From the Administrator: Mental Health Care: Transforming Our Vision and Our System

Transforming Mental Health Care in America—The Federal Action Agenda: First Steps, released in July, represents both a vision and a plan. It is both a vision of the attainability of recovery and a living document that charts the initial steps for altering the form and function of the mental health service delivery system (see Recovery Is Key for Mental Health Action Agenda article).

The Action Agenda is a milestone in the evolution of our views of mental illness and mental health. This shift began just 40 years ago, when President John F. Kennedy signed the Community Mental Health Centers Act, which aimed to move psychiatric patients out of state hospitals and into community clinics. President Jimmy Carter continued the momentum by establishing the President's Commission on Mental Health in 1977 and signing the Mental Health Systems Act in 1980.

In 1999, the publication of Mental Health: A Report of the Surgeon General documented the scientific evidence that mental illnesses are health conditions that are diagnosable and treatable.

However, many obstacles to care still remain.

President George W. Bush established the New Freedom Commission on Mental Health in 2002 to conduct a comprehensive study of the problems in the mental health system and to make concrete recommendations. The message of the Commission's report in July 2003 was unequivocal: Reform of the mental health care delivery system in the United States is not enough—a fundamental transformation is needed.

The Department of Health and Human Services was charged with reviewing the Commission's report and identifying action steps to accomplish this goal, and asked SAMHSA to lead the effort.

The resulting Action Agenda is particularly noteworthy in the breadth of collaboration it requires among a broad array of Federal partners. Simultaneously, the effort calls for shared responsibility by government at the state and local levels, the private sector, and consumers of services and their family members.

More than 25 years ago, when President Carter's commission released its report, recovery from mental illness was not the expectation. Today, we know more about mental illness, mental health, and recovery than ever before. Now, it is up to us to transform our system of care to make recovery a reality for everyone. 

Charles G. Curie, M.A., A.C.S.W.
Administrator, SAMHSA

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