The Mental Health Maze: Some Progress, Many Pitfalls

ON THE DAY IN APRIL 2002 that presidential candidate GeorgeW. Bush heralded his intentions to create a commission on improvingthe way mental health services are delivered, Sen. Pete V. Domenici,a Republican who has long been a strong advocate for peoplewith mental illnesses, was at his side in New Mexico. Bush asserted:"Americans with mental illness...deserve excellent care. Theydeserve a health system that treats their illnesses with thesame urgency as a physical illness." Fifteen months later, whenthe final report of the President’s New Freedom Commissionon Mental Health was released, the event lacked the presenceof Bush, the fanfare of a White House ceremony, or even a pressconference. Two years after that, when lack of progress towardachieving the report’s sweeping goals was readily apparent,advocates mobilized behind a campaign that called for more-aggressiveaction by policymakers on behalf of people with mental illnesses.With this issue, Health Affairs is weighing in on this subjectas well. Most of our papers point to some modest signs of progressbut, overall, a lack of political will to improve the mentalhealth system. Richard Frank and Howard Goldman were our editorialadvisers and provided invaluable assistance in helping shapethe issue. This is the fifth thematic issue on mental healththat Health Affairs has published since 1992 with support fromthe John D. and Catherine T. MacArthur Foundation. We acknowledgethis support with great appreciation because it has enabledthe journal to attract the best minds in mental health policyand research. The foundation also deserves high praise for itsunstinting support of mental health research networks whosemembers have produced many of the manuscripts we have publishedover the past fifteen years.

John K. Iglehart, Founding Editor

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The Mental Health Maze: Some Progress, Many Pitfalls