In this Book


Few afflictions are as frightening or as heartbreaking as mental illness. It may be a topic that many would prefer to sweep under the rug, but it is a fact of life that we as a society can and must face. We have come a long way over the past few decades in our understanding of mental illness and its potential treatments. Yet, tragically, many across the country who struggle with serious mental illness are unable to find effective, quality medical treatment. As a federal commission on mental health concluded, the system of care is in shambles. But why? And how do we fix it?

Timothy A. Kelly, former Commissioner of Virginia's Department of Mental Health, Retardation, and Substance Abuse, brings his three decades of experience as mental health commissioner, psychology professor, and clinician to bear in confronting this crisis in America's mental health care system. In clear and accessible terms, he exposes the weaknesses in the current system, examining how and why one of the world's richest and most advanced countries has allowed its most vulnerable citizens to be victimized by the very system designed to help them.

Armed with the latest statistics, a lifetime of experience, and heartrending life stories, Kelly argues that the patchwork of care traditionally employed to treat mental illness is simply not up to the task, and that what we need is profound, fundamental, and system-wide change. He then goes on to provide an easy-to-follow road map for achieving lasting transformation, centered on five recommendations for creating a truly effective mental health system of care that enables patients to achieve a lasting recovery.

Mental illness is not going to just go away, but Kelly prescribes a comprehensive plan to make treatment accessible and effective so that those who suffer can rejoin their families and their communities. He shows how a transformed system of community-based care allows those with serious mental illness to finally be able to go home.

Table of Contents

  1. Contents
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  1. Acknowledgements
  2. p. ix
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  1. List of Abbreviations
  2. p. xi
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  1. 1. Men in Diapers: A System in Shambles
  2. pp. 1-33
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  1. 2. That Which Is Measured Improves
  2. pp. 35-64
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  1. 3. Monopolies Don’t Work
  2. pp. 65-89
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  1. 4. Fair Is Fair: Parity for Mental Health Coverage
  2. pp. 91-113
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  1. 5. Let the People Speak
  2. pp. 115-113
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  1. 6. Transforming America’s Mental Health System
  2. pp. 139-164
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  1. Postscript—Information on Mental Illness
  2. p. 165
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  1. Notes
  2. pp. 167-172
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  1. References
  2. pp. 173-179
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  1. Index
  2. pp. 181-192
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  1. About the Author
  2. p. 193
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