Mental Health Services This page intentionally left blank Mental Health Services A Public Health Perspective Third Edition Edited by BRUCE LUBOTSKY LEVIN, DrPH, MPH Associate Professor & Head Graduate Studies in Behavioral Health Program Editor-in-Chief Journal of Behavioral Health Services & Research Louis de la Parte Florida Mental Health Institute & College of Public Health University of South Florida K E V I N D H E N N E S S Y, P h D Senior Advisor Office of Applied Studies Substance Abuse and Mental Health Services Administration JOHN PETRILA, JD, LLM Professor Department of Mental Health Law & Policy Louis de la Parte Florida Mental Health Institute University of South Florida 2010 Oxford University Press, Inc., publishes works that further Oxford University’s objective of excellence in research, scholarship, and education Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Copyright © 1996, 2004, 2010 by Oxford University Press, Inc Published by Oxford University Press, Inc 198 Madison Avenue, New York, New York 10016 www.oup.com Oxford is a registered trademark of Oxford University Press All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press Library of Congress Cataloging-in-Publication Data Mental health services: a public health perspective / edited by Bruce Lubotsky Levin, Kevin D Hennessy, John Petrila —3rd ed p ; cm Includes bibliographical references and index ISBN 978-0-19-538857-2 (alk paper) Mental health services—United States Mental health policy—United States I Levin, Bruce Lubotsky II Hennessy, Kevin D III Petrila, John [DNLM: Mental Health Services—organization & administration—United States Health Policy—United States Mental Disorders—United States Mental Health Services—economics—United States WM 30 M5531625 2010] RA790.6.M445 2010 362.20973–dc22 2009041119 135798642 Printed in the United States of America on acid-free paper CONTENTS Abbreviations ix Contributors xiii Foreword Howard H Goldman xxiii Preface Bruce Lubotsky Levin, Kevin D Hennessy, John Petrila xxvii Part I Services Delivery Issues Chapter Chapter A Public Health Approach to Mental Health Services Bruce Lubotsky Levin, Ardis Hanson, Kevin D Hennessy, and John Petrila The Financing of Mental Health and Substance Abuse Services: Insurance, Managed Care, and Reimbursement Samuel H Zuvekas 13 Chapter Law, Services Delivery, and Policy John Petrila and Bruce Lubotsky Levin 43 Chapter Quality Improvement Kevin D Hennessy 67 Chapter Workforce Rebecca Morris and Anne Lezak 83 vi Part II contents Selected Populations and Treatment Settings Section A At-Risk Populations Chapter Addressing the Global Burden of Mental Disorders: The WHO World Mental Health Survey Initiative Philip S Wang, Sergio Aguilar-Gaxiola, Jordi Alonso, Sing Lee, Tevfik Bedirhan Üstün, and Ronald C Kessler; for the WHO World Mental Health Survey Consortium 115 117 119 Chapter The Epidemiology of Mental Disorders Ronald C Kessler, Kathleen Ries Merikangas, and Philip S Wang 169 Chapter Children and Adolescents Sharon Green-Hennessy 201 Chapter Adults Alexander S Young and Noosha Niv 227 Chapter 10 Older Adults Stephen J Bartels, Aricca D Van Citters, and Tina Crenshaw 261 Chapter 11 The Treatment System for Alcohol and Drug Disorders Dennis McCarty and Traci Rieckmann 283 Chapter 12 The Public Health Implications of Co-occurring Addictive and Mental Disorders Fred C Osher and Jill G Hensley 299 Section B 319 Treatment Settings Chapter 13 State Mental Health Agencies Theodore C Lutterman, Michael Hogan, Bernadette E Phelan, and Noel A Mazade 321 Chapter 14 Community