National Alliance on Mental Illness
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NAMI's Recommendations for States and the Federal Government

2. Improve Data Collection, Outcomes Measurement, and Accountability

Where We're Failing

In a time of economic crisis, it is critical that public funds are spent wisely. And yet, data collection in mental health-the basis for smart spending-lags far behind comparable efforts in other health care disciplines. Across the country, there is an extremely limited capacity to provide even the most rudimentary information on mental health services.

  • Data are limited on the level of available services, how well services meet needs, and whether they achieve positive outcomes.
  • Data are not standardized within or across states, making comparisons and the identification of useful avenues for improvement extremely difficult.
  • Federal officials, state mental health agencies, and community providers continue to haggle over leadership, definitions, and strategies, resulting in repeated false starts and little forward progress.

Taking Action

Standardize Data Collection within States

  • In Arkansas, all community mental health centers use a standard collection instrument to report uniform data to the state mental health agency.

Report on Evidence-Based Practices

  • California's Department of Mental Health has combined resources from a federal Data Infrastructure Grant and the state's Mental Health Services Act to modify its data systems to better track individuals receiving integrated treatment. All county systems now collect and report this data.

Reestablish Priority for Mental Health Data Collection at the Federal Level

  • Resource allocation within SAMHSA should support state- and small-area level estimates. In particular, the agency should support states in collecting data through the Behavioral Risk Factor Surveillance System (BRFSS).
  • The Bureau of Justice Statistics should reinstate mental health questions in its periodic census of state and federal adult correctional facilities, and must support state-level estimates.
  • Systematic, state-by-state analysis of Medicaid claims data for people with serious mental illnesses should be conducted. This analysis should encompass general health care as well as all aspects of mental health care.

Track Wait-times in Emergency Rooms

  • Very few states currently track the time it takes for an individual with a serious mental illness to access a psychiatric bed or alternative service after entering an emergency room. This information is essential if serious efforts are to be undertaken to address national problems that exist in access to crisis and acute psychiatric care.

Establish Firm Leadership

  • As the federal agency responsible for overseeing public mental health services, SAMHSA must exert stronger leadership in developing meaningful outcomes measures and in enforcing good data reporting by state mental health systems, all of which receive federal funds.

Continue to recommendation 3: Integrate mental and physical health care  >>

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