The mental health system in the United States is in crisis. The President's New Freedom Commission on Mental Health, the Institute of Medicine, and the U.S. Surgeon General all have reported on a fragmented mental health delivery system, fraught with barriers that impede care for people with mental illness. The availability and quality of services vary radically between states. For example, the public health system in New York spends an average of $206 per person for mental health services, while Florida spends only $37 per person.
For the dedicated individuals rendering mental health services, compensation is startlingly insufficient. Starting salaries for a college undergraduate entering the field is often as low as $24,000 a year—barely enough to pay for rent, reliable transportation, and groceries, let alone meet a student loan's repayment obligations.
People can and do recover from mental illness to live successful, satisfying, and productive lives in their communities. Recovery rates for mental illnesses are comparable to, and even surpass, the treatment success rates for many physical health conditions. For example, up to 85% of people with depression who are treated with a combination of medication and psychotherapy experience substantially reduced symptoms, enhanced quality of life, and increased productivity. Even individuals with the most serious of psychiatric disabilities are able to recover. Multiple international and domestic studies have concluded that approximately one-half to two-thirds of people with schizophrenia are able to significantly improve their self-care, social relationships, and employment, or even recover completely with no signs or symptoms of the disease.
As Americans prepare to elect their new President and Congress, the leaders who will govern this great nation into the next decade, it is time to have our voices heard. Now is the time to adopt mental health policy reform so that tens of thousands of individuals can enjoy the full benefits of citizenship and reclaim a successful and satisfying life in the community.
Now is the time to pass and have signed into law a parity bill, so that equitable and adequate mental health coverage in all public and private healthcare plans is ensured. It must mandate that individuals receiving services have choices regarding their mental healthcare options and that services are collaborative, person-directed, individualized, and evidence-based.
Now is the time to ensure a well-qualified and fairly compensated workforce, one capable of assisting individuals with developing skills and access resources needed to achieve full community integration, and to create incentives to prevent the forecasted workforce shortages in the mental healthcare field.
And lastly, now is the time for Congress to ensure service delivery outcomes that are measurable in terms of “real life” results, such as increased job opportunities, reduced hospital stays, and obtaining affordable housing.
For more than 30 years, the U.S. Psychiatric Rehabilitation Association (USPRA) has focused on promoting recovery. It has set international standards and guiding principles for the delivery of psychiatric rehabilitation services. We bring together agencies, practitioners, families, persons living with psychiatric disabilities, leaders in psychiatric rehabilitation education and research from major U.S. universities, and state and federal government entities dedicated to improving outcomes in a cost-effective, evidence-based, and highly successful model. We stand resolute to ensure the workforce is knowledgeable in recovery-oriented services. We promote innovative psychiatric rehabilitation programs, which believe strengths-based, person-centered planning and services are central to the delivery of mental health services. USPRA and its members have long known that recovery is more than simply promoting medication, treatment, compliance, or stability. Recovery involves personal empowerment and regaining one's life.
The time is at hand for Congress to finally take action. Adopting a mental health policy focused on recovery needn't cost more; it simply requires support of the types of services known to bring about recovery. Let the candidates know that your vote rides, in part, on their articulation of and commitment to these basic and just principles.
Marcie Granahan, CAE, is CEO of the U.S. Psychiatric Rehabilitation Association (USPRA).
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Behavioral Healthcare 2008 September;28(9):29