{
  "id": "R40536",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "R40536",
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  "source": "EveryCRSReport.com",
  "versions": [
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      "source": "EveryCRSReport.com",
      "id": 347805,
      "date": "2009-04-21",
      "retrieved": "2016-04-07T02:34:54.597178",
      "title": "The U.S. Mental Health Delivery System Infrastructure: A Primer",
      "summary": "In the past decade, four federal reports have offered insight into the nation\u2019s mental health care system and recommended a fundamental transformation of the system. According to these reports, transformation of the mental health care system would require timely incorporation of evidence-based practices in routine practice, resolution of workforce shortage issues, removal of financial barriers, coordination of mental health care with general health and social services, and systematic measurement and improvement of the quality of care delivered. While each of these recommendations may result in some benefits, the findings suggest that a comprehensive transformation of the mental health system could be necessary to ensure the availability and accessibility of quality mental health care to all individuals who need it. \nIn 2007 about 11% of adults (23.7 million) in the United States experienced serious psychological distress, such as anxiety and mood disorders, that resulted in functional impairment that impeded one or more major life activities. Different types of providers deliver care in a range of settings and are financed by various combinations of public and private payers. Congress has been increasingly interested in transforming the mental health system in the aftermath of tragedies involving mentally ill individuals\u2014such as the shootings at Columbine and Virginia Tech, which led to heightened public interest in the adequacy of the mental health care system. Two federally funded efforts, one through the Agency for Healthcare Research and Quality (AHRQ) and the other through the Substance Abuse and Mental Health Services Administration (SAMHSA), attempt to measure the quality of mental health care on an annual basis. At this time, neither effort is adequately developed to guide the transformation of the system. \nSAMHSA estimates that less than half of individuals with serious psychological distress receive mental health care due to various social, financial, and systemic barriers. While there have been advances in treatment options, the delivery system and financing mechanisms have been slow to transform and apply these findings in routine practice. For this reason, despite substantial investments that have increased the knowledge base about mental illness and have led to the development of many effective treatments, experts agree that many Americans are not benefiting from these investments. Mental health care is often not coordinated with other care that an individual may be receiving or may need. Access to competent mental health providers is scarce in rural areas and even some urban areas. Coverage for mental illness provided by private health insurance, Medicare and Medicaid, is sometimes less comprehensive than that for physical illnesses, negatively affecting access. In addition, some issues, such as social stigma around mental illness, and inadequate public awareness that mental health problems are treatable create disincentives for individuals to seek care. These issues affect both the access to, and the quality of, care delivered and, by consequence, the mental health outcomes achieved. \nIn the past decade, Congress passed two far-reaching laws on mental health care. The first law, the Children\u2019s Health Act, reauthorized the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2000 and called for greater focus on measurement of mental health care outcomes. The second law, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, expands federal requirements for mental health coverage. Congress could consider transformation of the mental health system as part of larger health care reform efforts.",
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      "typeId": "REPORTS",
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  "topics": [
    "Health Policy"
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}