America's poor grade in mental health care.
Subject: Psychiatric services (Evaluation)
Psychiatric services (Demographic aspects)
Author: Rosenberg-Javors, Irene
Pub Date: 06/22/2009
Publication: Name: Annals of the American Psychotherapy Association Publisher: American Psychotherapy Association Audience: Academic; Professional Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2009 American Psychotherapy Association ISSN: 1535-4075
Issue: Date: Summer, 2009 Source Volume: 12 Source Issue: 2
Product: Product Code: 8000186 Mental Health Care; 9105250 Mental Health Programs NAICS Code: 62142 Outpatient Mental Health and Substance Abuse Centers; 92312 Administration of Public Health Programs
Geographic: Geographic Scope: United States Geographic Name: America Geographic Code: 1USA United States
Accession Number: 218314000

The National Alliance on Mental Illness (NAMI) recently released its findings on the state of mental health services across the country. (For the full report, see The nation received a D rating in providing adequate public mental health services to consumers. The NAMI study states emphatically that, "the report card is dismal." The report points out, "Without a significant commitment from our nation's leaders--in Washington, among governors, and in state legislatures--state mental health agencies will continue to struggle to provide even minimally adequate services to people living with serious mental illnesses."

NAMI gathered its data from state mental health agencies and also conducted a nationwide internet survey, which received some 13,000 responses from consumers and families. Additional material was taken from academic research findings, health care associations, and federal agencies. Grading was based on 65 specific criteria; each state received grades in four areas, which were then added up to provide the final grade.

From this data, NAMI (2009) points out that one of the primary problems with public mental health services stems from the fact that, "an information gap exists in measuring the performance of the mental health care system ... and that ... to some degree, states are groping blindly in the dark while seeking to move forward." The report faults the U.S. Department of Health and Human Services (HHS) and Substance Abuse and Mental Health Services Administration (SAMHSA) as the federal level that has "failed to provide adequate leadership in developing uniform standards for collecting state, county, and local data."

NAMI reports that many "state mental health agencies [are] making valiant efforts to improve systems and promote recovery despite rising demand for services, serious workforce shortages, and inadequate resources." In addition, NAMI praises those states that are "adopting better policies and plans, promoting evidence-based practices, and encouraging more peer-run and peer-delivered services." Unfortunately, even those states that are at B level are doing no better than those with lower scores at knowing "what share of people in need their systems serve, or how well people fare once they are served."

The study concludes with a plea for "leadership, political will, and investment from governors, legislatures, and other champions to preserve and build on the modest progress being made to improve public mental health care." The NAMI report goes on to say, "[W] e need to rise above existing inadequacy ... we need to save lives and help people to recover."

In difficult economic times, those most vulnerable often fall between the cracks; those with severe mental illness need our help. The mental health care delivery system is broken, and as mental health counselors we need to become advocates for change. As the NAMI report states, "Transformation of the mental health care system will take time ... it will occur incrementally ... we can measure its progress, but progress will only occur if we make it happen."


NAMI. (2009). Retrieved April 12. 2009, from ContentManagement/ContentDisplay.cfm&ContentiD=75106

Irene Rosenberg-Javors, MEd, Diplomate of the American Psychotherapy Association, Licensed Mental Health Counselor, is a psychotherapist in NYC. She is also Adjunct Associate Professor of Mental Health Counseling, Mental Health Counseling Program, Ferkauf Graduate School of Psychology, Yeshiva University. She can be reached at
Gale Copyright: Copyright 2009 Gale, Cengage Learning. All rights reserved.