. "1 The Quality Chasm in Health Care for Mental and Substance-Use Conditions." Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington, DC: The National Academies Press, 2006.
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Improving the Quality of Health Care for Mental and Substance-Use Conditions
… a person with mental illness can recover even though the illness is not “cured”…. [Recovery] is a way of living a satisfying, hopeful, and contributing life even with the limitations caused by illness.
Although a conceptual model of recovery from chronic M/SU illnesses is not yet fully developed (Onken et al., 2004), recovery as articulated in the Surgeon General’s report has been an accepted concept in use for over a century for individuals with alcohol-use problems and illnesses (White, 1998). More recently, recovery has become a widely accepted goal not just of mental health care (NAMI, 2005; New Freedom Commission on Mental Health, 2003), but of treatment for all individuals with M/SU problems and illnesses.
CONTINUING ADVANCES IN CARE AND TREATMENT ENABLE RECOVERY
The U.S. Surgeon General, the National Institutes of Health (NIH), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Institute of Medicine (IOM), and many others (DHHS, 1999; IOM, 1997) continue to document ongoing advances in our understanding of M/SU problems and illnesses. These advances include the development of efficacious psychotherapies, drug therapies, and psychosocial services, as well as strategies for delivering these treatments effectively. Dissemination of information on brain functioning—the interplay of genetic, environmental, biological, and psychosocial factors in brain function and M/SU illnesses; our ability throughout our lives to influence the structure and functioning of our brains through environmental and behavioral factors (our brains’ “plasticity”); and improved treatments—has helped educate consumers,5 the health care community, and the public at large about M/SU problems and illnesses and the effectiveness of care for these conditions. Now that NIH has made translation of bench science to clinical applications a high priority in its strategic plans for the coming years (NIMH, 2005; Zerhouni, 2003), society is poised to reap even greater returns from developments in such basic science fields as genetics, proteomics, neuro-
The committee notes that many different words are used to refer to individuals who are in need of or receive M/SU health care, including “patient,” “client,” “consumer,” “survivor,” “recipient,” “beneficiary,” and others. The committee respects the different perspectives represented by proponents of each of these terms. For convenience, we use the terms “patients,” “consumers,” and “clients” interchangeably in this report because of their widespread use by the public at large and within general and specialty health care systems. The use of these words is not intended to exclude the families of adults who, with the consent of the individual patient, can play an essential therapeutic role. With respect to children and adolescents, we always intend these words to include families and other informal caregivers.