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President's New Freedom
Commission on Mental Health

Achieving the Promise: Transforming Mental Health Care in America


This Final Report conveys the Commission's bold vision for transforming the existing, often intimidating maze of mental health services into a coordinated, consumer-centered, recovery-oriented mental health system. Although barriers stand in the way, with national resolve and leadership, they will be overcome.

The Commission recognizes that historically Americans have assumed responsibility locally and regionally for working together to meet challenges and to support their neighbors and communities. A major step toward achieving the vision will require genuine collaborative efforts from all parties who deliver or use mental health services and supports. All must recognize the interwoven nature of the diverse programs that make up the mental health system and, in turn, must see where program flexibility and cooperation can be strengthened in the interest of consumers and families.

To transform the mental health care system, the Commission proposes a combination of goals and recommendations that together represent a strong plan for action. No single goal or recommendation alone can achieve the needed changes. No level or branch of government, no element of the private sector can accomplish needed change on its own. To transform mental health care as proposed, collaboration between the private and public sectors and among levels of government is crucial.

Mental illness is the only category of illness for which State and local governments operate distinct treatment systems, making comprehensive care unavailable in the larger health care system. Ultimately, this situation must change, but to do so requires health care reform beyond the Commission's scope.

As has long been the case in America, local innovations under the mantle of national leadership can lead the way for successful transformation throughout the country.

Health care in America is at a pivotal point where reform must occur and mental health must share in that reform. The Nation has a vested interest and a tremendous stake in doing what is right to correct a system with problems that resulted from layering multiple, well-intentioned programs.

The integrated strategy outlined in this Final Report can achieve the transformation that will allow adults with serious mental illness and children with serious emotional disturbances to live, work, learn, and participate fully in their communities. Indeed, as has long been the case in America, local innovations under the mantle of national leadership can lead the way for successful transformation throughout the country.

As a Commission, we are grateful to the many strong and courageous individuals who gave their time, and in some cases traveled great distances to share their stories. It is for these individuals - as well as for the ones who continue to go unserved - that we must take swift, courageous action to transform the current maze of services, treatments, and supports into an efficient and cohesive mental health care delivery system. We owe them, their families, and future generations nothing less.


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