GAPS in the Mental Health Care System


Increasingly, people are not getting the mental health care help they need. The mental health care system is overloaded, resulting in long wait times for appointments, or complicated systems of care that are difficult to understand. In some cases, there is nothing to offer a patient in need.

Major GAPS include:

—  Initial evaluation for diagnosis – develop new symptoms and wait up to 3-6 months to find out what’s happening or begin any treatment

—  Crisis wait 2 weeks to 6 months for an appointment, or go to the hospital

—  After hospitalization – released without clinic appointment, still cannot get an appointment for up to 3 months, and risk going back into crisis while waiting

Primary care doctors can start treatment, but many times mental health cases are complicated and require the involvement of a specialist with a months long wait.

Emergency rooms assess people in crisis and may recommend hospitalization, but they don’t prescribe treatments for the long term psychiatric needs of people who come in, so those who aren’t hospitalized often go home with no treatment at all.

Moving to a new community can cause a mental health crisis because it takes months to get an appointment with a new doctor in that community.

After an outburst or a meltdown at work or school, it can impossible to get timely assessment for safety to return to work/school.

Major life stressors can snowball into serious episodes of illness without early intervention.

People with chronic mental illness who fail to follow the complicated policies in the public mental health system may be thrown out of care, and have to start over from the beginning to get necessary treatment.

Those with severe mental illness often end up in jail for minor charges like trespassing when their untreated illness causes problem behavior.


These gaps have grown over time, and continue to worsen. If you’ve ever tried to find help for a loved one in a mental health crisis, it can be a nightmare. Creative solutions are being developed in communities:

            Jail diversion (people with illness are placed in monitored treatment instead of punishment when appropriate)

            “Integrated” mental health services into primary care (a mental health professional – often a counselor- is employed by a primary care group to offer counseling and advise primary care doctors and staff on complicated mental health issues in their patients)

            Crisis clinics (assess people in crisis, and may provide short term observation as well as start care by providing prescription medication)

            Walk-in mental health clinics (allow patients who need mental health care to start care immediately, and then refer to regular systems of care with longer wait times)


Posted on September 3, 2018 .