A Report on America’s Health Care System for Adults with Serious Mental Illness
Grading the States 2009: A Report on America’s Health Care Sytem for Adults with Serious Mental Illness
Overview | State by State | Findings | Recommendations | Methodology | Full Report | Media | How You Can Help | Discuss
Overview & Grades    |    Key Findings    |    Policy Recommendations    |    Conclusion

Executive Summary

Key Findings

Many states are valiantly trying to improve systems and promote recovery, despite a stranglehold of rising demand and inadequate resources. Many states are adopting better policies and plans, promoting evidence-based practices, and encouraging more peer-run and peer-delivered services. But state improvements are neither deep nor widespread across the nation. This report’s findings follow the four categories in which each state was graded:

Health Promotion and Management

  • States are not focusing on wellness and survival for people with serious mental illnesses.
  • States do not have adequate data on critical mental health services.
  • Few states have public health insurance plans that adequately meet the needs of people with serious mental illnesses.
  • Private insurance plans often lack sufficient coverage for mental health and substance use disorders.
  • Most states have inadequate plans for developing and maintaining the mental health workforce.

Financing and Core Treatment/Recovery Services

  • State mental health financing decisions are often penny-wise, pound-foolish.
  • States are not adequately providing services that are the lynchpins of a comprehensive system of care, such as Assertive Community Treatment, integrated mental health and substance abuse treatment, and hospital based care when needed.
  • States are not ensuring that their service delivery is culturally competent.

Consumer and Family Empowerment

  • Information from state mental health agencies is not readily accessible.
  • States are not creating a culture of respect.
  • Consumers and family members do not have sufficient opportunities to help monitor the performance of mental health systems.

Community Integration and Social Inclusion

  • Few states are developing plans or investing the resources to address long-term housing needs for people with serious mental illnesses.
  • Effective diversion from the criminal justice system is more common, but remains scattershot without state-level leadership.
  • Most states are beginning to provide public education on mental illness, but stigma remains a major concern.

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"Recovery is a unique process for each person. It means having a better quality of life, hope, and resiliency."
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Mike Fitzpatrick, NAMI Executive Director

Consumer and Family Member Comments
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