This new report examines those differences, finds that the Quality Chasm framework can be applied to health care for mental and substance-use conditions, and describes a multifaceted and comprehensive strategy for doing so and thereby ensuring that:

  • Individual patient preferences, needs, and values prevail in the face of residual stigma, discrimination, and coercion into treatment.

  • The necessary infrastructure exists to produce scientific evidence more quickly and promote its application in patient care.

  • Multiple providers’ care of the same patient is coordinated.

  • Emerging information technology related to health care benefits people with mental or substance-use problems and illnesses.

  • The health care workforce has the education, training, and capacity to deliver high-quality care for mental and substance-use conditions.

  • Government programs, employers, and other group purchasers of health care for mental and substance-use conditions use their dollars in ways that support the delivery of high-quality care.

  • Research funds are used to support studies that have direct clinical and policy relevance and that are focused on discovering and testing therapeutic advances.

The strategy addresses issues pertaining to health care for both mental and substance-use conditions and the essential role of health care for both conditions in improving overall health and health care. In so doing, it details the actions required to achieve those ends—actions required of clinicians; health care organizations; health plans; purchasers; state, local, and federal governments; and all parties involved in health care for mental and substance-use conditions.


Each year, more than 33 million Americans use health care services for their mental problems and illnesses1 or conditions resulting from their use


Whenever possible, this report uses the words “problems” and illnesses,” as opposed to “disorders,” for reasons explained in the full report. Nonetheless, the word “disorder” appears often in this report because it is used so frequently in the literature. Collectively, this report refers to problems and illnesses as “conditions.”

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