Mental Health Centers Thomas W Doub, Dennis P Morrison, and Jan Goodson 349 Chapter 15 Specialty Hospitals and Psychiatric Units Faith B Dickerson and Steven S Sharfstein 375 Chapter 16 Evolution and Integration of Primary Care Services with Specialty Services Ronald W Manderscheid 389 Chapter 17 School Mental Health Mark D Weist, Robert Burke, Carl E Paternite, Julie Goldstein Grumet, and Paul Flaspohler 401 Chapter 18 Mental Health Treatment in Criminal Justice Settings Allison D Redlich and Karen J Cusack 421 Contents Part III Special Issues vii 441 Chapter 19 Mental Health Disparities Junius J Gonzales and Airia Sasser Papadopoulos 443 Chapter 20 The Recovery Movement William A Anthony and Lori Ashcraft 465 Chapter 21 Economic Issues in Psychotropic Medication Use Marisa Elena Domino and Joel F Farley 481 Chapter 22 The Complexity of Mental Health Services Research Data Ardis Hanson and Bruce Lubotsky Levin 499 Chapter 23 Evaluating Mental Health Systems and Systems Change H Stephen Leff and Crystal R Blyler 511 Index 533 This page intentionally left blank A B B R E V I AT I O N S AAGP ACT ADA ADHD AHCPR AHRQ AoA CASSP CATIE Child STEPs CIDI CIT CJ-DATS CMHBG CMHCs CMHI CMHS CMS CPES CSAT CUtLASS DATOS DHHS American Association for Geriatric Psychiatry Assertive Community Treatment Americans with Disabilities Act attention-deficit/hyperactivity disorder Agency for Health Care Policy and Research Agency for Healthcare Research and Quality Administration on Aging Child and Adolescent Service System Program Clinical Antipsychotic Trials of Intervention Effectiveness MacArthur Foundation Child System and Treatment Enhancement Projects Composite International Diagnostic Interview Crisis Intervention Teams Criminal Justice Drug Abuse Treatment Studies Community Mental Health Block Grant community mental health centers Children’s Mental Health Initiative Center for Mental Health Services Centers for Medicare and Medicaid Services Collaborative Psychiatric Epidemiology Surveys Center for Substance Abuse Treatment Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study Drug Abuse Treatment Outcomes Studies U.S Department of Health and Human Services Chapter 23: Evaluating Mental Health Systems 527 References Aron, L., Honberg, R., Duckworth, K., Kimball, A., Edgar, E., Carolla, B., et al (2009) Grading the States 2009: Report on America’s Health Care System for Adults with Serious Mental Illness Arlington, VA: National Alliance on Mental Illness Behar, L B (1997) Fort Bragg evaluation: A snapshot in time American Psychologist, 52(5), 557–559 Best, S J., & Krueger, B (2002) New approaches to assessing opinion: The prospects for electronic mail surveys International Journal of Public Opinion Research, 14(1), 73–92 Bethell, C., Fiorillo, J., Lansky, D., Hendryx, M., & Knickman, J (2004, January 20) Online consumer surveys as a methodology for assessing the quality of the United States Health care system Journal of Medical Internet Research, 6(1), e2 Bickman, L., Guthrie, P R., Foster, E M., Lambert, E W., Summerfelt, W T., Breda, C S., et al (1995) Evaluating Managed Mental Health Services: The Fort Bragg Experiment New York: Plenum Bickman, L., Lambert, E W., Andrade, A R., & Penaloza, R V (2000) The Fort Bragg continuum of care for children and adolescents: Mental health outcomes over years Journal of Consulting and Clinical Psychology, 68(4), 710–716 Blasinsky, M., Cohen, B., Goldman, H., Hambrecht, K., Johnsen, M., Landow, W., et al (1998) Integrating Process and Outcome Evaluation Cambridge, MA: The Evaluation Center@HSRI Bond, G R., Evans, L., Salyers, M P., Williams, J., & Kim, H W (2000) Measurement of fidelity in psychiatric rehabilitation Mental Health Services Research, 2(2), 75–87 Bowling, J M., Rimer, B K., Lyons, E J., Golin, C E., Frydman, G., & Ribisl, K M (2006) Methodologic challenges of e-health research Evaluation and Program Planning, 29(4), 390–396 Braithwaite, D., Emery, J., De Lusignan, S., & Sutton, S (2003) Using the Internet to conduct surveys of health professionals: A valid alternative? 