Following are highlights from Missouri's Comprehensive Plan for Mental Health, completed in February 2008 on behalf of Missouri's Transformation Working Group and approved by the Federal Substance Abuse and Mental Health Services Administration in June 2008. To review the full plan and the Action Plan Updates, click the links below.
Lifespan Mental Health Services: The current mental health system fails to address the mental health needs of citizens across the full spectrum of life. Service gaps that must be addressed are:
• Early childhood and school age prevention and early intervention services,
• Services to successfully transition from school to adulthood,
• Prevention and early intervention services for an aging population.
Public Education: Public stigma surrounding mental health issues is one of the most formidable barriers keeping people from accessing appropriate and timely mental health services. A major goal of the Transformation Comprehensive Plan is to assure that Missourians recognize that mental health is essential to overall health. To this end, a multi-faceted public education and stigma reduction effort is proposed, including the introduction of Mental Health First Aid, a mental health literacy training program that originated in Australia. It uses the familiar model employed for many years for physical health first-aid intervention.
Consumer Direction and Empowerment: As Missouri moves to promote wellness and create a culture of acceptance and hope within the mental health service system, consumers need the skills and decision tools to better manage their own mental health. The Comprehensive Plan for Mental Health calls for the implementation of a Wellness Model that empowers consumers to establish their own mental health goals and take more oversight and control their own treatment processes.
Physical and Mental Health Interface: Mental health is significantly affected by physical health, and vice versa. According to recent, prominent national studies, mental health consumers with addictions, developmental disabilities and serious mental illnesses die 16-25 years younger than the average Missourian. Six in ten will die from a co-occurring medical disorder related to diabetes, COPD, Cardiovascular diseases, etc. According to the DHHS’s Agency for Healthcare Research and Quality, almost one fourth of all stays in U.S. community hospitals involved mental health or substance use related disorders. The Transformation Comprehensive Plan strongly emphasizes the need for better interface between mental health and general medical care. Treatment professionals in each arena have traditionally failed to consider areas of health outside their narrowly focused specialties. This must change.
Evidence-based Practices: An evolving national array of evidence-based and promising practices allows for successful treatment for the vast majority of people with mental health needs; however, many Missourians are not yet benefiting from them. The Transformation Comprehensive Plan recognizes the need to incorporate these practices, such as Person-centered planning, School-based mental health services, Integrated Dual Diagnosis Treatment, Supported Employment, Assertive Community Treatment etc. for designated populations. Promising practices such as Trauma Informed Care also need to be incorporated throughout the system in growing recognition of the devastating impact of trauma on mental health conditions and treatment outcomes.
Easy, Early and Equal Access: Currently there are long waiting lists for addiction, community mental health and disabilities services. Particularly in the mental illness field, this has resulted an over use of emergency rooms and psychiatric inpatient settings. Jails and prisons have also seen dramatic increases in severe mental illness problems among incarcerated populations. Under the current system, many consumers are forced to enter into treatment at later stages of their illness. This is compounded by cultural and geographic barriers. The Transformation Comprehensive Plan calls for increased service capacity through development of targeted community-based services to prevent crises that lead to more costly, tertiary care.
Collaboration-Shared Ownership and Investment: The mental health service system is complex and connects many sectors (public–private, specialty–general health, health–social welfare, housing, criminal justice, and education). Currently mental health care is organizationally fragmented creating many barriers to access. The Transformation Comprehensive Plan calls for collaborative efforts between the private and public sectors, and across all levels of government, to transform policies, practices, and financing to assure early and effective access to care.
