Healthy People 2010—Conference Edition

Chapter 18 Mental Health and Mental Disorders

State Activities

18-12. Increase the number of States and the District of Columbia that track consumers’ satisfaction with the mental health services they receive.

Target: 30 States.

Baseline: 10 States in 1998.

Target setting method: 200 percent improvement.

Data source: Mental Health Statistics Improvement Program, SAMHSA.

The health care industry increasingly is using consumer opinion to gain information on service needs and changes. Patient satisfaction studies are becoming standard practice for many health care organizations. Health care executives have indicated that consumers have a major impact on the development of health care products.⁸⁶ Nearly 90 percent of health care executives reported that they have expanded both the number and type of services based on consumer preference. The Mental Health Statistics Improvement Program has pioneered the development of a consumer-oriented mental health report card that includes a consumer survey designed to address questions of access, appropriateness, quality, and outcome of care.

Rehabilitation is an essential part of care for adults with severe mental illness. To promote independent living, rehabilitation programs often evaluate and place these persons in jobs. Rehabilitation programs also provide continuing support and help ensure that the placement is working well. Research shows that working provides both economic and personal benefits for persons with SMI that extend beyond a paycheck and workplace companionship.⁵⁴ Employment also improves self-esteem and independence; it helps a person to manage his or her own illness and return to community life. ^{55, 56} A majority of persons with SMI want to be employed and rank employment as a primary personal goal.⁵⁷ Helping persons with mental illness secure employment can reduce the use of mental health services and reduce the number of persons who receive Federal and State disability payments.⁵⁷

18-13. (Developmental) Increase the number of States, Territories, and the District of Columbia with an operational mental health plan that addresses cultural competence.

Potential data source: National Technical Assistance Center for State Mental Health Systems (NRI/NASMHPD), SAMHSA, CMHS.

To work effectively, health care providers need to understand the differences in how various populations in the United States perceive mental health and mental illness and treatment services. These factors affect whether people seek mental health care, how they describe their symptoms, the duration of care, and the outcomes of the care received. Research has shown that various select populations use mental health services differently. They may not seek mental health services in the formal system, drop out of care, or seek care at much later stages of illness, driving the service cost higher.^{87, 88, 89} This pattern of use appears to be the result of a community-based mental health service system that is not culturally relevant, responsive, or accessible to select populations.^{89,
90, 91, 92} Hospitals have become the primary mental health treatment site for a disproportionate number of African Americans.^{93,
94, 95, 96}

18-14. Increase the number of States, Territories, and the District of Columbia with an operational mental health plan that addresses mental health crisis interventions, ongoing screening, and treatment services for elderly persons.

Target: 50 States and the District of Columbia.

Baseline: 24 States.

Target setting method: Total coverage.

Data source: National Technical Assistance Center for State Mental Health Systems (NRI/NASMHPD), SAMHSA, CMHS.

The Nation is growing older; the number and proportion of the population aged 65 years and older will grow rapidly after 2010. As the Nation ages, the mental health needs of elderly persons must be addressed because their needs will continue to grow. Mood disorders affect between 2 and 4 percent of community-living elderly persons.³⁸ Older Americans with clinically significant depressive symptoms range from 10 to 15 percent of the population.⁹⁷ State mental health authorities and localities should become increasingly engaged in meeting the mental health needs of this growing population.

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