If you need heart surgery, you don't want a surgeon who only got a C in medical school. The same principle applies in helping people with mental illnesses.

Access to treatment depends on access to information.

Getting help means getting access to information. When 40 states can't pass a pop quiz on providing basic information to the people whom they are supposed to serve, then the system is in trouble.

Treatment works, if you can get it, and if states get it right. Unfortunately, too many states are willing to risk or tolerate premature deaths.

Some good things are happening even in abysmal states.

Southeast Asia was home for much of my childhood, but I moved to Hawaii when I was in high school.