What Is Happening to Mental Health Care?

Our mental health care system is always changing. We, Frank Pittman and Judith Herman, want to address current issues and difficult questions related to all aspects of mental health care. How is it that we have reached the point where many of those involved at all levels, as practitioners, patients, and members of the public, describe the system as “broken?”

Obviously – and neither of us is uniquely qualified to undertake it.

We are shaped in an academic mold, in both practice and research. And we’re old fogies to boot. But we have seen how a number of paradigms, conventional wisdom, policies, and accepted practices have turned out.

Doing our homework in preparation for the first few posts, we were impressed by the complexity of the deeply intertwined mental health and substance abuse systems, and how they, in turn, overlap with numerous other enormous public and private systems such as Medicaid, Medicare, commercial insurance, and city and state welfare policies. We can’t possibly cover it all, but we want to hear from our readers about their thoughts and experiences relevant to improving services, practices, and policies.

Among the myriad potential blog topics we are considering:

What are the most common problems encountered by mental health practitioners and patients seeking care?
Why are prisons the biggest providers of housing and inpatient care for people with severe and persistent mental illness in the US?
Why do we have such high rates of homicide and suicide and so many incidents of mass shootings?
What should be the role of the mental health system in predicting and/or preventing violence?
What should be done about our high rates of substance abuse and addiction? What about our epidemic of drug overdoses?
How can we reduce mental health stigma? What is the role of the media in this?
Why is it so hard to achieve parity between medical and mental health services?