Both the APA and NMHA called on the U.S. Congress to pass parity legislation immediately. "The interim report fails to address a fundamental problem with the mental health system today--equal access to insurance coverage for mental health treatment," Appelbaum said.
"We urge the commission to end our patchwork national policy on the coverage of treatment for mental illness," Appelbaum added. "The APA hopes any final commission report will provide real solutions to fix the current fragmented mental health delivery system, address the critical need to pass mental health parity legislation, provide adequate funding in the public health system, and increase the supply of psychiatrists in underserved areas."
Despite the criticisms, the interim report amounts to a scathing denunciation of the existing health care system, while singling out individual programs that show positive results.
"The Commission has found creative, community-based programs that begin to circumvent the barriers," the report stated. "These programs carry a track record of success in achieving desired outcomes. Our review indicates that the best results are often achieved despite--not because of--financing systems and bureaucracies that often create fragmentation instead of focus and reward dependency instead of recovery."
Underscoring the extent of the mental health care crisis in the United States, the commission found that approximately 5% to 9% of children--a similar percentage to the affected adult population--have a serious emotional disturbance, as defined by federal regulations.
"The annual prevalence figures translate into millions of adults and children disabled by mental illness," the commission stated, quoting a 2001 World Health Organization study. "The disability toll can be quantified in a way that cannot be ignored: when compared to all other diseases [such as cancer and heart disease], mental illness ranks first in terms of causing disability in the United States, Canada, and Western Europe."
Yet, the commission found, "About one out of every two people who needs mental health treatment does not receive it ... For ethnic and racial minorities, the rate of treatment is even lower than that for the general population, and the quality of care is poorer."
The commission identified what it called five barriers that needlessly impede access to care within the mental health system. Those barriers are:
- Fragmentation and gaps in care for children
- Fragmentation and gaps in care for adults with serious mental illness
- High unemployment and disability for people with serious mental illness
- Older adults with mental illness are not receiving care
- Mental health and suicide prevention are not yet national priorities