President Bush's New Freedom Commission on Mental Health recommends a "wholesale transformation" of the mental health system in its final report, released today.
The repair of the mental health system must involve consumers and providers, policymakers at all levels of government, and both the public and private sectors, the White House commission says, and mental illness should be addressed with the same urgency as other medical problems.
Because of fragmentation and uneven quality of care, the current mental health system is focused on managing disabilities associated with mental illness instead of on promoting recovery, the report finds. The panel recommends changes in federal programs, greater state responsibility for planning services, and placing patients and their families at the center of service decisions.
A year in the making, the final report was a legal requirement for the president's commission, created by executive order on April 29, 2002. The report was built on research, expert testimony and input from more than 2,300 patients, family members and providers.
The report comes on the heels of a study released Monday by the Substance Abuse and Mental Health Services Administration that finds fewer than half of the 15 million U.S. adults who have a serious mental illness received treatment or counseling during the last year.
The president's panel emphasized a model of early intervention and disability prevention, which will require stronger involvement and education of primary care providers, as well as improved awareness in schools, child welfare programs and the criminal and juvenile justice systems.
"Early detection, assessment and linkage with treatment and supports can prevent mental health problems from compounding and poor life outcomes from accumulating," the report says.
Another recommendation is the more rapid adoption of evidenced-based practices, which the commission says will require reimbursement from mental health payers. The American Psychiatric Association strongly concurs and is calling on Congress to pass a comprehensive mental health parity bill requiring equal coverage for mental illnesses as for other medical illnesses.
"We urge an end to our patchwork national policy on the coverage of treatment for mental illness," says APA President Marcia Goin, M.D., in a written statement. "There are wide disparities in private insurance coverage. Federal programs such as Medicare still discriminate against patients seeking treatment for mental disorders by limiting their care and forcing them to pay more for it. Deeper cuts in mental health services, particularly in state Medicaid programs, are leading to a wholesale collapse of our mental health system."
Bush publicly endorsed mental health parity legislation last April, and 66 senators and 242 representatives currently support the Senator Paul Wellstone Mental Health Equitable Treatment Act (S 486 and HR 953), according to the Coalition for Fairness in Mental Health Coverage.