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Sage This page intentionally left blank INDEX Page numbers followed by “f ” indicate figures, those followed by “t” indicate tables Access to health care, 27, 50, 51, 53, 62, 97, 161, 210, 243, 245, 247, 250, 264, 266, 283, 288–89, 302, 304, 362, 363, 368, 448, 453, 454, 457 Achieving the Promise: Transforming Mental Health Care in America, 36 Action for Mental Health, 351 Addiction Technology Transfer Centers, 91, 102, 105, 291 Addington v Texas, 49 Adherence to treatment, 59, 61, 63, 360, 492 Adult mental health comorbidity, 262 history, 233–34 infrastructure, 275 outcomes, 227, 228 quality improvement, 230–31, 242, 243–46 quality of care, 228, 229, 230, 242, 246–49, 266 quality of life, 231, 232, 242, 249–50, 262 services delivery, 227, 247, 263–65, 270, 271, 272 system assessment, 228–29, 230, 234, 247, 249, 263–65 treatment, 227, 229, 231, 233–38, 239, 241–43, 245, 247–49, 274 Adverse selection, 22, 23, 24, 29, 35, 289 Advocacy, 86, 267, 268, 269, 323, 384 Alcohol and drug abuse, 283 caseloads, 286 criminal justice, 288, 289, 291 efficacy, 288 evidence-based practice, 284, 287, 288, 291–93 expenditures, 283, 284–85 financing of care, 289 health insurance, 285, 289 implementation, 290, 292 integrated care, 284, 289–90 “medicalization” of addictions, 310 pharmacotherapy, 284, 287, 290 public revenue, 285 quality improvement, 293 screening, 286, 290 services delivery, 285 translational research, 292 treatment centers, 284, 285–86, 290 treatment gap, 287, 288 treatment services, 283, 284, 286, 287, 288, 289, 290, 291, 292–93, 302 workforce, 286–87 534 index Alzheimer’s disease, 262, 265, 271–72, 332, 333 Americans with Disabilities Act, 44, 51–53, 63, 262, 266 Americans with Disabilities Amendments Act, 52 Annapolis Coalition, 75, 76, 83, 84, 86, 87, 90, 94, 95, 96, 99, 101, 102, 213, 311, 367 Anxiety disorders, 124 125, 135, 137, 139t, 140t, 145t, 171, 172, 176, 177, 178t, 180, 182t, 184t, 188, 189, 190, 231, 235, 243, 248, 301 Arnold v Arizona Department of Health Services, 51 Assertive Community Treatment (ACT), 227, 234, 239, 247, 250, 341, 342, 432–33, 523 Behavioral Risk Factors Surveillance Survey, 517 Brown v Board of Education, 43, 45 Care coordination, 73–74, 235 Caring for an Aging America Act of 2008 (S 2708), 274 Caregivers, 54, 205, 207, 227, 265, 454 Centers for Health Workforce Studies, 91 Child and Adolescent Service System Program (CASSP), 210, 326 Childhood psychopathology, 201 Children’s Health Act of 2000, 309 Children’s mental health barriers, 215 caregiver problems, 205, 207 effectiveness studies, 212, 213 epidemiology, 202 evidence-based practice, 202, 211–13, 214 gateway providers, 206 informal help, 206–7 infrastructure, 213 intervention services, 201, 205, 210, 211 parent awareness, 205, 206 parental perspectives, 208 service models, 203–6 specialty mental health providers, 203 system characteristics, 203–6 systems of care, 210–11 treatment choice, 208, 209 treatment trajectories, 203–4, 208 Civil commitment children, 49 constitutional