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In the past decade, four federal reports have offered insight into the nations mental health care system and recommended a fundamental transformation of the system. According to these reports, transformation of the mental health care system would require timely incorporation of evidence-based practices in routine practice, resolution of workforce shortage issues, removal of financial barriers, coordination of mental health care with general health and social services, and systematic measurement and improvement of the quality of care delivered. While each of these recommendations may result in some benefits, the findings suggest that a comprehensive transformation of the mental health system could be necessary to ensure the availability and accessibility of quality mental health care to all individuals who need it. In 2007 about 11% of adults (23.7 million) in the United States experienced serious psychological distress, such as anxiety and mood disorders, that resulted in functional impairment that impeded one or more major life activities. Different types of providers deliver care in a range of settings and are financed by various combinations of public and private payers. Congress has been increasingly interested in transforming the mental health system in the aftermath of tragedies involving mentally ill individualssuch as the shootings at ...