Mental Health Systems Compared

The primary objective of this book is to provide comprehensive descriptions and make comparative evaluations of each of the mental health systems of four Western, industrialized countries. The countries selected illustrate a continuum from a highly centralized and publicly financed, national health service in Great Britain to a predominantly decentralized and more privately financed market of mental health services in the United States. In between these two contrasting types are examples of national health services and insurance programs in Norway and Canada. Contributing experts from each country begin their chapters with an overview of the geographic, demographic, political, economic, and cultural contexts in which their mental health systems are situated. Thereafter, they (a) present national data to estimate the need for mental health services, (b) describe national mental health policies and programs designed to meet their population's need, (c) indicate how mental health services are organized and delivered, and (d) discuss how their system is financed and provided resources. A common chapter outline facilitates comparisons among all four systems on relevant evaluation criteria: (a) access and equity, (b) quality and efficacy, (c) cost and efficiency, (d) financing and fairness, (e) protection and participation, and (f) population relevance. In the final section of each chapter, the authors provide recommendations for improved performance of their mental health system. In the initial chapter, the editor provides an overview, introduces the four countries selected, and defines the evaluation criteria applied by all contributing authors. The final two chapters address convergence and divergence among the four systems and provide recommendations for improvement and for future comparative studies. The intended audience includes mental health policymakers, program administrators and managers; teachers of graduate level courses relat

Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

This revised, expanded edition uses a public health framework and the latest epidemiological, therapeutic, and service systems research to give readers a comprehensive understanding of the organization, financing, and delivery of mental health and substance abuse services in the United States. Written by national experts, it will provide policymakers, administrators, clinicians, and graduate students with the knowledge base needed to manage and transform mental health service systems, both nationally and locally.

This revised and expanded third edition text utilizes a public health framework and the latest epidemiological, treatment, and service systems research to promote a comprehensive understanding of the organization, financing, and delivery of mental health and substance abuse services in the United States. Written by national experts in the field, this timely work will provide policymakers, administrators, clinicians, and public health and behavioral health graduate students with the knowledge base needed to manage and transform mental health service systems, both nationally and locally.The book is unique in providing a public health framework of the most significant issues facing mental health policy makers, administrators, planners, and practitioners. It combines issues (e.g., evaluation; law; ethnicity) that extend across different age groups, treatment settings, and disorders, with issues that are population and disorder specific.The publication of this book is timely for those involved with the debate over national health care reform legislation, and provides important and timely information (on populations at-risk for mental disorders, services, and systems issues) for those responsible for implementing policies and programs resulting from this reform effort.

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

Young adulthood - ages approximately 18 to 26 - is a critical period of development with long-lasting implications for a person's economic security, health and well-being. Young adults are key contributors to the nation's workforce and military services and, since many are parents, to the healthy development of the next generation. Although 'millennials' have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults. Currently, the nation is experiencing economic restructuring, widening inequality, a rapidly rising ratio of older adults, and an increasingly diverse population. The possible transformative effects of these features make focus on young adults especially important. A systematic approach to understanding and responding to the unique circumstances and needs of today's young adults can help to pave the way to a more productive and equitable tomorrow for young adults in particular and our society at large. Investing in The Health and Well-Being of Young Adults describes what is meant by the term young adulthood, who young adults are, what they are doing, and what they need. This study recommends actions that nonprofit programs and federal, state, and local agencies can take to help young adults make a successful transition from adolescence to adulthood. According to this report, young adults should be considered as a separate group from adolescents and older adults. Investing in The Health and Well-Being of Young Adults makes the case that increased efforts to improve high school and college graduate rates and education and workforce development systems that are more closely tied to high-demand economic sectors will help this age group achieve greater opportunity and success. The report also discusses the health status of young adults and makes recommendations to develop evidence-based practices for young adults for medical and behavioral health, including preventions. What happens during the young adult years has profound implications for the rest of the life course, and the stability and progress of society at large depends on how any cohort of young adults fares as a whole. Investing in The Health and Well-Being of Young Adults will provide a roadmap to improving outcomes for this age group as they transition from adolescence to adulthood.