Five Big Steps to Rebuild the System
1. Create single points of access: 24-hour hotlines for patient evaluation, treatment, family information as well as a federal website for referral to resources
2. Coordinate services for patients and their families: provide broad offerings for people with mental illness and facilitators for quick access to integrated care
3. Develop an array of community-based services: individual and group psychotherapy; marital and family therapy; substance abuse treatment; medication; rehab and supported housing options
4. Provide accessible crisis and inpatient services: rather than current resort to Emergency Room and in many cases jail/prison, we need timely crisis services, outpatient treatment linked to inpatient care and quicker access to beds
5. Build a stable funding stream: long-term state budget commitments; aggressive oversight of insurers’ coverage decisions; federal dollars to fill the gaps
Paul S. Appelbaum, MD
Dr Appelbaum is Dollard Professor of Psychiatry, Medicine, and Law; Director, Division of Law, Ethics, and Psychiatry; Director, Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics in the department of psychiatry at the Columbia University College of Physicians & Surgeons.