People with mental illness do not always seek treatment in the same way someone suffering from acute physical pain might. Sometimes they don't know where to turn for help, or perhaps they don't realize they need it. In fact, sometimes they actively avoid it. For this reason, providers of mental health services must be creative and opportunistic in their approach to some who are in need of treatment.

For many, the mental health system is invisible and unknown. A person who shows signs of a mental illness may have no idea where to call for information or treatment. More shockingly, family doctors and other professionals in the community may be unfamiliar with local mental health agencies. Mental health providers need to maintain and improve community contacts so that finding help is an easily navigated process. Referrals from other agencies - housing and homeless assistance agencies or substance abuse treatment and detox centers, for example - should be welcomed by mental health providers. Rather than apply rigorous screening so that all but a few are excluded from the system, mental health providers should actively seek out cases. To serve a community effectively, public mental health agencies should be as visible and active as any health care resource.

When the affected individual doesn't realize help is needed, a family member or someone else in the community may reach out to a provider agency. In such instances, the agency should be responsive. If the individual will not go to the agency's intake facility, outreach staff from the agency should visit the person wherever he or she is and, if appropriate, they should be able to access acute care hospital beds or crisis intervention services. Similarly, if the person is homeless or without apparent social support, agency staff should make efforts - repeated, if necessary - to engage him or her in a setting where that individual is most comfortable.

For outreach to be effective, it must be done in a culturally appropriate manner. Certainly, an outreach specialist must be able to use the individual's primary language. Yet, as has been increasingly understood throughout the mental health system, cultural competency involves the ability to listen to each individual and pick up cues that are culturally based. By meeting an individual's needs in a culturally sensitive manner, providers significantly increase the likelihood that that person will accept and continue services.