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ABSTRACT. This article explores the complexity of American mental health policy, noting that it results in a wide range of challenging and contentious policy questions that go beyond health policy and involve social welfare policy, disability policy, criminal justice policy, and more. The complexity arises from the heterogeneity of populations with mental and/or substance use disorders; the range of potentially useful interventions (including but not limited to treatment services); the diverse mix of public and private providers and funding sources; shifting responsibilities among federal, state, county, and municipal governments; and vituperatively competitive ideologies. The author maintains that even though the complexity makes it unlikely that there can be extensive transformation of mental health policy at this time, there are many ways in which the mental health system can be made better incrementally. He urges mental health advocates to unite to pursue an agenda of achievable improvements that they are all willing to support. pp. 170–181

Keywords: American mental health policy; systems improvement

How to cite: Friedman, Michael B. (2015), “The Complexity of American Mental Health Policy: Implications for Systems Improvement,” American Journal of Medical Research 2(2): 170–181.

Received 1 October 2015 • Received in revised form 17 October 2015
Accepted 17 October 2015 • Available online 22 October 2015

MICHAEL B. FRIEDMAN
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Columbia University School of Social Work

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