Debate Magazine

Fixing Our Mental Health System

Posted on the 30 May 2014 by Alanbean @FOJ_TX

By Alan Bean

The Guardian continues its series on the American mental health system with a practical article by Paul Appelbaum, Professor of Psychiatry, Medicine and Law at Columbia University.  It seems the last rethinking of the American mental health system took place in 1955.  Can we improve our mental health system without investing billions of dollars?  No, we can’t.  Therein lies the problem.

We have pretty good mental health services for those who can afford to pay.  For those who can’t . . . well, just thinking about it can make you crazy.

How to rebuild America’s mental health system, in 5 big steps

Paul S. Appelbaum

Paul S. Appelbaum

Paul S. Appelbaum

No genuine system of mental health care exists in the United States. This country’s diagnosis and treatment of mental health problems are fragmented across a variety of providers and payers – and they are all too often unaffordable. If you think about it, the list of complications is almost endless:

  • Families of loved ones with mental illness recount horror stories, as several have in the Guardian’s interactive series this week.
  • Patients transitioning from inpatient to outpatient treatment often fall between the cracks.
  • Mental health and general medical treatment are rarely coordinated.
  • Substance abuse treatment usually takes place in an entirely different system altogether, with little coordination.
  • Auxiliary interventions that are so essential to so many people with serious mental illnesses – supported housing, employment training, social skills training – are offered through a different set of agencies altogether … if they are available at all.

Our mental health system is a non-system – and a dysfunctional non-system at that.

Read the entire article here


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