Tuesday, September 30, 2014

We Must Focus Resources on the Most Seriously Ill, Urge Prominent Members of the APA

From the Treatment Advocacy Center's blog
(Sept. 29, 2014) Two prominent members of the American Psychiatric Association called for major reforms to the mental illness treatment system in an editorial in JAMA Psychiatry (“Fixing the troubled mental health system,” Sept. 24).
sharfstein“The first step in reform is to focus attention and resources on the most severely ill, high-need, high-cost patients,” wrote Lloyd Sederer, MD, and Steven Sharfstein, MD. “We have to have the right structure for the delivery of care.”

Sederer is medical director of the New York State Office of Mental Health and was director of APA’s Division of Clinical Services from 2000 to 2002. Sharfstein is CEO and medical director of the Sheppard Pratt Health System and was president of APA from 2005 to 2006.

“Federal and state governments should prioritize the move of patients from the criminal justice system to the treatment system,” they urged. “Some of the neediest people who would have been institutionalized are now in the criminal justice system. This is an absolute disgrace. We need to provide incentives for people to be treated in the community and to avoid jail and prison.”

In an interview with Psychiatric News, Sharfstein argued that the Helping Families in Mental Health Crisis Act (HR 3717) has the potential to offer some relief to the suffering of the most severely ill, their families and their communities. “In my view it tackles head-on some of the major impediments to access to care for a critical subset of individuals who are high cost and very difficult to retain in treatment, in large part because they don’t recognize they are sick,” he said.

Even though the some of the nation’s leading psychiatrists are calling for more resources and attention for the most high-need patients, the plan put forth by the leading federal agency dedicated to improving mental health efforts, the Substance Abuse and Mental Health Services Administration, falls short, said the current president of the APA, Paul Summergrad, MD, in this month’s issue of Psychiatric News (“SAMHSA strategic plan falls short on serious mental illness,” September).

The plan leaves out “a focus on the appropriate medical care of patients with serious mental illness,” Summergrad said.

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