In Reply: Dr. McCreath raises important points that we wholly support. The establishment of a trusting, empathic relationship with a caregiver is essential to the success of any treatment and recovery plan and cannot be underestimated. Having a mental health home increases the likelihood of such a relationship because the client has an identified person and place as a starting point for developing a plan and as a "home base" for coordinating all subsequent services. Too often clients do not have a chance to form an effective treatment alliance because it is never clear whom the alliance should be with.
Dr. McCreath also correctly notes that advocacy alone will not solve all the problems inherent in large, fragmented public mental health systems of care. Support and funding for service resource management are a must, and as noted in our Open Forum, demonstration projects will be critical to establish the level and degree of support necessary to develop the model and improve coordination of services and outcomes. One example of a potentially effective approach is the program that Dr. McCreath describes in his letter. This is exactly what we endorse—small-scale, data-driven efforts to define and test system reorganization efforts that are developed with the mental health home model. Dr. McCreath's example is compelling and should serve as a model for other similar such efforts.