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Where’s the ‘Individual’ in the Mental Health Care Reform Discussion?

Where’s the “Individual” in the Mental Health Care Reform Discussion?Much has been written in the last several months about national mental health care reform in response to two separate bills making their way through Congress.

The most well-known is the Murphy bill introduced by U.S. Representative Timothy Murphy from Pennsylvania. Rep. Murphy is a credible expert on the topic. He has been a practicing psychologist and has co-authored publications on child and adolescent mental health. His bill has stirred controversy among mental health providers and advocates with both groups expressing varying opinions of support and dissent. One of the more controversial elements of the bill is expansion of Assisted Outpatient Treatment (AOT).

But all of this discussion is a distraction from what should be our real focus.

  • What do people participating in mental health care want?
  • How do they want to receive services?
  • Where do they want to receive services?
  • What is preventing them from participating in services?

Care For Your Mind examines these issues in our series on AOT authored by Harvey Rosenthal, Executive Director, New York Association of Psychiatric Rehabilitation Services (NYAPRS).

In the first post of this series, Mr. Rosenthal asks why we don’t Fix Services Rather than Force Services. His post raises a valid point that seems to be lost on our legislators. Individuals participate in services. The World English Dictionary defines participate as: become actively involved, to share. Mr. Rosenthal supports that definition, revealing that “when once asked by a director of a large NYC mental health agency what to do when someone consistently rejected the care that they were being offered by their community worker, I replied, ‘send someone else.'”

In the second post in this series, Care For Your Mind provides concrete details to support Mr. Rosenthal’s claim that “rather than forcing patients to conform to one standard treatment course, we should offer a diversity of paths.”  In this post, we are all challenged to rethink our definition of Provider Engagement.

Meeting individuals where they are at and building trust is at the center of this mental health care service model discussed in the post. Mr. Rosenthal suggests that providers need to stop hiding behind clinic doors and hit the streets, bringing mental health services to individuals and their families where they are living their lives.

Unfortunately, many of our mental health policy decision makers still subscribe to an outdated model that suggests noncompliance is choosing not to participate in treatment at a location and time defined by the provider’s preference. Perhaps these decision makers have not recognized that our society has evolved in the last 25 years. We are now a mobile, person-centric, 24/7 community, and all of us, not just individuals living with a mental health condition, thrive when offered personalized services that recognize our individuality and specific needs.

So what do you think? Are we being distracted by outdate recommendations for mental health care reform? What does true mental health care reform look like?

Join the conversation at Care For Your Mind. Share with us your own personal experiences. Do you think more aggressive AOT is the solution to engaging more participation in mental health care? What would you offer as an alternative?

Where’s the ‘Individual’ in the Mental Health Care Reform Discussion?

Phyllis Foxworth

Phyllis Foxworth is the Director of Advocacy at the Depression and Bipolar Support Alliance (DBSA).

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APA Reference
Foxworth, P. (2018). Where’s the ‘Individual’ in the Mental Health Care Reform Discussion?. Psych Central. Retrieved on October 21, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 16 Aug 2014)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
Published on Psych All rights reserved.