protection, 45, 49 due process, 45, 47, 59 federal lawsuits, 45 involuntary, 43, 45–46, 48, 60 laws, 43, 45, 46, 49 Lessard v Schmidt, 46 limits, 46, 50 Civil rights, 43, 45, 46, 48, 49, 62 Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), 485, 492 Coercion, 60–62, 63, 208 Cohort effects, 125, 176, 188, 189 Community based care, 60, 76, 211, 229, 265, 325, 349, 362, 375 Community Mental Health Block Grants, 322, 326, 330 Community Mental Health Centers Act of 1963, 13, 44, 265 Community Mental Health Centers Construction Act, 233, 325, 349, 351, 368 Community mental health services co-occurring disorders, 363 financing of care, 363 history, 351–52 housing, 351, 364 integrated care, 353–54 managed care, 352 Medicaid, 352, 363 prevention, 351, 355–56 psychopharmacology, 359 psychosocial therapy, 350, 353 rehabilitation, 351, 353 telemedicine, 354 workforce development, 366–67 Community mental health system, 51, 326, 327, 330, 333, 335–37, 346, 362, 364, 368, 412, 426 Community science framework, 412, 414 Community Support System (CSP), 326, 526 Community-based care See Communitybased services Community-based services, 14, 16, 240, 263, 264, 269, 272, 322, 326, 327, 337, 337t, 366, 384, 422, 431 Index Comorbid disorders, 189 Comorbidity See Co-occurring disorders Competency, 48, 75, 76, 93, 100, 102, 103, 107, 213, 242, 243, 429 Composite International Diagnostic Interview (CIDI), 119, 120, 122, 124, 126t, 128t, 130t, 132t, 133t, 134t, 145t, 146t, 147t, 171 Comprehensive Alcoholism Prevention, Treatment and Rehabilitation Act, 308 Confidentiality 42 CFR Part 2, 57, 58 Family Educational Right to Privacy Act (FERPA), 57 health information, 57 Health Insurance Portability and Accountability Act, 51, 57 health records, 73 substance abuse and alcohol treatment, 57 Tarasoff v Regents of University of California, 56 Consumer Assessment of Health Plans Survey, 245 Consumer-operated mental health services, 337t, 338–39 Continuous Quality Improvement (CQI), 348 Co-Occurring Center for Excellence (COCE), 301, 303, 305, 309 Co-occurring disorders assessment, 301–2, 303 definition, 301 demographics, 303 outcomes, 300–301, 305 screening, 303 state initiatives, 309 Cost effectiveness studies, 162, 188, 242, 354, 368, 485, 486, 523–24 Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS), 485 Cost-efficiency studies, 523–24 Costs of care, 262, 384 Cost-sharing, 21–22, 24, 25, 30, 32, 33, 489–90 See also Moral hazard Cost-shifting, 31, 210 Criminal Justice Drug Abuse Treatment Studies (CJ-DATS), 291 535 Criminal Justice Mental Health Standards, 428 Criminal justice system contact with, 291 Crisis Intervention Teams (CIT), 425, 426 demographics, 422 diversion, 425, 426, 427, 428, 429, 432 Criminalization of mental illness, 58–60 diversion programs, 59 Crisis Intervention Teams (CIT), 425 diversion programs, 425 effectiveness, 426 Memphis model, 425 infrastructure, 425 policy issues, 425–26 prevalence, 425 sequential intercept model, 427 Data collection consistency, 91 infrastructure, 91, 103, 520 lack of, 91 Deficit Reduction Act of 2005 (DRA), 272 Deinstitutionalization, 16, 26, 44, 50–53, 380 Depression primary care, 27, 36, 74 Diagnosis Related Group (DRGs), 28 Diagnostic Interview Schedule (DIS), 119, 120 Disability definition, 51–52 Disease management, 192, 193 Diversion programs, 63, 425, 426, 427, 428, 429, 431, 435 effectiveness, 59 Dixon v Weinberger, 47 Donaldson v O’Connor, 47 Drug Abuse Treatment Outcomes Studies (DATOS), 288 Drug courts, 59, 291 See also Diversion programs Drug formularies, 25, 26, 32, 33, 487 Drug Office