Except as a recounting of the last half-century of public attitudes and treatment of mental illness, a new report by Surgeon General David Satcher isn’t likely to tell advocates for the mentally ill anything they do not already know. The surgeon general missed an opportunity to advance the dialogue on this important topic beyond current widely accepted conventions.

That’s not to say Dr. Satcher’s work is devoid of important points. He reviews public misunderstanding of mental illness, the lack of insurance coverage for it, the growing evidence that many mental illnesses can be effectively controlled through drug treatment and the effect that untreated mental illnesses have on society. It is a detailed and thoughtful analysis of much of the accepted thought on these illnesses.

Unfortunately, it is not much more than that. His observation that one American in five has a diagnosable mental disorder is a startling conclusion, culled from several studies, that deserves further explanation. He concludes that a primary barrier to treatment for many mental illnesses is a lack of health care coverage or public resources. But while recognizing the improvements brought by some health maintenance organizations, his call for parity between mental health and other health coverage doesn’t adequately describe how that might happen or recognize the difference between treating, say, schizophrenia vs. a broken arm.

Mental health advocates have fought for years to reduce the public’s fears about mental illness, and they have been successful in many ways — political debate now regularly shows respect for the validity of mental illness and its treatment. Dr. Satcher, however, spends a fair amount of his report debunking myths about mental illness that already have been debunked in just about every place the report is likely to be read or applied.

Perhaps the most valuable component of the surgeon general’s report is his call for increased research on the brain. Expanded research in neuroscience and molecular genetics hold particular promise right now, and “the opportunities available underscore the need for the federal mental health research community to strenghten partnerships with both biotechnology and the pharmaceutical industries.” It is an important point that budgeteers in the Clinton administration and in Congress should heed.