National Alliance on Mental Illness
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Grading the States 2009: A Brief Overview of Methodology
In August 2008, NAMI surveyed state mental health agencies in preparation for this 2009 report. While covering similar topic areas to the 2006 Grading the States report, this latest edition of the survey has evolved in several ways:
State Scorecards Scoring
All states except South Dakota responded to NAMIís survey for this 2009 Grading the States report. The information was scored and weighted in four broad categories:
Challenges in Assessing a Complex System
Our nationís public mental health system is complex, bridging inpatient and community-based health services, housing and economic support programs, vocational and social supports, and the criminal justice system, among others. Because of this complexity, it is extraordinarily challenging to accurately assess not only its overall quality, but also the effectiveness of each component and the extent to which the components successfully interact.
The lack of reliable outcome data generally limits the ability to measure the effectiveness of state services. Plans and policies may exist, but they do not necessarily translate to implementation. Evidencebased practices may be intended, but fall short of fidelity standards.
With those caveats in mind, this report provides the best comprehensive, comparative assessment of state mental healthcare systems to date. State-by-state narratives go beyond existing state data and shed light on each stateís qualitative performance.
"[Recovery means] functioning normally within society without mental health issues proving to be a barrier."