and Treatment Act, 308 Eastern State Hospital, 323 Effectiveness studies, 212, 518, 524 Efficacy studies, 212, 518 536 index Elderly community-based care, 263, 264–65, 269, 272 costs of care, 262, 263, 265, 267, 268, 269 institutional care, 263–64, 270 outreach, 264, 270 policy areas, 266 prevalence, 261–63 services delivery, 263–65 underdiagnosis, 261 Employee assistance plans (EAP), 31 Epidemiologic Catchment Area (ECA) study, 170, 302 Ethics, 54, 55 Evaluation accountability, 524 barriers, 521–22 calibration studies, 524 concept mapping, 521 control series, 519 cross-national assessments, 122, 123 design, 518–19 federal efforts fidelity, 520 formative, 511, 524 grounded theory, 521 hierarchical linear modeling, 525 impact studies, 516 implementation, 520 multiple random effects analyses, 525 outcomes, 517–18, 522 performance assessment, 515 performance measurement, 515, 517, 522 qualitative methods, 455, 521 quality control, 122 quality improvement, 69, 243 quality of care, 67, 71, 72, 230, 244, 246, 249, 288 quality of life, 8, 242, 433, 445, 469, 483 random regression, 519, 525 report cards, 193, 245 summative, 524 time series data, 517, 519 web-based, 518 Evidence-based behavioral therapies, 31, 287 Evidence-based practice adoption, 9, 70, 71, 107–8, 291, 292 alcohol and drug abuse, 292 APIC model, 431 barriers, 105, 344 cognitive behavioral therapy, 236 definition, 213 dissemination, 211, 275 homelessness, 239 knowledge gaps, 71 models, 273, 346 Oregon, 275, 289 Science-to-Services agenda, 274 state initiatives, 275 state mental health agencies (SMHAs), 321, 340–41, 345 Experience of Care and Health Outcomes (ECHO) survey, 245 Fair Housing Amendments Act, 240 Fair Housing Amendments Act of 1988, 51 Family Educational Right to Privacy Act (FERPA), 57 Federal Mental Health Parity Act, 29 Federally Qualified Health Centers (FQHCs), 394, 395, 396, 395f Financing of care, 10, 162–63 Fragmentation of care, 169 Functional assessment, 237 Functional impairment, 171, 205, 453, 458 criteria, 202 Funding streams, 93, 97, 100, 169, 285, 322, 380 Fair Housing Amendments Act of 1988, 51, 240 Family Educational Right to Privacy Act (FERPA), 57 Federal Mental Health Parity Act, 29 Federally Qualified Health Centers (FQHCs), 394–95 Financing of care, 267–75, 289 Fragmentation of care, 169, 394 Functional assessment, 237 Functional impairment criteria, 202 Funding streams, 8, 93–94, 100, 101, 169, 247, 285, 336, 380 Gender difference, 177, 202 Geriatricians Loan Forgiveness Act” (H.R 2502), 274 Gross Domestic Product (GDP), 36 Index Health information, 57, 73, 365, 509 Health information technology, 26, 73 Health insurance alcohol and drug abuse, 289 lack of coverage, 19–21 minority coverage, 167 premiums, 19, 20, 22–23, 34 reimbursement mechanisms, 26, 27 psychotropic medications, 486 Health Insurance Portability and Accountability Act (HIPAA), 51, 57, 58 Health Plan Employer Data and Information Set (HEDIS), 244 Health records, 73, 365 See also Confidentiality Health Savings Accounts (HSAs), 35 Homelessness, 50, 238 evidence-based care, 239 factors, 238–39 housing, 239, 240 model programs, 240 programs, 239–40 risk for violence, 381 state response, 240 statistics, 383 McKinney-Vento Homeless Assistance Act, 239 Individuals with Disabilities Education Act (IDEA), 405 Informed consent, 48–49, 50 Institutions for Mental Disease (IMD), 13 Insurance models, 352 Integrated care alcohol and drug abuse, 289–90 Integrated services, 427 Involuntary outpatient commitment (IOC) See also Civil commitment access to treatment, 61 state law, 