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Making the case for mental healthcare

March 1, 2008
by Ronald W. Manderscheid, PhD
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Those from outside the field can be valuable partners in advancing our field

In the fall, the Park City Center for Public Policy held its inaugural forum in Park City, Utah. This initial forum focused on mental health. The Center represents former state governors and business leaders. The forum created a strategic opportunity to make the case for mental healthcare to an influential external audience.

Center representatives included the former governor of Wyoming, Jim Geringer, and the former governor of South Carolina, Jim Hodges, together with several current and former business leaders from the banking and investment industries. The forum was organized by Charles Curie, former administrator of SAMHSA, and Gail Hutchings, former SAMHSA chief of staff.

The forum's program consisted of three panels: the research case, the practice case, and responses from a public and a consumer leader. The goal was to identify a course of action for the Center to take to improve mental healthcare. After a period of discussion, a consensus was reached that a focus on integration of mental health and primary care could be a useful avenue for the Center to explore. As of this writing, the Center is examining how former governors and business people can contribute to this endeavor.

From this forum we can derive several important lessons. First and perhaps foremost is the importance of seeking the help and support of others not part of our immediate mental healthcare community. Through this outreach we can elicit new points of view and insights that may not be obvious to us. For example, one business person from the Center wondered why we have such difficulty adopting new innovations in mental healthcare, such as information technology, when such innovations are purposely sought in the business community to improve quality. New points of view such as this can bring us new insights in how to address our field's problems.

This raises the important question of why we don't reach out to influential groups more frequently. Such groups include political candidates at all levels, as well as representatives of the business and religious communities, to name but a few. One could argue that we frequently are so enmeshed in our day-to-day activities that we believe we don't have time to engage others. At another level, one could argue that we have become too isolated from the surrounding community. Clearly, some self-examination is needed.

A second lesson from the forum is that we need to do a better job bridging research and practice. Colleagues at the forum were astonished that it takes us 17 years to implement effective clinical practices. If we are to overcome this well-known delay, then a closer alliance between research and practice is essential.

Fortunately, some promising approaches are developing. Leading-edge provider organizations are putting together teams that include both researchers and providers so that research findings are immediately available for implementation. The strong argument for doing this is that better practices will lead to better outcomes more quickly, thus reducing case costs and improving consumer satisfaction. A related question for each of us is to what degree are we open to innovation, to doing things in a new way. Will we create partnerships, or will we ignore or oppose them?

A third lesson from the forum is that a broad base of external groups are interested in mental healthcare. In fact, threescore forum participants were from outside the field. Many of these people were senior leaders with demanding roles. They chose to attend the forum and discuss the mental healthcare field's future when they could have been doing other things. We need to learn from this.

A major agenda for us should be how to identify and build on this external interest as we continue to evolve our field. I suspect that most of the people who show interest know little about the mental healthcare field, how it operates, or its problems. This is an opportunity to educate and build additional support. It also is an opportunity to combat stigma and promote the vision of a recovery-oriented system directed by consumers and families.

As we look to the future, I hope that we will take every opportunity to make the case for mental healthcare when external groups express interest in our field. We owe this to consumers and their families, ourselves, and the future of our field.

Ronald W. Manderscheid, PhD, currently Director of Mental Health and Substance Use Programs at the consulting firm Constella Group, LLC, worked for more than 30 years in the federal government on behavioral health research and policy. He is a member of Behavioral Healthcare's Editorial Board.

For more information about the Park City Center for Public Policy, visit http://www.parkcitycenter.org. To contact Dr. Manderscheid, e-mail him at rmanderscheid@constellagroup.com.

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