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Mental Health System Reform

RESOLVED, That the North Carolina Medical Society supports state and local mental health care system reforms that include appropriate program requirements for ongoing monitoring of patients’ clinical outcomes and adequate physician input to ensure the provision of high-quality public mental health care; and be it further

RESOLVED, That the North Carolina Medical Society supports the inclusion of the following general principles in any mental health system reform effort:

  1. Every individual with psychiatric symptoms has the right to a comprehensive evaluation and an accurate diagnosis, which leads to an appropriate, individualized plan of treatment.
  2. Mental health care should be patient- and family-centered, community-based, culturally sensitive, and easily accessible without discriminatory administrative or financial barriers or obstacles.
  3. Mental health care should be readily available for patients of all ages, with particular attention to the specialized needs of children, adolescents, and the elderly. Unmet needs of ethnic and racial minorities require urgent action.
  4. Access to mental health care should be provided across numerous settings, including the workplace, schools, and correctional facilities. An emphasis should also be placed on the early recognition and treatment of mental illness.
  5. Patients deserve to be treated with dignity and respect. They are entitled to choose their own physicians or community-based agencies and to make decisions regarding their care. When they are incapable of making these decisions, they should receive the treatment they need and when able, they should choose future care.
  6. Patients deserve to receive care in the least restrictive, community-based setting possible that encourages maximum independence with access to a continuum of clinical services, including emergency/crisis, acute inpatient, outpatient, intermediate level, and long-term residential programs.
  7. Since mental illness and substance abuse occur together so frequently, mental health care should be fully integrated with the treatment of substance use disorders, primary care and other general medical services.
  8. Research must expand into the etiology and prevention of mental illness and into the ongoing development of safe and effective treatment interventions.
  9. Efforts must be intensified to combat and overcome the stigma historically associated with mental illness through enhanced public understanding and awareness.
  10. Health benefits, access to effective services, and utilization management must be the same for people with mental illness as for other medical illnesses, preferably funded by integrated financing systems.
  11. Funding for care should be commensurate with the level of disability caused by a psychiatric illness.
  12. Mental health treatment plans should include a cooperative relationship and communication between a patient’s mental health and other health professional(s) to ensure the patient receives ongoing, appropriate treatment; and be it further

RESOLVED, That the North Carolina Medical Society supports sufficient allocation of resources to training an adequate supply of psychiatrists, especially child psychiatrists, to meet the current and future needs of the population.

(Substitute Resolution 6-2003, adopted 11/16/03)
(revised, Report R-2007, Item 3-28, adopted 10/21/2007)
(reaffirmed, Report F-2012, Item 3-43, adopted 10/27/2012)
(technical corrections, Board Report-2018, Item 59, adopted 11/3/2018)