60, 61 Jaffee v Redmond, 56 Joint Commission on Mental Health and Illness, 351 “Kendra’s law”, 60 Lessard v Schmidt, 46 Leverage See Coercion 537 Lifetime prevalence, 124–25, 126, 173, 176 Logic model, 513–15 Long-term care, 269, 272 Malpractice, 53–54 breach of duty, 54–55 causation, 55 damages, 55 duty, 54 Managed care ASOs, 339 capitation, 28 cost-sharing, 21–22, 25 drug formularies, 32 enrollment, 25 fee-for-service, 25, 28, 486 HMOs, 24–26 MBHOs, 31 MCOs, 25, 339 models, 352 prospective payment systems, 28 psychotropic medications, 486–90 Medicaid drug formularies, 487 dually eligibles, 34, 269 eligibility, 24, 327, 334 funding formula, 326 psychotropic medications, 483, 484, 487, 488, 489, 490 spending, 14, 269, 272, 483 statutes, 44 Medicaid 1915(b) Waivers, 339 Medicaid Home and Community-Based Waiver, 339 Medicaid Research and Demonstration (1115) Waiver, 339 Medicaidization, 15 Medicare Part D, 24, 33–34, 267–68, 493 statutes, 44 Medicare Improvement for Patients and Providers Act of 2008, 269 Medicare Prescription Drug, Improvement, and Modernization Act (MMA), 267 Mental Health Act of 1946, 308 Mental health courts, 62, 384, 429 See also Diversion programs effectiveness, 59 Mental Health Equitable Treatment Act, 269 538 index Mental health parity federal employees, 23 federal parity, 30, 384 Mental health system assessments, 123 definition, 511 elder care, 325 community outcomes, 517–18 comparative studies, 522 consumer driven, 513 criminal justice, 368, 421, 422, 424 direct services, 516–17 evaluation, 512 evaluation, theory-driven, 513–18 financing, 13 geopolitical characteristics, 515 health professional shortages, 86 implementation science, 247 infrastructure, 515–16 integration, 345 recovery paradigm, 9, 465, 475, 517 rural areas, 354 schools, 354–55 treatment issues, 444, 446 Mental Health Systems Act, 326, 352 Mental Health Transformation State Incentive Grant Program, 518 Mental Health Transformation-State Incentive Grants (MHT-SIG), 275, 518 Mental Health, United States, 85 META Services, 86 See also Recovery Military veterans, 324 Mood disorders, 130, 135, 137, 141–42, 180, 189, 231, 244 Moral hazard, 21–22 Narcotic Addict Rehabilitation Act in 1966, 308 National Alliance for the Mentally Ill (NAMI), 84, 272, 426 National Alliance of Multi-Ethnic Behavioral Health Associations (NAMBHA), 97 National Alliance on Mental Illness, 103, 518 National Association of State Mental Health Program Directors (NASMHPD), 84, 230 National Coalition for Jail Reform, 426 National Coalition of Mental Health Consumer/Survivor Organizations, 392 National Community of Practice on Collaborative School Behavioral Health, 411, 414 National Comorbidity Survey (NCS), 121, 170 National Comorbidity Survey Replication (NCS-R), 170, 457 National Coordinator for Health Information Technology, 73, 509 National Council on Quality Assurance, 244 National Drug Abuse Clinical Trials Network, 291 National Drug Abuse Treatment Clinical Trials Network, 287 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), 301 National Longitudinal Alcohol Epidemiologic Survey, 302 National Mental Health Act, 324 National Network to Eliminate Disparities in Behavioral Health (NNED), 97 National Outcome Measures, 72, 517 National Registry of Evidence-Based Programs and Practices (NREPP), 108, 211, 274, 292, 305, 406, 502, 507 National Survey of Substance Abuse Treatment Services (N-SSATS), 285 National Survey on Drug Use and Health, 99, 287, 517 Network for the Improvement of Addiction Treatment, 72, 288, 351 No Child Left Behind legislation, 403 