March 1, 2006
Grading the States: A Report on America's Health Care System for Serious Mental Illnesses , funded by the Stanley Family Foundation, was released by the National Alliance on Mental Illness (NAMI).
The 230-page report, including individual state narratives and scoring tables, is available on-line at www.nami.org/grades. A list of state grades is included at the end of this release. The report calls on states to make smarter investment choices through proven, cost-effective practices, and to link taxpayer funding to performance and individual outcomes.
"Grades are more than report cards," said NAMI executive director Michael J. Fitzpatrick. "They reflect standards that help people recover, and choices being made by governors and legislatures every day. States doing well in the report have developed a common vision and political will to move their treatment systems forward."
For the first time, the report confirms in detail what a presidential commission appointed by President George W. Bush has called "a system in shambles" and what the Institute of Medicine of the National Academy of Sciences recently called a "chasm" between promise and practice. Grades were calculated by scoring 39 criteria, based in part on a survey of state mental health agencies conducted in October-December 2005.
Only five states received grades in the B range:
Eight states received Fs:
"Treatment works, if you can get it, and if states get it right," said NAMI medical director Ken Duckworth. "Unfortunately, too many states are willing to risk or tolerate premature deaths."
Millions of adults with schizophrenia, bipolar disorder and major depression, depend primarily on state public health systems for treatment and support services.
Duckworth warned that Ds are unacceptable and Cs cannot be considered a passing grade. "If you need heart surgery, you don't want a surgeon who only got a C in medical school. The same principle applies in helping people with mental illnesses."
"Too many states are behind the curve. They are not keeping pace by moving toward a recovery-oriented health care system, based on proven, cost-effective practices. They are selling taxpayers short by settling for pieces of systems that are largely obsolete."
The NAMI report makes several recommendations:
The report particularly criticized
"Getting help means getting access to information," Duckworth said. "When 40 states can't pass a pop quiz on providing basic information to the people whom they are supposed to serve, then the system is in trouble."
States that received excellent "Test Drive" scores were
Fitzpatrick predicted the report will have policy consequences.
"Consumer and family advocates will use it as a tool for change. Governors and legislators should use it as a check list. The goal is to raise the level of awareness, dialogue and creative action," he said.
The impact may extend to national debate.
D Alaska, Alabama, Georgia, Mississippi, Nebraska, New Hampshire, Oklahoma, Utah, Virginia, Washington, West Virginia, Wyoming
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