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President's Commission Calls Mental Health Care System 'A Maze'

President's Commission Calls Mental Health Care System 'A Maze'

Charged with improving America's mental health care delivery system, President Bush's commission has found what many health care professionals and patients have known for some time: The system is in shambles and, according to the commission, "is incapable of efficiently delivering and financing effective treatments."

Created by Bush in April, The President's New Freedom Commission on Mental Health issued an interim report in October to a complete lack of attention by the news media. A final report, including recommendations, is due in April 2003.

In his transmittal letter to the president, Commission Chair Michael F. Hogan, M.D., suggested that a lack of a coherent approach to mental illness and substance abuse, coupled with a lack of coordination among existing programs, stymies health professionals in providing care to the estimated "5-7 percent of adults [who] in a given year, have a serious mental illness."

Hogan noted:

There are so many programs operating under such different rules that it is often impossible for families and consumers to find the care that they urgently need. The efforts of countless skilled and caring professionals are frustrated by the system's fragmentation. As a result, too many Americans suffer needless disability, and millions of dollars are spent unproductively in a dysfunctional service system that cannot deliver the treatments that work so well.

Elaborating on this theme, the report pointed out, "Many of the problems are due to the 'layering on' of multiple, well-intentioned programs without overall direction, coordination, or consistency."

Despite its sweeping indictment of the delivery system, the commission report came under fire from the mental health care establishment. In a press statement, Michael M. Faenza, president and CEO of the National Mental Health Association (NMHA), agreed with the commission's call for dramatic reform of the system but added, "We urge the commission to focus as well on the broad range of unmet mental health needs not addressed specifically in the report."

"The commission has unreasonably limited its examination of the United States mental health service-delivery system to advise President Bush on budget-neutral methods to improve the system," Paul S. Appelbaum, M.D., president of the American Psychiatric Association, said in a statement. "The nationwide lack of adequate care for people with mental illness goes beyond the problem of state funding and affects patients in the private sector. It requires a broad societal response."

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