One in every five Americans suffers from a mental illness in any given year. Many more meet the minimum diagnosable threshold of a mental disorder at any given moment. When considering that 30% of low back pain patients presenting for chiropractic care actually meet the minimum threshold care must be given to train chiropractors and other musculoskeletal care providers in the recognition of potential mental illness in their patients and perhaps in their patient populations. With the disenfranchised nature of the American mental health system it behooves us as healthcare practitioners to remember that health promotion and wellness takes into account the entire individual not just what we can see and feel in front of us. Documentation also needs to be streamlined in accordance with HIPAA: What can and cannot be placed in patient files to protect the sanctity of the doctor-patient confidential relationship must also be discussed with respect to scope of practice, availability of mental health resources, and timeliness of the intervention if one is deemed necessary.