ABSTRACT
The two of the most commonly advocated service improvement proposals for adults with severe mental illnesses are to redesign services based on recovery principles and to increase the availability of services with strong research support. The two improvement strategies complement and inform each other much more than they conflict. To improve, the field needs the insights of people who have personally experienced severe mental illnesses and it needs the scientific process. Applied together, the two strategies can guide the development of an optimal service system: The kind of service system that most people would want for themselves or their family should they have the need.
Subject(s)
Community Mental Health Services/organization & administration , Evidence-Based Medicine , Health Services Accessibility , Schizophrenia/rehabilitation , Adult , Community Mental Health Services/standards , Humans , Quality Assurance, Health Care , United StatesABSTRACT
After nearly 20 years of progress in general medicine, the evidence-based practice movement is becoming the central theme for mental health care reform in the first decade of 2000. Several leaders in the movement met to discuss concerns raised by six stakeholder groups: consumers, family members, practitioners, administrators, policy makers, and researchers. Recurrent themes relate to concerns regarding the limits of science, diversion of funding from valued practices, increased costs, feasibility, prior investments in other practices, and shifts in power and control. The authors recommend that all stakeholder groups be involved in further dialog and planning to ensure that practices emerge that represent the integration of the best research evidence with clinical expertise and consumer values.
