, defines mental health:"The successful performance of mental function, resulting in productive activities, fulfilling relationships with others, the ability to adapt to change and to successfully cope with adversity."Source: The Satcher Health Leadership Institute.MENTAL HEALTH FACTS - Each year, 1 in 5 Americans develops a diagnosable mental disorder.- Some 16 million American adults live with major depression.- In a recent study, 9.3 million Americans acknowledged having serious thoughts of suicide during the past year.Sources: Substance Abuse and Mental Health Services Administration.