Friday, September 16, 2011

Mental Health Care Reform Urged by Top Scientists

Psychotherapy experts say that as Americans work to reform the medical care system, they should also redesign how mental health care is delivered.

In a new paper, Yale University’s Dr. Alan Kazdin, a former president of the American Psychological Association, believes that we must acknowledge a basic truth — all of our progress and development in evidence-based psychotherapy has failed to solve the rather serious problem of mental illness in the United States

In a prior paper, Kazdin urged psychological scientists to rethink the current mental health system in order to make adequate treatment available and accessible to all who need it.

In the current paper, several distinguished scientists have highlighted important points that will need to be addressed before the mental health care system can be overhauled.

The first area of reform is the need to better understanding what types of interventions work — and for whom. Psychological scientists Varda Shoham, Ph.D., and Thomas R. Insel, M.D., contend that knowing which treatments work won’t matter unless we know how to target the interventions to the people who will benefit most. “In the absence of such knowledge,” they argue, “we risk treatment decisions guided by accessibility to resources rather than patient needs – the very problem Kazdin and Blase aim to solve.”

The paper also suggested the need to better integrate several levels of care. Psychologists Drs. Marc S. Atkins and Stacy L. Frazier argue that “only a comprehensive and integrated public health model can adequately address the pervasive societal problems that underlie our country’s mental health needs.” Adopting such a public health approach will require that we pay attention to all levels of mental health care, distributing resources equally from the prevention to intervention stage of the treatment process.

Finally, the researchers believe that they need to do a better job identifying optimal methods of delivery. According to Brian Yates, Ph.D., we have to find more effective ways to deliver treatment — “methods that use less therapist time, less client time, minimize client transportation costs as well as brick-and-mortar space, and use less of other increasingly scarce and costly resources.”

Although a new delivery model for mental health care sounds like a pipe dream, precedent does exist.

As the authors of one commentary point out, the U.S. Department of Veterans Affairs has already developed and implemented new and innovative programs to address the mental health of its veterans.

In sum, the commentaries provide frank insights into the challenges we face in trying to address the mental health burden in the United States.

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