Opportunities and Challenges

Many barriers to mental health services exist for Americans, including cost, fragmentation of services, lack of availability of services, and societal stigma toward mental illness.²³ Additional challenges—mistrust and fear of treatment, racism and discrimination in the health care environment, and differences in language and communication styles—deter some populations.²³ The ability of consumers and providers to communicate with one another is essential for all aspects of health care.²³ This ability carries special significance in the area of mental health because mental disorders affect thoughts, moods, and the highest integrative aspects of behavior. The diagnosis and treatment of mental disorders depend on verbal communication and trust between patient and clinician.²³ The cumulative weight and interplay of all barriers to care, rather than any single barrier, is likely to be responsible for continued mental health disparities.

The research literature on promising practices related to clinical and community settings continues to grow. Promising practices, defined as smaller controlled studies that demonstrate efficacy, have been developed that directly relate to several objectives. Evidence-based practices that could be more widely implemented include, but are not limited to, assertive community treatment, new medication and medication management, psychiatric rehabilitation, and integrated treatment for individuals with co-occurring mental illness and substance abuse. Policy experts recognize that the expansion of these services must take place within the broader efforts to transform the mental health care system through improving access and addressing the fragmentary nature of mental health care.⁶

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