Health Affairs, 25, no. 3 (2006): 680 doi: 10.1377/hlthaff.25.3.680 © 2006 by Project HOPE	New Online   Pay Cuts For Medicare Docs   Access To Care Woes   Public Coverage More Efficient   Empowering Consumers

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Quality & Access

PROLOGUE

Ensuring Quality And Access In Mental Health Services

However, a true field test of the veracity of this wellspring of political attention was just on the horizon in the form of soldiers returning from the Iraq War. Comprehensive studies have revealed that upward of one-third of returning U.S. soldiers in 2003 and 2004 received mental health care within a year of their return. So, how robust would the governmental response be to providing this most deserving of subgroups access to needed high-quality mental health services?

Clearly some uptick in societal awareness and acceptance is perceptible and has translated into an increase in Pentagon screenings for symptoms of mental illness since post-traumatic stress disorder first entered the national lexicon at the close of the first Persian Gulf war. Nevertheless, in recent times, many in the veterans community have criticized the Bush administration for chronically under-funding the Department of Veterans Affairs and deprioritizing mental health services for active and discharged soldiers, despite this period of acute need and public rhetoric to the contrary. Sadly, the experience of soldiers—a group perhaps most likely to garner societal good will and benevolence—could be the veritable canary in the coal mine indicating the reality that when it comes to ensuring broad access to high-quality mental health care, we still have a long way to go.

The papers that follow provide needed insights to help bridge this gap between rhetoric and reality. First, Kavita Patel, Brittany Butler, and Kenneth Wells offer up a roadmap for improved mental health care quality, including recommendations for greater application of evidence-based interventions and more innovation in financial incentives. Next, Peter Cunningham, Kelly McKenzie, and Erin Fries Taylor chronicle deficiencies in services offered to low-income populations with serious mental illnesses and state and local strategies for addressing these gaps in the face of omnipresent resource shortfalls.

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