1- More than three-fourths of the elderly needing assistance is cared for by family members, many of whom also work outside the home. What implications does this have for employers? What types of employer policies might be appropriate regarding those engaged in providing long-term care for a family member?

2- Discuss: In what ways does assuring quality in the long-term care industry pose special challenges to regulators and consumers?

3- The value of informal long-term care provided by family members and friends is estimated at over $450 billion annually, more than double the national expenditures for skilled nursing and home care combined. Much of this cost would fall to government if it were not for this informal system. Would you support government assistance for informal caregivers, through mechanisms such as tax reduction incentives, or subsidy for respite care? Why or why not? If not, what alternative measures would you propose to help keep the informal system intact?

4- Shortages of health care personnel in the long-term care industry pose critical future challenges to the health care system. Review reasons for these shortages. Suggest government and institutional policy changes that might help attract more workers to this industry.

5- The recipients of mental health services in the U.S. represent only a small percentage of those in need of services. Discuss the factors that impede access to mental illness treatment.

6- In what ways did WWI and WWII affect awareness of mental health disorders among the federal government and the American public? With what results?

7- From colonial times through the 1960s, the primary mode of mental illness treatment was institutional. In the 1960s, mental health treatment shifted to a community-based orientation. What factors were responsible for this shift? What were the effects on patients and on the community?

8- As mental illness treatment shifted from the institutional to the community setting, public dollars were allocated on the basis of units of service delivered, not on results of care. Discuss the implications of this policy on the deinstitutionalized severely mentally ill.

9- The author states, "In contrast to widely held assumptions, mental disorders can now be diagnosed and treated as effectively as physical disorders." Identify and discuss factors that have contributed to the persistence of erroneous assumptions about mental illness treatment and identify and discuss factors that "allow mental disorders to be diagnosed and treated as effectively as physical disorders."

10- Research the topic: "Primary care practitioners' roles in treatment of mental illness." 1) Identify primary care practitioners' challenges in diagnosing mental illness in their patient populations; 2) Identify and discuss patient mental health management challenges for primary care practitioners; 3) Suggest recommendations to primary care practitioners for policy changes to support "Recovery-oriented Systems of Care."