The
Final Report of the President’s New
Freedom Commission on Mental Health
In July of this year, the President’s
New Freedom Commission on Mental Health issued its final report,
Achieving
the promise: Transforming mental health care in America. The
Commission was asked to study problems in the current mental health
delivery system, and to make recommendations for improvements that
could be implemented immediately.
The final report identified six goals that the Commission’s
members believed should serve as the basis for reforming the mental
health system in America. The Commission also recommended specific
strategies for achieving each goal. While the report focuses primarily
on adult systems, several of the recommendations specifically mention
children and youth and the role of families. Other recommendations
apply equally to both adult and child populations. (Publication
of the report of the Subcommittee on Children & Families is
expected soon, and will be the topic of a future Featured Discussion.)
The goals and associated recommendations are as follows:
Goal 1 - Americans Understand that Mental Health Is Essential
to Overall Health
1.1 Advance and implement a national campaign to reduce the
stigma of seeking care and a national strategy for suicide prevention.
1.2 Address mental health with the same urgency as physical
health.
Goal 2 - Mental Health Care Is Consumer and Family Driven
2.1 Develop an individualized plan of care for every adult with
a serious mental illness and child with a serious emotional disturbance.
2.2 Involve consumers and families fully in orienting the mental
health system toward recovery.
2.3 Align relevant Federal programs to improve access and accountability
for mental health services.
2.4 Create a Comprehensive State Mental Health Plan.
2.5 Protect and enhance the rights of people with mental illnesses.
Goal 3 - Disparities in Mental Health Services Are Eliminated
3.1 Improve access to quality care that is culturally competent.
3.2 Improve access to quality care in rural and geographically
remote areas.
Goal 4 - Early Mental Health Screening, Assessment, and
Referral to Services Are Common Practice
4.1 Promote the mental health of young children.
4.2 Improve and expand school mental health programs.
4.3 Screen for co-occurring mental and substance use disorders
and link with integrated treatment strategies.
4.4 Screen for mental disorders in primary health care, across
the lifespan, and connect to treatment and supports.
Goal 5 - Excellent Mental Health Care Is Delivered and
Research Is Accelerated
5.1 Accelerate research to promote recovery and resilience,
and ultimately to cure and prevent mental illnesses.
5.2 Advance evidence-based practices using dissemination and
demonstration projects and create a public-private partnership
to guide their implementation.
5.3 Improve and expand the workforce providing evidence-based
mental health services and supports.
5.4 Develop the knowledge base in four understudied areas: mental
health disparities, long-term effects of medications, trauma,
and acute care.
Goal 6 - Technology Is Used to Access Mental Health Care
and Information
6.1 Use health technology and telehealth to improve access and
coordination of mental health care, especially for Americans in
remote areas or in underserved populations.
6.2 Develop and implement integrated electronic health record
and personal health information systems.
It is clear that the work of the President’s New Freedom
Commission on Mental Health will have an important effect on the
lives of the people who work in or are served by the mental health
system. The goals and recommendations as set out in the final report
have already begun to have an impact on public dialogue. Federal
agencies are being asked to align their policies with the goals
and recommendations, and this work has direct implications for program
evaluation and funding. It also seems likely that the goals and
recommendations will serve as a common frame for interagency work
and for future legislation.
We invite you to post your opinions, observations, or reactions
to the goals and recommendations and/or to the
final report of the President’s New Freedom Commission.
For example:
- Do you agree with the goals and recommendations?
- Are there important concerns that were overlooked in the report?
- Do you think the report will impact your life or your work,
and if so, how?
- What are important first steps that must be taken to move from
recommendations to action?
We look forward to hearing from you.
