North Carolina is facing a very big mental health care challenge — 28 counties across the state do not have a single psychiatrist. That's despite the fact that in recent years, emergency rooms in the state have seen more patients with mental health, developmental disability or substance abuse problems.
Cook County, Ill., Sheriff Tom Dart walks the halls of his jail every day. With 10,000 inmates, this place is a small city — except a third of the people here are mentally ill.
Dart has created some of the most innovative programs in the country to handle mentally ill inmates, hiring doctors and psychologists, and training staff. But if you ask anyone here, even this jail is barely managing.
"I can't conceive of anything more ridiculously stupid by government than to do what we're doing right now," Dart says.
The Obama administration delivered on a long-delayed health care promise when it issued rules to ensure equal health insurance treatment for people who have problems with mental health or need treatment for substance abuse.
The rules, issued Friday, require that most health insurance plans offer the same amount of coverage for mental health and substance abuse claims as they do for medical and surgical coverage.
In the corporate world of American health care, psychologists and other mental health therapists are still mostly mom-and-pop shops. They build their own solo practices, not unlike Lucy in the Peanuts comic strip gang who hung her own shingle: "Psychiatric Help, 5 [Cents] — The Doctor Is In."