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By now it’s common knowledge that the often siloed, under-resourced American mental health system is bowing under the strain of the Covid-19 pandemic.1 Worse, the cracks that already existed in treating chronic mental illness before the global health crisis are threatening to become even more fractured at a time when the need for reliable, timely, and affordable mental healthcare has never been more urgent.

According to Mental Health America, the nation’s leading community-based nonprofit dedicated to addressing the needs of those living with mental illness, over 5.4 million people took their online mental health screen in 2021. This figure represents a nearly 500 percent increase over the number of people who completed a screening in 2019 and a 103 percent increase over 2020.

Recently, RAND Health Care, a division of the prestigious RAND Corporation, a nonprofit, nonpartisan research organization, published its findings on How to Transform the U.S. Mental Health System report. The study, sponsored by Otsuka America Pharmaceutical, Inc., a leader in mental healthcare, identified several, evidence-driven recommendations that need to be implemented across federal, state, and local levels of government.

Researchers examined the broad mental health system including the institutions that provide resources and delivery of care as well as social determinants of health such as homelessness, incarceration, unemployment, and education. Based on their insights, RAND articulated specific recommendations aimed at improving the U.S. health care system in three areas:

Area 1: Promote pathways to care

This includes promoting comprehensive mental health education, integrating behavioral health expertise into general health care settings, linking homeless individuals with mental illness to supportive housing, and developing a mental health diversion strategy centered on community behavioral health which can help to prevent our jails and prisons being the primary place of care for so many living with mental illness.

Area 2: Improve access to care

Recommendations include recognition that mental illness is a chronic disease. There is a need to strengthen mental health parity regulation and enforcement, reimburse evidence-based behavioral health treatments at their true cost, establish an evidence-based mental health crisis response system, and expand access to digital and telehealth services for mental health.

Area 3: Establish an evidence-based continuum of care

To enhance quality of care within the system, RAND recommends that decision-makers consider defining and institutionalizing a continuum of care in states and communities, launching a national care coordination initiative, and forming a learning collaborative for Medicaid behavioral health financing.

Finally, and perhaps the most critical, the evolved mental healthcare system must be designed to meet patients where they are with on-demand, real-time assistance. This type of innovative infrastructure won’t be easy to enact, and it will not be brought about by a single entity. True change will require tremendous collaboration among all key stakeholders affecting the system. Enormous financial resources and support from policymakers will be needed to equip and empower local communities nationwide to drive integrated, evidence-based mental healthcare in familiar settings.

To that end, Otsuka is committed to continuing to serve as a bridge-builder to bring together a coalition of people to discuss the pressing issues that impact outcomes for patients with serious mental illness and advance the actions needed to transform our health care system into a patient-centric one that responds first and foremost to their needs and respects the value of every mind.


1. American Hospital Association. TrendWatch: The Impacts of the COVID-19 Pandemic on Behavioral Health