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Secretary of Health and Human Services Kathleen Sebelius told a crowd of health care providers and others Wednesday at Baltimore's Sheppard Pratt Health Systems that health care reform would save money and improve care for millions of Americans who do not get all the mental health services they need.

Bills passed by the House and being debated in the Senate would require mental health and substance abuse coverage for people getting new coverage for physical care. Other legislation passed last year will require that insurers that provide physical coverage also provide an equal level of mental health coverage, Sebelius said. That takes effect in January.

The measures could bring down costs for providers, taxpayers and paying customers by providing preventive care before more expensive crises happen, she said. The impact would be enormous, according to Sebelius: Half of the country's 700,000 homeless people have a mental illness, one in five prisoners has a substance abuse problem, and mental illness in Americans under 25 costs almost $250 billion annually.

But the problems are more widespread than that. One in five Americans will have a mental health illness this year and almost half will have a mental illness in their lifetimes. Yet 10 million people didn't get the mental health care they needed last year, and 20 million didn't get substance abuse services, Sebelius said.

"If 10 [million] or 20 million Americans were walking around bleeding, we'd have alarm bells going off," she said.

Sebelius and Sheppard Pratt President Steven S. Sharfstein also honored Maryland Secretary of Health and Mental Hygiene John Colmers for his leadership of a state that they said is recognized nationally for mental health programs.

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