North American Prodrome Longitudinal Study, 302 Nursing homes, 263–64, 265–66, 270–71, 272 psychotropic medications, 483 O’Connor v Donaldson, 47, 325 Office of the National Coordinator (ONC), 73 Older Americans Act (OAA) of 1965, 270 Index Olmstead v L.C., 52, 266 Omnibus Budget Reconciliation Acts (OBRA), 265, 266 Parham v J.R., 49 Parity See Mental health parity Patient outcomes, 25, 26, 230, 242 Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008, 105 Peer services, 86, 89–90, 98, 238, 473 Peer specialists, 85, 90, 338–39 Peer support, 86, 98, 235, 238, 474 Peer training programs, 98 Pharmacoeconomics, 481, 482, 485, 492, 493 Pharmacy Benefit Managers (PBMs), 32 Phobias, 177, 231 Preadmission Screening and Resident Review (PASRR), 264, 265 Prescription Drug Plans (PDPs), 34, 267 See also Medicare Part D Prescription medications See Psychopharmacology President’s Commission for Mental Health, 351 President’s New Freedom Commission prevention, Primary Care-Behavioral Health Learning Community initiative, 392 Privilege definition, 55–56 Program for All-Inclusive Care for the Elderly (PACE), 269–70 Projects for Assistance in Transition from Homelessness (PATH), 239–40 Psychopharmacology, 457 Psychotropic medications adherence, 491–92 barriers, 482 cost effectiveness, 485 cost of care, 485 cost offset, 488, 489 cost sharing, 489–90 diffusion, 484 drug formularies, 487–88 expenditures, 483 first generation, 482 539 health insurance, 486 managed care, 484, 486–90 marketing, 482, 484, 486 Medicaid expenditures, 483 Medicare Part D, 483, 486, 493 off label use, 482, 483, 485 quality of life, 483, 484 second generation, 237, 391, 482 selection, 485–86 stigma, 482 value, 484–85 Psychotropics, 482–83, 484 Quality of care, 228, 230, 246–47 assessment, 71 definition, 68 Veterans Administration, 489, 500 Quality of life, 8, 242, 248, 262, 433, 517 Racial and ethnic disparities, 20, 444, 445, 446, 449F, 456, 457, 458 RAND Health Insurance Experiment (HIE), 22 Recovery, 9, 465, 466–68, 469f, 476 barriers, 350, 364 medical home, 396 personal experience, 474 power dynamics, 471 research, 468 services delivery, 469–72, 482 staff training, 474 use of language, 292, 471 values, 350, 473, 476 workforce development, 75–76, 101, 106, 213, 366, 472, 476 Recovery-oriented systems of care (ROSC), 356 See also Recovery Rehabilitative services, 353 Research to practice, 63, 107–8 policy, 472–73 Resilience, 213, 472 Resource allocation, 120, 188, 304 Right to refuse treatment, 44, 47–49 Right to treatment, 46–47, 422 Risk adjustment, 23, 28 Risk selection, 22–23 Rouse v Cameron, 47 Rural mental health, 87 substance abuse, 87, 300 540 index Safe Schools/Healthy Students, 410 See also School-based mental health Schizophrenia, 21, 228, 231, 232–33, 236, 242, 243, 248, 263, 270–71, 234, 353, 365, 380–81 Schloendorff v Society of New York Hospital, 47 School-based mental health, 210–11 challenges, 406–12 evidence-based practice, 408–10 federal role, 410 prevention, 355–56, 355f, 403, 405, 407 program, 413 services, 354–55 state initiative, 402 School-based health centers (SBHCs), 404 See also School-based mental health School-based mental health services, 354–55 See also Workforce development Service utilization, 9, 249, 262, 404, 452, 456–57, 509 Social insurance, 24 See also Public benefits programs Social Security, 44, 363 Social Security Disability Income (SSDI), 235, 364 Souder v Brennan, 324–25 Specialty mental health providers, 203, 263, 264, State Children’s Health Insurance Program (SCHIP), 20 State Comprehensive Mental Health Planning