Running Commentary

In July of last year, President Bush's New Freedom Commission on Mental Health released the final report on its one-year study of our nation's mental health service-delivery system. We heralded the report in an APA press release, applauding its over-arching goal of transforming our mental health system by improving access to high-quality and effective mental health care.

APA helped to form the commission and shape the report through both our Public Policy Office staff and the APA Practice Organization Government Relations staff. Three APA members served on the commission: Deanna F. Yates, PhD, a private practitioner in San Antonio and immediate past-president of the Texas Psychological Association; Larke Nahme Huang, PhD, director of research at the Center for Child Health and Mental Health Policy at Georgetown University; and Stephen Wright Mayberg, PhD, director of the California Department of Mental Health.

Other APA members testified before the commission, emphasizing the need for increased access to effective treatments, support for both basic and applied research, collaboration across health specialties, opportunities for professional training, and efforts to decrease stigma.

Report recommendations

The landmark report specifically calls for: full parity in insurance coverage for physical and mental health care, early screening, assessment and intervention across the life span, individualized care that is consumer and family focused, integrated care teams of health professionals, and increased efforts to provide services to underserved populations, including people of color, and to prevent suicide.

During an interview with the news media shortly after the report's release, I explained that the commission's recommendations, when implemented, would help ameliorate the fragmentation that currently exists within the system and would significantly improve the lives of people living with mental disorders. With this goal in mind, APA's efforts are now targeted toward helping to implement the commission's recommendations at all levels of government, as well as within psychology and across health disciplines.

Top priorities

In November, APA was invited by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services to provide input into the development of its "action agenda" for implementing the commission's report. Specifically, we were asked to identify three of the commission's many recommendations that we believed offered the most promise for achieving the desired "transformation" in the nation's mental health system.

The three recommendations we selected as most critical, in order of priority, were: to align relevant federal programs to increase access to mental health services; to improve and expand the work force to provide culturally competent and effective mental health services; and to screen for mental disorders in primary health care across the life span to connect those in need of mental health care to treatment and support services.

Last April, in anticipation of the release of the commission's final report, APA joined with a number of other professional and consumer organizations to form the Campaign for Mental Health Reform. The goal of the campaign is to help implement the commission's recommendations through both federal legislation and regulatory action. Campaign members have already met on several occasions with Commission Chair Michael Hogan, PhD, and with A. Kathryn Power, the new director of the Center for Mental Health Services at SAMHSA, to discuss the report and its recommendations.

APA staff also met separately with each of them to discuss APA's specific issues and concerns. Campaign members are also meeting with other key stakeholders in various federal agencies, including the Department of Veterans Affairs, the Department of Education and congressional offices. In November, APA helped to draft campaign testimony on the commission's report that was presented at a hearing before the Senate Subcommittee on Substance Abuse and Mental Health Services.

APA is actively involved with the campaign in preparing a set of recommendations for the forthcoming reauthorization of SAMHSA, which is likely to serve as the primary legislative vehicle to implement the commission's recommendations. APA is also contributing to this process as an invited member of the Bipartisan Technical Advisory Workgroup, which advises the Senate Subcommittee on Substance Abuse and Mental Health Services regarding the SAMHSA reauthorization and other related issues. This is a challenging and all-consuming effort, but it holds the promise of bringing our nation's mental health system into the 21st century.

Further Reading

View the report online at www.mentalhealthcommission.gov or call (800) 662-4357 for a copy.