One in four Americans experience mental health problems at some point during their lifetime.
Considering that four people are running for president and vice president this year, it's perhaps worthy to ask if all four are mentally fit for the job.
Whatever their response is would also send a signal that the next administration is willing to be the first -- besides the Carter administration -- to take mental health issues seriously or not.
So far, however, John McCain, Barack Obama, Sarah Palin and Joe Biden have shown no indication that they're willing to serve as role models for disclosure, mental health professionals say.
The New York Times has reported that serious gaps remain in the public's knowledge about the health of the presidential and vice-presidential nominees, and each candidate has been less than forthcoming about their physical and mental histories.
McCain's fitness, in particular, has been questioned because of the potential effects of his nearly six years as a prisoner of war in the Vietnam War. According to U.S. Veterans Dispatch website, McCain was much more forthcoming during his 2000 presidential campaign than he has been lately -- though he carefully controlled the release eight years ago of some "redacted medical records" in what appeared to be an effort to counter discussions of McCain's legendary "short fuse" temperament.
In 2000, McCain's campaign released a statement by Dr. Michael M. Ambrose, director of the Robert E. Mitchell Center for Prisoner of War Studies, that said: ''Senator McCain has never been diagnosed with or treated at the center for a psychological or psychiatric disorder. He has been subject to an extensive battery of psychological tests and following his last examination in 1993, we judged him to be in good physical and mental health.''
The doctors said McCain explained that while in solitary confinement he created for himself a fantasy world in which he lived. The doctors said McCain always heard the guards coming with his food, but "was often so much in his private world, that he strongly resented their coming around and bringing him back to reality by intruding. He was enjoying his fantasies so much," according to the website.
Since 2000, McCain has offered little more than what was already reported. Doctors once again say he is in good physical and mental health -- despite having surgery for skin cancer. Friends say he's calm and collected, despite what some people consider his erratic behavior on the campaign trail.
To be fair, Obama has had past issues with addiction, admitting that he used cocaine as a young man. But he hasn't been so forthcoming about his smoking addiction that, according to The New York Times, he's either kicked or reduced to an occasional habit. Either way, coming clean about his habit and revealing the impact it's had on his health would do the public more good than just merely kicking it, some say.
The National Alliance on Mental Illness say it's a serious matter, pointing out that if John McCain or Barack Obama were to ever need to seek help from their home states through public mental health services, they would be appalled. So too would Joe Biden or Sarah Palin.
"Mental health care is an essential part of health care reform. It is an issue that every candidate for public office at every level needs to be addressing in this election," said Michael J. Fitzpatrick, executive director of the National Alliance on Mental Illness.
In 2003, the President's New Freedom Commission on Mental Health reported that the nation's public mental health care system is "a system in shambles" in which mental health services are "fragmented, disconnected and often inadequate, frustrating the opportunity for recovery," according to NAMI.
In 2006, NAMI published "Grading the States: A Report on the Nation's Mental Health Care System for Serious Mental Illnesses." In the survey, the national average was D. The home states of the presidential and vice-presidential candidates hardly fared better.
Their scores: Alaska (D); Arizona (D+); Delaware (C-); and Illinois (F).
Mental health advocates say the effects of the Iraq war, as well as the Bush administration's approval of mental health parity as a component of the financial bailout legislation, could provide momentum for the next administration to take mental illnesses as seriously as physical illnesses.
"Mental illness doesn't discriminate between Republicans and Democrats," Fitzpatrick said. "It affects millions of Americans, including veterans of Iraq and Afghanistan, families recovering from natural disasters like Hurricane Katrina, and families confronting home foreclosures or other financial upheavals."