Act, 233 State mental health agencies (SMHAs), 319 challenges, 327 children’s mental health, 332 community-based care, 325, 337–38 consumer-operated mental health services, 338–39, 338t definition, 319 eligibility, 333–34 evidence-based practice, 340–41, 341–42f, 346 financing of care, 342 forensic services, 333 health care reform, 345 history, 323–25 infrastructure, 330–32 integrated care, 345 interagency collaboration, 331 managed care, 339–40 Medicaid, 330 military veterans, 345 organization, 335–37 other providers, 346 policy issues, 343–46 public safety, 322 quality improvement, 340 revenue sources, 330 role of, 322 services delivery, 327–28 traumatic brain injury, 333 trends, 332, 346 Uniform Reporting System (URS), 328 workforce, 332–33, 333t Stewart B McKinney Homeless Assistance Act, 239–40 Stigma, 241, 357, 362–63, 451–52 Student assistance programs (SAPs), 404 Substance Abuse and Mental Health Services Administration (SAMHSA), 14, 72, 73, 75–76, 91, 97, 102, 210, 211, 234, 274–75, 285, 301, 303, 305, 311, 330, 405, 406, 502, 517 creation, 309 Substance use disorders See Alcohol and dug abuse disorders Supported employment, 237, 248, 364 System of care, 83, 93, 209, 306, 357f definition, 356 Systematic reviews, 69, 508 Systems theory, 513–14, 514f Tarasoff v Regents of University of California, 56 The Network for the Improvement of Addiction Treatment (or NIATx), 72, 288, 351 The Shame of the States, 324, 376 Transformation Systems Improvement Grants (TSIGs), 322 Transformation Transfer Initiative (TTI), 322 Treatment Outcome Prospective Study (TOPS), 288 Index Uninsured See Health insurance United Nations’ Convention on the Rights of the Child, 208 Wellness, 392, 469 models, 397–98 White House Conference on Aging (WHCoA), 266–67, 270 WHO World Mental Health (WMH) Survey Initiative, 119–63 Workforce development, 83, 366–67 Annapolis Coalition, 75–76, 101, 367 accreditation, 101 aging, 91–92 alcohol and drug abuse, 286–87 assessment, 99–100 burnout, 94, 96 barriers, 107, 311 Connecticut, 102 competencies, 89–90 consumers in, 98–99 continuing education, 75, 90 cross-training, 92–94 cultural competence, 89–90, 96–98 data collection, 90–91 definition, 84–87 demographics, 87, 88t diversity, 106–7 educational level, 75, 86, 96 evidence-based practice, 92–94, 107–8 541 federal initiatives, 102–4 fragmentation, 83–84, 93, 96 Geriatric Health Professions Programs, 274 health professional shortages, 105–6 infrastructure, 84 licensing, 85, 91, 101 Ohio, 102 parity, 105 peer run services, 90 professional programs, 94–96 quality data, 104–5 recovery-orientation, 99, 385, 473, 525 research agenda, 89 rural areas, 95, 100 state initiatives, 102–4 Workforce Development Resource Center, 75, 76, 102 World Health Organization (WHO), 7, 119, 170, 362, 405, 508 Communicable Disease Global Atlas, 508 health, definition of, WMH survey initiative See WHO World Mental Health Survey Initiative Wyatt v Stickney, 325 Youngberg v Romeo, 49 ... women’s mental health, mental health, and public health for pharmacists, with research interests in managed behavioral health care, mental health policy, graduate behavioral health education, and mental. .. National Advisory Mental Health Council National Alliance on Mental Illness National Association of State Mental Health Program Directors National Council for Community Behavioral Healthcare National... Financing Administration health information technology Health Plan Employer Data and Information Set Health Insurance Portability and Accountability Act Health Maintenance Organization Health