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Published Online: 23 May 2022

A New Agenda for Optimizing Investments in Community Mental Health and Reducing Disparities

Publication: American Journal of Psychiatry

Abstract

The Biden-Harris Administration’s FY22 budget includes $1.6 billion for the Community Mental Health Services Block Grant program, more than double the FY21 allocation, given the rising mental health crises observed across the nation. This is timely since there have been two interrelated paradigm shifts: one giving attention to the role of the environmental context as central in mental health outcomes, the other moving upstream to earlier mental health interventions at the community level rather than only at the individual level. An opportunity to reimagine and redesign the agenda of mental health research and service delivery with marginalized communities opens the door to more community-based care interventions. This involves establishing multisector partnerships to address the social and psychological needs that can be addressed at the community level rather than the clinical level. This will require a shift in training, delivery systems, and reimbursement models. The authors describe the scientific evidence justifying these programs and elaborate on opportunities to target investments in community mental health that can reduce disparities and improve well-being for all. They select levers where there is some evidence that such approaches matter substantially, are modifiable, and advance the science and public policy practice. They conclude with specific recommendations and the logistical steps needed to support this transformational shift.

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Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 402 - 416
PubMed: 35599537

History

Received: 1 October 2021
Revision received: 17 January 2022
Revision received: 2 March 2022
Revision received: 29 March 2022
Accepted: 7 April 2022
Published online: 23 May 2022
Published in print: June 2022

Keywords

  1. Environmental Risk Factors
  2. Mental Health Care/Service Delivery Systems
  3. Minority Issues and Cross-Cultural Psychiatry
  4. Community Integration and Recovery-Oriented Care

Authors

Details

Margarita Alegría, Ph.D. [email protected]
Disparities Research Unit, Massachusetts General Hospital, Boston (Alegría, Zhen-Duan, O’Malley); Department of Medicine (Alegría, Zhen-Duan) and Department of Psychiatry (Alegría), Harvard Medical School, Boston; Department of Psychology, Florida International University, Miami (DiMarzio).
Jenny Zhen-Duan, Ph.D.
Disparities Research Unit, Massachusetts General Hospital, Boston (Alegría, Zhen-Duan, O’Malley); Department of Medicine (Alegría, Zhen-Duan) and Department of Psychiatry (Alegría), Harvard Medical School, Boston; Department of Psychology, Florida International University, Miami (DiMarzio).
Isabel Shaheen O’Malley, B.A.
Disparities Research Unit, Massachusetts General Hospital, Boston (Alegría, Zhen-Duan, O’Malley); Department of Medicine (Alegría, Zhen-Duan) and Department of Psychiatry (Alegría), Harvard Medical School, Boston; Department of Psychology, Florida International University, Miami (DiMarzio).
Karissa DiMarzio, M.S.
Disparities Research Unit, Massachusetts General Hospital, Boston (Alegría, Zhen-Duan, O’Malley); Department of Medicine (Alegría, Zhen-Duan) and Department of Psychiatry (Alegría), Harvard Medical School, Boston; Department of Psychology, Florida International University, Miami (DiMarzio).

Notes

Send correspondence to Dr. Alegría ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

Supported by the National Institute on Minority Health and Health Disparities (grant R01MD014737-02; Drs. Alegría and Zhen-Duan), the National Institute of Drug Abuse (grant R25DA035692; Dr. Zhen-Duan), the National Institute of Alcohol Abuse and Alcoholism (grant K08AA029150; Dr. Zhen-Duan), and the National Institute of Child Health and Human Development (grant F31 HD106768; Ms. DiMarzio).

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