Crossing the Quality Chasm: Reforming Behavioral Health Services Through Community Collaborations

Recent reports, including the Institute of Medicine's (IOM) Crossing the Quality Chasm [1] and the President's New Freedom Commission's (NFC) Achieving the Promise: Transforming Mental Health in America [2], raise serious concerns about the state of health and mental health-care delivery systems in the United States. Both reports call not just for systems reform but instead for a more profound transformation. Although the IOM report brings forward a renewed definition of health care quality that includes six core aims and ten operational rules and the NFC identifies mental health system change goals, neither report lays out a clear and direct strategy for effecting large systems change.