Supporting Improved Access to Mental Health Care
February 6, 2003 | Press Release

MacArthur has announced two grants totaling nearly $5.5 million in support of efforts to improve access to effective mental health services.

"Mental health is an integral part of a person's overall health and well-being, but efforts to prevent and treat mental illness have been, and continue to be, viewed as outside the mainstream of public health," said Jonathan Fanton, President of the MacArthur Foundation. "Research shows that one of five Americans experiences a diagnosable mental disorder each year, but fewer than one-third of those receives treatment. Through research designed to improve policies and practices, we are committed to helping ensure better and more effective treatment for people with mental health problems."

A grant of $3.9 million over three years was made to the University of Virginia Law School in continued support of the Research Network on Mandated Community Treatment. Mandated Treatment is a controversial and emotional topic. It refers to the different ways people with serious mental illness are compelled or induced to participate in treatment while they are living in the community. There is considerable debate about the rights of individuals to refuse treatment and how to require some people with specific mental disorders to follow a treatment plan. Examples of ways to ensure compliance include controlling access to housing and financial resources or threatening jail or hospitalization. The multidisciplinary network of researchers, legal scholars, and practitioners will use the grant to continue their exploration of how often and in what ways mandated treatment is used. They will investigate the effects of such treatment to build a base of evidence to inform policy choices about the role of mandated treatment in ensuring the use of effective mental health services.

Dartmouth Medical School received a grant of $1.5 million in support of the Depression in Primary Care Initiative, an effort to enhance the quality of diagnosis and care of people with depression who are seen by primary care physicians, such as internists and family practitioners, from whom most patients seek treatment. Depression is one of the most common and disabling psychiatric disorders. It affects about seven percent of the general population each year and is highly prevalent among patients in primary care settings, affecting about 10 percent of all patients. A major public health problem, the effects of depression are pervasive, causing decreased functioning, impaired work performance, decreased adherence to treatments for other physical illnesses, and even death.

The early work of the Initiative helped develop a successful clinical approach for treating patients with depression called the Three Component Model (TCM). Evaluations of patients treated with this intervention showed a significantly larger reduction in depression than those who received regular care from their physicians. Partnering with six major health care organizations, the Initiative plans to implement the model in more than 1,000 practices, with at least 5,000 clinicians, a strategy that could ultimately affect millions of patients. The new grant will be used to provide primary care physicians across the country with the knowledge and resources needed to use the TCM model.


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