Introduction

Descriptions of the ideal mental health system contain certain common characteristics, which taken together, may be used to form a basis for a comprehensive program. According to these descriptions, an ideal system is:

· Integrated and collaborative.

· Preventive.

· Appropriate and comprehensive.

· Culturally competent.

· Outcomes oriented.

· Family centered.

· Cost effective.

An integrated system makes it easier for individuals and families to receive the help they need and ensures efficient use of providers' time and resources. A system that is fragmented is troublesome for those individuals or families who have multiple needs that are often related to each other in complex causal chains. No matter which aspect of the system they enter, they often find someone who can respond to only one piece of their problem.

An ideal system is geared toward preventing problems rather than reacting to them. A focus on prevention ensures that the need to provide intensive treatment and crisis-oriented services is balanced with an investment in preventive and early intervention services for individuals and families.

An appropriate and comprehensive service system provides a variety of opportunities and services to respond to the full range of individual and family needs. This service system works to help people develop activities which advance their talents, and allows them to pursue their interests and participate in community life. Services are not static; plans are responsive to functional status, age, and other individualized conditions.

Respect for cultural differences is reflected in system-wide policy and practice; this respect is evident in all levels of the system. Representatives from key cultural groups are consulted and invited to participate in policy-making, program planning, program administration, and service delivery. A number of elements have been identified as system characteristics that contribute to a system's ability to be responsive to cultural diversity. A system must:

· Value diversity;

· Have the capacity for cultural self-assessment;

· Understand the dynamics inherent when cultures interact; and

· Be able to use institutionalized cultural knowledge to enhance services.

If these elements are present at every level of the system, they contribute to a total system of care that is effective across cultures.

Measuring success by improved outcomes for individuals and families paves the way for more client-centered services. Service providers help families to set reasonable goals and share responsibility for attaining them. More sensible and fruitful outcome measures can be viewed as an accountability mechanism that affects the system at both the state and community levels. Outcomes need to be consumer oriented in addition to system oriented.

The service system must recognize that every family has strengths. As a result, individuals and families have a major voice in setting goals and deciding what services they need to meet those goals. Hours and location of services serve the individual's and family's needs rather than organizational preferences.