U.S. mental health care needs an overhaul, argues former NIMH ...

For over a decade, psychiatrist and neuroscientist Dr. Thomas Insel headed the National Institute of Mental Health and directed billions of dollars into research on neuroscience and the genetic underpinnings of mental illnesses."Our efforts were largely to say, 'How can we understand mental disorders as brain disorders, and how can we develop better tools for diagnosis and treatment?'" Insel said in an interview with NPR. I think we've got to understand why it is that we've been able to do so well on the science [front] and so poorly on the delivery of care for the 14.2 million people with serious mental illness in this country. But most of the time when you talk about treatments, people immediately get into a conversation about medication. There are extraordinarily important forms of rehabilitative care, like housing support and supportive employment [and] education, things that help people to get a life.So I was talking to a psychiatrist who works on Skid Row in Los Angeles, and he said, "You know, we really need to be thinking about recovery, not just acute care here." And I said, "So what is that? Of the many things I think we don't understand about people with serious mental illness, we don't fully appreciate how loneliness is such a major part. And so the beauty of programs like Fountain House [a social club for people with mental illness] is that it begins to give them that opportunity to to regrow that social capital and create connections.The way I've come to think about it more and more is that if you're a runner and you break your leg, you need that acute medical care to get the leg repaired, but it takes you months of hard work to get back to running again. That means hopefully not jail [or] a medical surgical emergency room where we now have this crisis of people being boarded for many, many days at a time with mental health problems.