Improving Mental Health Services
As we work to address the serious gaps in the mental health system, it is important that we continue to provide the best possible services as more and more people gain access to treatment and supports. Regardless of the point at which an individual begins receiving services, we should work towards promoting systems that create the best possible outcomes for each person.
Recovery is possible for all people. With the right combination of supports and services, people living with mental health conditions can and do live full, satisfying lives and contribute to their communities. In order to create the best environments for recovery, we must create a system that places the individual at the center and builds the supports they want and need around them. This means valuing an individual's autonomy and understanding that recovery may not look the same for everyone. In addressing issues in mental health services, it is crucial to emphasize informed decision-making and comprehensive supports and services.
Individuals living with mental health conditions have the right to make informed decisions about their treatment and supports. Because recovery is self-defined, the ability to make decisions regarding one’s life and treatment is essential in creating recovery-oriented systems with the best long-term outcomes for people. Self-determination initiatives that promote autonomy and choice, like self-directed care, can include freedom to make decisions about one’s care, authority over a target amount of dollars, and support to organize resources in ways that are life enhancing and meaningful to the individual. In order to make the best decisions possible—and to adjust as necessary—people need access to all relevant information when making decisions about their mental health. Whether it is access to medication or Electroconvulsive Therapy, individuals should know all benefits and costs when creating their personalized recovery plan.
MHA calls for the following changes:
- Public behavioral health systems and policy-makers should invest in evidence-based and emerging practices that are community-based and consumer/family-driven and promote recovery-oriented outcomes and ensure that people in recovery have meaningful involvement in the planning, delivery, and evaluation of mental health service systems.
- Public and private plans and provider groups should incorporate self-determination into their existing benefit offerings, which could include using case management to assist with personal budgeting or investing in self-determination programs, such as Self-Directed Care.
- Fail-first requirements (currently referred to as "step therapy") and "therapeutic substitution" should be reconsidered and modified or eliminated to provide optimal mental health and substance use care. These policies, which prevent physicians and consumers from using expensive medication unless and until a trial of cheaper medication fails to mitigate the condition or causes unacceptable side effects, often result in serious symptoms jeopardizing job performance and continued employment, housing arrangements, and family relationships, even resulting in hospitalization. These policies are particularly dangerous for mental health consumers in crisis.
Comprehensive Supports and Services:
To best support people in recovery, a variety of supports and services beyond traditional treatment should be available. In addition to access to things like talk therapies and medications, supports and services that engage people where they are and support them toward where they would like to be are critical. Peer Support Services, offered by individuals who have lived experience of recovery, provide the tools, strategies, and empathy that keep people feeling supported and engaged. Housing, education, and employment services are essential in helping people to thrive in their communities. Addressing a person’s specific needs, from integrating substance use disorder treatment for individuals with co-occurring disorders to promoting services targeted to aging Americans, is also key to ensuring a person has the services that empower them in their recovery. Beyond an hour a week of treatment or crisis services that take a person out of their community, systems that support people in the ways they need it save both lives and money.
MHA calls for the following changes:
- Financing methods for service improvements, including reimbursements for coordination activities, community case management, transportation, and other supports should be in place to ensure access to comprehensive services. Total healthcare costs are actually reduced, both in the near and long-term when appropriate physical and behavioral services, including rehabilitation-recovery services, are provided in a coordinated healthcare system.
- The peer workforce should be an integral part of mental health and substance abuse service delivery. Parent, partner, adolescent, and veteran peer services should be developed to complement adult peer services.
- Mental health and substance dependence/abuse recovery and general health services for persons experiencing co-occurring interactive disorder regardless of service delivery setting.
To read our full position statement and more about MHA’s specific policy goals, check out Services Issues.
To see a full list of our position statements, go to Position Statements.