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November 1, 2005

The Institute of Medicine
Prescription for Mental Health Care;
NAMI Calls for Action

Statement of
Michael J. Fitzpatrick, Executive Director
National Alliance on Mental Illness

We know what is wrong with America’s mental health care system.

In 1999, the landmark U.S. Surgeon General Report on Mental Health documented barriers to treatment. Two years ago, President Bush’s New Freedom Commission on Mental Health called for transformation of a fragmented “system in shambles.”

Today’s report by the Institute of Medicine (IOM) emphasizes that the challenge is more than a gap, but a chasm, between promise and performance.  See

The report is an excellent prescription of principles, some of which have been reflected in earlier reports but never acted upon, others of which provide a greater vision of   a 21st century system of care.

We know what must be done. The challenge now is to make sure that the report does not end up simply gathering dust on shelves in the White House, the Library of Congress, or state medical libraries.

Read the report. Act on it. It is a serious blueprint for serious transformation, building on the foundation of the Surgeon General’s Report and the New Freedom Commission’s recommendations. We urgently need:

  • A health care system that no longer separates general health care from mental health care, but instead rests on an understanding of the inherent link between the brain and the rest of the body. This must include an end to discrimination in health care coverage for treatment of mental illnesses.
  • Early screening and monitoring for persons at risk.
  • A consumer (patient) centered system that emphasizes self-management, treatment choices, comparative information, and most of all recovery.
  • Evidence-based treatment and quality measurements, linked especially to public funding choices.
  • Coordinated management models that provide a true continuum between primary care, mental health care, and other specialties.
  • Integrated mental health and substance abuse care.
  • Licensing of mental health care workers and insistence on clinical competence throughout the system.

Action is needed now. Without it, the chasm will only grow wider.

Mental illness affects one out of every five Americans. It does not discriminate. It affects men and women, the young and old, Republicans and Democrats alike.

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