Improving the Quality of Health Care for Mental and Substance-Use Conditions

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are serious?for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substance?use conditions will benefit from this guide to achieving better care. Table of Contents Front Matter Summary 1 The Quality Chasm in Health Care for Mental and Substance-Use Conditions 2 A Framework for Improving Quality 3 Supporting Patients' Decision-Making Abilities and Preferences 4 Strengthening the Evidence Base and Quality Improvement Infrastructure 5 Coordinating Care for Better Mental, Substance-Use, and General Health 6 Ensuring the National Health Information Infrastructure Benefits with Mental and Substance-Use Conditions 7 Increasing Workforce Capacity for Quality Improvement 8 Using Marketplace Incentives to Leverage Needed Change 9 An Agenda for Change Appendix A: Study Process and Committee Membership Appendix B: Contraints on Sharing Mental Health and Substance Use Treatment Information Imposed by Federal and State Medical Records Privacy Laws Appendix C: Mental and Substance Use Health for Veterans: Experience with Performance Evaluation in the Department of Veterans Affairs Index