Jan 11, 2021
The United States is at a time of promise for historic transformation in mental health care. This report describes the landscape of mental health in the United States and identifies opportunities for transformative change. The result is an analysis of key problems and the research evidence for solutions, with recommendations to promote change to improve the lives of the millions of Americans living with mental illness.
The United States is at a time of promise for historic transformation in mental health care. For decades, systemic problems have persisted — including high levels of unmet need, underdevelopment of community-based supports, and inequities in access and quality of care. In 2019, only 45 percent of people with a mental illness received any mental health treatment. This translates to unmet need for more than 30 million Americans. Additionally, despite similar levels of mental health care need, racial/ethnic minorities in the United States are about half as likely to use mental health care as non-Hispanic Whites. There are also striking geographic variations in availability of mental health specialty care, with rural areas particularly underserved.
Yet recent years have seen positive signs of change. Congress has passed key legislation — such as the 2008 Mental Health Parity and Addictions Equity Act — with overwhelmingly bipartisan support, states have endorsed an expanded role of Medicaid in providing coverage for individuals with serious mental illness who are often lower income and struggling with employment, and researchers have identified new evidence-based treatment models that health systems can implement.
This report provides recommendations to promote transformational change to improve the lives of the millions of Americans living with mental illness. To identify these recommendations, the authors conducted a broad review of policy ideas related to goals for the mental health system. They conducted an extensive analysis of mental health systems processes, policies, and solutions supported by evidence and received input from experts around the country.