Janet S. Walker,
Web editor
Your
thoughts…
Comments:
 Diagnosing 'mental disorders' is NOT an exact science. That's what makes it dangerous sometimes. I worked with 'autistic' kids in a hospital setting, and the 'Psychiatrist' had intense psychotropic ordered for 'acting out behaviors.' WBR LeoP Posted Thursday, March 29, 2007 at 05:30 PM
Current mental health practices are commonly driven by politics and economic interests rather than by science and common sense. Until we can set up a system that actually works for children and adults, we are sending good money after bad by screening whole populations to discover that they "have a mental illness" without having committed to any effective means of dealing with this conclusion. For example, medication has become the treatment of choice for many problems, not because it changes any long term outcomes, but because it is cheap in the short term and profitable in the long. Medication does nothing to address the concepts of recovery and resiliance. In fact, it tends to undermine these ideas by promoting the scientifically unsupported concept that recovery from mental illness is not possible and that lifelong medication is an absolute necessity for certain conditions, and promotes a "disability" viewpoint rather than a strengths-based approach. Until and unless we can have the courage to face this and other political conflicts that plague the mental health industry and drive us away from evidence-based practice, I can't support screening huge numbers of people to feed the needs of the current profit-driven system of mental health care. Posted Tuesday, May 24, 2005 at 12:01 PM
I have read portions of the report and, while I am sympathetic to the goals and the overall spirit it communicates, there is a strange mix of supported claims (ie with at least some citation to back it up) vs unsupported claims (ie those that seem like they should have some evidence or resources) vs simply stating what ought to be. I am not sure what to make of this except that it seems like the document couldn't decide between expressing some sort of expert consensus and being more of a review of research like the Surgeon General's report. Posted Monday, December 1, 2003 at 01:52 PM
I would have liked to see more about children's mental health in the document. The goals/recommendations don't show it that much, but the text of the report really focuses on adults and uses the terminology associated with the adult system. For example, there are many references to "recovery" as the main goal of mh systems, but that really is vocabulary from the adult "side." I think the concepts are similar, but the report could have explicitly included children and families and family support more. Posted Friday, November 21, 2003 at 01:09 PM
I am glad to see that one of the goals focuses on the need for mh care to be consumer and family driven and on the need for individualized planning. Now we just need to learn more about how to reallly do these... Posted Thursday, November 20, 2003 at 09:05 AM
"not optimistic about impact" has a good point. I just read an article in our local paper about how the mental health "system" in our state has been cut so much that the only place left to "serve" the mentally ill is prison (and we konw how effective that is). The New Freedom Commision may have a good vision, but we are moving in the opposite direction. Posted Wednesday, November 19, 2003 by not optimistic either at 10:09 AM
Well.... I have read about half the report and I agree that the recommendations are progressive and express a vision I can agree with. On the other hand, I can't help but feel that this document must apply to some parallel universe where there is political and financial commitment to funding reforms. The report is very optimistic about the idea that improved technology and research will be part of realizing better outcomes, but I don't see how the vision to "ensure that every American has easy and continuous access to the most current treatments and best support services... (from the exec summary)" can be brought closer much less realized given the ongoing cuts to human services that currently exist and that are likely to be ongoing for the forseeable future given the huge budget deficits and reallocation of available resources towards business subsidies and warmaking. Posted Wednesday, November 19, 2003 by not optimistic about impact at 09:08 AM
Several members of the RTC staff were recently in Washington, DC for the summative review/evaluation of the Center by NIDRR (one of our funders). It was clear that the New Freedom Commission's report had already had an impact within NIDRR and that it was being used in discussions within other federal agencies as well. I agree with the previous post that part of the potential power of the report rests in its clarity and accessibility. The framework of goals and recommendations is very clear, and the supporting material/evidence provided in the report provides strong substantiating argumentation. Posted Tuesday, November 18, 2003 by RTC staff member at 04:46 PM
I have read the final report and have two reactions. First, the document is accessible and interesting to read. Second, the goals and recommendations are "in synch" with a systems of care perspective. I think that the report is a good outcome and a useful product that will be helpful for people who advocate for systems of care, family support, flexible services, and so on. I was pleasantly surprised to discover this! Posted Tuesday, November 18, 2003 at 04:42 PM
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