Failure™ Magazine

Healing the Broken Mind

Transforming America’s failed mental health system.

Written by Jason Zasky   Filed under Life, Science & Technology

What are the five components?
The first thing we need to do is to embrace evidence-based practice. The idea is to offer treatments that are scientifically proven to help people get better quickly. Embracing an outcome-based system of care means we start measuring how effective we are in the lives of people who come for services. It may sound simple, but it would be transformative to the field of mental health to embrace this concept and run with it.

The second thing we need is to break the state monopoly on public sector psychiatric care, which is the system that cares for most of the people with serious mental illness. We need to inject the private sector competitive work environment into the public sector mental health system.

The third thing is to work for parity coverage. People with mental illness should get the same amount of coverage received by people with medical-surgical needs. A federal law was passed last year that will greatly advance this cause, but it’s yet to be implemented and implementation is going to be a challenge.

The fourth point is to develop a consumer-focused system, where those who are being treated are invited to collaborate with the caregiver. In other words, the provider sits down with the patient to discuss the relative advantages and disadvantages of the treatment options to get feedback and figure out what his or her preferences are. In the mental health system—as well as the health care system—the best care is delivered when the physician collaborates with the patient.

The last point concerns overcoming resistance to change. A lot of people are saying the same things I say in the book, yet the changes still haven’t happened. The reason is that there is a system in place that spends about a hundred billion dollars a year, so there is a lot of vested interest. People who benefit from the status quo aren’t crazy about the dramatic reforms that I and others are calling for.

So we have to look for an opportunity where there is an economic imperative for change, a political imperative for change, and visionary leadership. We need people who have the courage to stand up and push reforms through, someone like a Ted Kennedy, who unfortunately is no longer with us. My argument is that we need a perfect storm of those three factors in order to overcome resistance to change.

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