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October 2, 2013

Investing in Evidence-Based Care for the Severely Mentally Ill

Author Affiliations
  • 1New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York
  • 2NewYork-Presbyterian Hospital and Healthcare System, New York
JAMA. 2013;310(13):1345-1346. doi:10.1001/jama.2013.278065

When the Affordable Care Act (ACA) is fully implemented in 2019, it will have extended health insurance to nearly 4 million previously uninsured people with severe mental disorders.1 This expansion in health insurance, the largest in a generation, is arriving at a time when the nation's capacity to deliver mental health care is already under considerable strain; the number of individuals with unmet mental health service needs nearly doubled between 1997 and 2010.2 Implementation of the ACA will compound demands on the mental health management skills of primary care physicians and force more sparing and efficient use of mental health specialists. To meet the mental health care needs of newly insured individuals, health policy makers and clinicians need to leverage opportunities within the ACA to increase availability of well-established, but currently underutilized, evidence-based treatments for serious mental illnesses. Opportunities exist to extend the use of evidence-based interventions across a range of psychiatric disorders from the management of depression and anxiety disorders by primary care physicians to the care of bipolar disorder and schizophrenia by mental health specialists.