Apparently, some people do have an idea, and their name may surprise you: the City of Philadelphia.
The city has been making sweeping changes in how it deals with behavioral health, embracing grassroots recovery movements on a scale that outside experts say no other city has attempted.
The shift introduces a wellness model that has been absent from care for addiction: After an episode of treatment, a network of support will, in theory, help sustain recovery in the community. And for mentally ill people, the new approach encourages real-life goals - riding a bus alone, getting a job - that go beyond managing symptoms.
Saturday will be a coming out of sorts for the city's "recovery transformation": Philadelphia's Recovery Walk is the focus of more than 1,000 September rallies nationwide, and organizers predict 10,000 people here.
"I've been very impressed with what I've seen" in Philadelphia, said Gil Kerlikowske, director of the White House Office of National Drug Control Policy, who will be at the Penn's Landing kickoff. "I think there is a lot to learn from them." The drug czar said the new health law would support similar efforts nationally.
There are challenges in the transition. Reimbursement nationwide is still based on acute care, and providers worry about how they will get paid for recovery services - and whether lawmakers will use the self-help model as a reason to cut treatment funding. More peer specialists raises questions about their training and ethical boundaries.
"Evolution happens very imperfectly," said Mike Flaherty, executive director of the Pittsburgh-based Institute for Research, Education and Training in Addiction. But "this is not a fad. This is a change in the entire way we approach addiction in this country."
