Two Dogmas Of Mental Health Policy

HEALTH AFFAIRS BLOG

Two Dogmas Of Mental Health Policy

By Isabel M. Perera
MARCH 2, 2020

As the presidential race heats up, candidates are weighing in on how they would reform the nation’s broken mental health system. Pundits have linked its flaws to a range of headline issues. Behavioral health care shortages purportedly exacerbate the increased frequency of mass gun violence, the negative effects of social media, and even the anxieties produced by the economic, environmental, and immigration landscape. The mental health system is far from the cause of those problems, but politicians (on both sides of the aisle) are rightly concerned about how to end the policy chaos that leaves millions of Americans untreated, and often homeless or incarcerated instead.

Many of these policy proposals, however, contain unexamined assumptions about our current system and how it operates. In previously published research in the Lancet Psychiatry and Psychiatric Services, I used cross-national data from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD) to examine the economic assumptions that guide mental health policy making and found reason to doubt two common beliefs: one, about the importance of private payers, and the other, about the relationship between inpatient and outpatient care.

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