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  • People with disabilities, such as individuals who are deaf, hard of hearing, or blind, who use wheelchairs, or who have had traumatic brain injury, frequently lack access to care that is appropriate.

  • Individuals who have child care responsibilities, most of whom are women, often have barriers to participating in treatment.

  • Individuals who have co-occurring substance abuse and mental health problems need coordinated care to maintain their recovery.


5.1 Research is needed to identify incentives for plans to serve vulnerable populations. The Substance Abuse and Mental Health Services Administration (SAMHSA) should work with other federal agencies to develop a plan to conduct such research.

5.2 Plans that serve distinct populations should measure and evaluate the needs of those groups through reviews of research literature, consumer surveys, and other appropriate mechanisms.

5.3 All plans should meet the same core standards. Supplemental standards can be developed for special populations, whether they are in stand-alone programs or in mainstream plans, for example, for a child of an employed person with family coverage.


  • Health services research stimulates collaboration among providers, researchers, and managed care organizations and can facilitate the development of valid and useful measures of treatment processes and outcomes through such collaborations.

  • Research and practice interact too infrequently, and few incentives exist for collaboration among researchers, practitioners, and policymakers.

  • Outcomes research is often unresponsive to emerging problems in clinical practice and also rarely provides direction for accreditation and quality improvement efforts.

  • The federal government plays a key role in the support of health services research and thus in the development of the necessary knowledge base for improving the quality of behavioral health care.

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