title: Convergence of service, policy, and science toward consumer-driven mental health care.
abstract: BACKGROUND
  A common theme is emerging in sentinel reports on the United States health care system. Consumer relevance and demands on service systems and practices are influencing how mental health care is delivered and how systems will be shaped in the future.
  
  
  OBJECTIVE
  The present report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions.
  
  
  METHODS
  The report reviews the relevant public mental health policy and data used in published work.
  
  
  RESULTS
  The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to wide-spread redesign of a consumer-centered mental health care system. Innovative consumer-driven practices are increasing as quality, choice, and self-determination become integral parts of a redesigned U.S. mental health care system.
  
  
  CONCLUSIONS
  The use of consumer-driven approaches in mental health is limited at best. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-directed programs.
  
  
  CONCLUSIONS
  Consumer-driven services indicate that mental health consumers are expecting to be more participative in their mental health care. This expectation will influence how traditional mental health services and providers become more consumer-centric and meet the demand.
  
  
  CONCLUSIONS
  Public and private interest in consumer-driven health care range from creating cost-conscious consumers to individualized control of recovery. The health care sector should seek to invest more resources in the provision of consumer-driven health care programs. The results of this study have implications and are informative for other countries where consumer-directed care is delivered in either the private or public health care systems.
  
  
  CONCLUSIONS
  More research is needed to obtain further evidence on the use of consumer-driven services and their overall effectiveness.
authors.affiliation: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Washington, DC, USA. Christopher.carroll@samhsa.hhs.gov
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Carroll
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Manderscheid
authors.forename: Allen S
authors.initials: AS
authors.lastname: Daniels
authors.forename: Amelia
authors.initials: A
authors.lastname: Compagni
mesh_terms: D003256:Community Participation; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D011050:Policy Making; D014481:United States