From Exclusion to Belonging:

Transforming Mental Health Care in America

The Vision: A Life in the Community for Everyone

The Substance Abuse and Mental Health Services Administration

The Centers and Offices
Transforming Mental Health Care in America
The New Federal Leadership
The Challenge
Highlights of the Federal Action Agenda
Components of Recovery
National Consensus Statement on Mental Health Recovery
Programs of Transformation
Making It Count






The New Federal Leadership

Building Resilience, Facilitating Recovery, and Transforming Mental Health Care

The President’s New Freedom Commission on Mental Health

The President's New Freedom Commission on Mental Health was established by Executive Order 13263 on April 29, 2002. The transformation of the mental health care system began with a vision of hope and equality that emerged from a campaign promise by then candidate George W. Bush. He pledged to "tear down" barriers to equality that face many of the 54 million Americans with mental and physical disabilities.

The Commission's work has been an essential part of the President's commitment—embodied in the New Freedom Initiative—to eliminate inequality for Americans with disabilities. The Commission’s final report, Achieving the Promise: Transforming Mental Health Care in America, the product of a year of study, finds that the Nation’s mental health care system is beyond simple repair. Building on research, expert testimony, and input from more than 2,300 consumers, family members, service providers, and others, the report concludes that "traditional reform measures are not enough...." Instead, it recommends a wholesale transformation that involves consumers and providers, policymakers at all levels of government, and both the public and private sectors.

Vision Statement

We envision a future when everyone with a mental illness will recover, a future when mental illnesses can be prevented or cured, a future when mental illnesses are detected early, and a future when everyone with a mental illness at any stage of life has access to effective treatment and supports—essentials for living, working, learning, and participating fully in the community.
—The President’s New Freedom Commission on Mental Health
Achieving the Promise: Transforming Mental Health Care in America

To achieve this vision, the Commission presented the President with six goals and a series of specific recommendations for Federal agencies, States, communities, and providers nationwide. Together, working through both the public and private sectors, the recommendations will transform systems and put limited resources to their best use.

The Commission’s six key recommendations are:  

  • Americans must understand that mental health is essential to overall health; that mental illnesses must be addressed with the same urgency as other medical problems; and that the stigma attached to mental illness, which discourages people from seeking care, must be eliminated.

  • Mental health care must be consumer- and family-driven; consumers’ needs, not bureaucratic requirements, must drive the services they receive; consumers and their families must be placed at the center of service decisions.

  • Disparities in mental health services must be eliminated; in particular, members of minority groups and people of rural areas have worse access to care; services must be designed that are culturally competent and acceptable and effective to people of varied backgrounds.

  • Early mental health screening, assessment, and referral to services must be common practice; too often services focus on living with disability, not the better outcomes associated with early intervention; early detection, assessment, and linkage with treatments can prevent mental health problems from compounding.

  • Excellent mental health care must be delivered and research accelerated; evidenced-based practices must be the bedrock of service delivery and research must be designed to promote recovery, and ultimately, to cure and prevent mental illnesses.

  • Technology must be used to access mental health care and information; the power of computer technology and communications must be harnessed to improve access to information and care, and to improve quality and accountability.

The Commission's findings, goals, and recommendations are designed to be assessed and carried forward not only by Federal agencies and offices, but also by States and communities, and public and private providers, nationwide. The Commission urged all shareholders in mental health to work together to make recovery from mental illness the expected outcome.