Mental health services in the USA

Citation

(2002), "Mental health services in the USA", International Journal of Health Care Quality Assurance, Vol. 15 No. 2. https://doi.org/10.1108/ijhcqa.2002.06215bab.006

Mental health services in the USA

Mental health services in the USAKeywords: Mental health, Predictions, USA

A look toward the future, a review of past developments and a discussion of the current status of mental health services and statistics are contained in Mental Health, United States 2000. The compendium of the latest information available on mental health services, published every two years since 1983, was released in October by’the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS).

The Report makes four major predictions for the future of mental health services in the USA:

1. 1.

   human rights will be established as fundamental in the US health-care system;

2. 2.

   consumers and family members will seek and be given more responsibility for health and health care;

3. 3.

   technology will become a primary vehicle for delivering health care; and

4. 4.

   genetic treatments for mental health disorders will become routine.

For the first time, this edition includes chapters on refugee mental health services, co-occurring addictive and mental disorders, mental health services in juvenile justice facilities, performance indicators for state mental health agencies, rates of psychiatric problems and related disability in the child and adolescent population, and new data standards for mental health services developed through Decision Support 2000+.

According to the report, 5,722 mental health organisations were operating in 1998. These organisations maintained 261,903 in-patient and residential treatment beds. In-patient residential treatment admissions numbered 2,313,594, and admissions to less than 24-hour services numbered 3,967,019. Total incidences of care in mental health organisations reached 10,714,398.

Overall, 2.3 million persons were under care and 5.5 million persons were admitted during 1997 to specialty mental health in-patient, residential, and less than 24-hour mental health-care programs. More males than females were treated in in-patient and residential programs, while both genders were fairly evenly represented in less than 24-hour settings. Although persons categorised as White comprised the preponderance of persons receiving services in 1997, American-Indians/Alaska Natives and African-Americans showed higher rates of care relative to their numbers in the population.

State mental health agencies spent more than $16 billion on mental health services in 1997. Although this number reflects an overall increase over the $12.1 billion spent in 1990, when the expenditures are adjusted for inflation, actual expenditures decreased by 7 per cent between 1990 and 1997. Community-based services represented 56 per cent of total expenditures in 1997, compared with 41 per cent for State mental hospitals. State mental health agency funding came from State government tax revenue ($11.4 billion); the Federal Government, principally through Medicaid ($4 billion); first- and third-party payments ($822 million); and local government ($95 million). The Community Mental Health Services Block Grant declined from 2.4 per cent of expenditure to 1.5 per cent of expenditure between 1990 and 1997.

The Substance Abuse and Mental Health Services Administration, a public health agency within the US Department of Health and Human Services, is the lead federal agency for improving the quality and availability of substance abuse prevention, addiction treatment and mental health services in the USA. Information on SAMHSA's programs is available on the Internet at www.samhsa.gov