What will mental health care in the United States be like during the coming decade? Laurie Flynn, executive director of the National Alliance on Mental Illness in Arlington, Va.—a leading grass-roots advocacy organization dedicated to improving the lives of persons with severe mental illnesses—made some predictions at a February briefing in Washington, D.C.

Her remarks were in reaction to a report released at the same time by the Institute for the Future in Menlo Park, Calif., a nonprofit research firm specializing in cross-industry, long-term forecasting. The report is titled "Health and Health Care 2010."

Here are some of Flynn’s mental health care predictions:

• In the near term, it will be possible to treat severe depression more effectively than at present and perhaps reduce the rising suicide rate.

• Better-targeted treatment and a new generation of antipsychotic drugs will offer major hope for better outcomes for people with schizophrenia, which is the most frequent diagnosis among the nation’s homeless population.

• With sophisticated electronic imaging techniques that allow researchers to see into the living brain, scientists can discern areas of the brain that malfunction during specific illnesses and soon may be able to target treatments more effectively.

• Scientific advances will allow policymakers to set priorities between serious brain disorders and other mental health problems, such as stress. Health insurance parity laws in many states already make this distinction.

• Policymakers will demand greater accountability for hundreds of millions of dollars that now support a fragmented and inadequate public mental health care system. A new image of mental health will emerge, focusing on early recognition, effective treatment, rehabilitation, and recovery for most patients.

• The Internet is helping overcome the stigma of mental illness and will continue to do so. It preserves anonymity while providing information about treatment options, current research, screening tests, online question-and-answer sessions with practitioners, and "virtual" support groups.

As for the Institute for the Future report, it forecasts the future of health and health care from now until 2010 in eight key areas: legislative and regulatory issues, patient demographics and attitudes, health care costs, health plans and insurers, the structure of hospitals, provider organizations and the public health system, medical information technologies, and shifts in health behaviors and medical management.

Here are a few of the report’s predictions: By the year 2010, Americans will be living longer and will benefit from futuristic medical technologies including sensors and gene therapy; public health will likely remain underfunded and fragmented; and anywhere from 30 million to 65 million Americans will be uninsured depending on various factors, such as health care costs, whether large employers get price breaks from health plans, and whether many small employers drop insurance benefits altogether.

The 200-page "Health and Health Care 2010" report can be purchased for $24.95 from the publisher, Jossey Bass, by calling (800) 956-7739. The report can also be read online at the Web site of the Robert Wood Johnson Foundation, which funded the project, at <www.rwjf.org>.