Introduction to the special issue on psychotherapy, the affordable care act, and mental health parity: obstacles to implementation.

Abstract

The articles in this Special Issue of Psychodynamic Psychiatry were written by members of The Committee on Psychotherapy of the Group for the Advancement of Psychiatry. Susan Lazar, M.D. is past Chair of The Committee; Frank Yeomans, M.D. is current Chair. The Group for the Advancement of Psychiatry (GAP) was created by the American Psychiatric Association shortly after WWII. It is organized in committees whose function is to publish articles and monographs on issues of contemporary interest. Psychodynamic Psychiatry is pleased to publish this Special Issue which is of substantial psychiatric and public health relevance. The journal staff commends the GAP Committee on Psychotherapy for calling attention to an area that requires sustained attention and action from the mental health community. Despite progressive legislation serious problems in psychiatric care delivery remain unsolved. These are systematically discussed in this Special Issue of Psychodynamic Psychiatry. America has a crisis in mental health care. Psychological difficulties are common and often reach clinical proportions. For example, in a definitive investigation, a representative sample of 9,282 Americans was interviewed to ascertain the lifetime prevalence and age of onset of DSM-IV psychiatric disorders. The investigators found that about 50% of the population met criteria for a psychiatric disorder sometime in their lives. The first onset of the disorder was usually during childhood or adolescence (Kessler, Berglund, Denker et al., 2005). In any given year approximately 57.7 million people suffer from mental disorders. These are severe, chronic, and/or recurrent and often coexist with other mental and physical disorders in about 15% of the population (Green, McLaughlin, Berglund et al., 2010; Kim-Cohen, Caspit, Moffit et al., 2003). Mental disorders are the leading cause of disability