Psychiatric Crisis Care and the More is Less Paradox

Community Ment Health J. 2021 Oct;57(7):1230-1236. doi: 10.1007/s10597-021-00829-2. Epub 2021 May 15.

Abstract

Psychiatric crisis care in the U.S. exemplifies the "more is less paradox" of U.S. health care. We spend more for health care than any other high-income country, yet our outcomes are typically poor compared to these other countries (OECD in OECD health statistics. Retrieved from https://www.oced.org/health/health-data.html , 2020). We do this, in part, by emphasizing medical treatments for problems that are inherently social, rather than addressing social determinants of health. Medical interventions for socio-economic problems are usually expensive and ineffective. For mental health crisis care, adding unfunded, untested, medical interventions to the current mélange of poorly funded, disorganized arrangements will not help. Instead, the U.S. should address social determinants, emphasize research-based interventions, and emphasize prevention-proven strategies that decrease costs and improve outcomes.

Keywords: Crisis care; Evidence-based practices; Mental health services; Prevention.

MeSH terms

  • Delivery of Health Care*
  • Humans
  • Income*