NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by multiple contracts and grants between the National Academy of Sciences and the Substance Abuse and Mental Health Services Administration (SAMHSA) of the Department of Health and Human Services (Contract No. 282-99-0045), the Robert Wood Johnson Foundation (Grant No. 048021), the Annie E. Casey Foundation (Grant No. 204.0236), the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism (Contract No. N01-OD-4-2139), the Veterans Health Administration (Contract No. DHHS 223-01-2460/TO21), and through a grant from the CIGNA Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the organizations and agencies that provided support for this project.

Library of Congress Cataloging-in-Publication Data

Institute of Medicine (U.S.). Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders.

Improving the quality of health care for mental and substance-use conditions / Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders, Board on Health Care Services.

p. ; cm.—(Quality chasm series)

Includes bibliographical references and index.

1. Substance abuse—Treatment. 2. Community mental health services. 3. Substance abuse—Patients—Services for. I. Title. II. Series.

[DNLM: 1. Mental Disorders—therapy. 2. Substance-Related Disorders—therapy. 3. Patient-Centered Care. 4. Quality of Health Care. WM 400 I59i 2006]

RC564.I47 2006

362.29—dc22

2005036202

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.