Greatest obstacles in the care of mental health in the U.S.A. are considered to be: 1) Fragmentation and gaps in the care of children with severe emotional disturbance, 2) Fragmentation and gaps in the care of adult patients, suffering from severe emotional disturbance, 3) high unemployment and the degree of work incapacity among adults suffering from severe mental disorders, 4) the fact that older patients with mental disorders are not treated, 5) mental health and prevention of suicide do not belong to national priorities. The committee considers the main goals to include: 1) the public understanding that mental health is a basic part of general health, 2) care of mental health should be family- and customer-oriented, 3) the unequal care of mental health should be eliminated, 4) early screening and evaluation should be extended into general practice, 5) research should be accelerated and fi rst-class health care should be delivered, 6) new technologies should be employed in the access to medical care and information. These observations are based on research whose effi ciency has been proved in practice. Studies of similar kind are rare in the Czech Republic. Moreover, in view of the system deformed by poorly paid physicians, nurses, psychologists and social workers, hospitalization is preferred against community forms of treatment, giving results which may cause worse care and consequent damage to the patients.

        Key words: New Freedom Commission, delivery of health care, institutionalization, integrated care.