Testimony presented during the Blue Ribbon Commission's public hearings describes the current system as one that emphasizes a crisis response to mental health problems but offers inadequate attention to continued care beyond the crisis period. There is no single cause for this crisis, and no easy solution. Managed care costs control efforts have adversely affected access to behavioral health care. Two major state hospitals have been closed during the past four years resulting in additional demand on community services. Community resistance has made it difficult to locate programs in neighborhood settings.
Stigma magnifies all barriers to access.
In the light of newer, best knowledge community-based services are now challenged to serve people who, in increasing numbers, have needs that are far more complex than those served in the past. These roadblocks to mental health and substance abuse services stand in stark contrast to the high success rates of treatment. In recent years, a wide range of effective treatments for mental illness and substance use disorders has been developed. Even for serious mental illness, including major depression, schizophrenia and bipolar disorder, treatment related improvement occurs in 60 to 80 percent of clients served. Treatment works if it is available.