In reviewing the literature on how people end up in acute systems of care, the primary issues that prevent individuals from seeking mental health treatment are uniformly listed as stigma, and access.Why then does it make any sense to put independent assessments in place that increase the stigma of seeking mental health treatment by forcing consumers to go into community service boards while simultaneously decreasing their access to mental health services by only providing specific appointment times and disqualifying more consumers than they approve? It seems at this point in time that Virginia pays four people to assess the needs of one client. The early assessment comes from school personnel, primary care physicians, psychiatrists, and family members who all indicate that there is a problem that needs to be addressed. Then the consumers are forced to go through an independent assessment,with the assumption that they will be accurate reporters, and have procured all of the requisite documentation for service authorization including psychiatric records, school reports, and failed interventions from other mental health providers. Following the independent assessment, the community-based provider has to assess the client to determine service eligibility,collect histories from all respective parties, and accurately diagnose; and then finally provide all of that information to Magellan for a clinical review and service authorization. While I agree with most of the previous comments from my colleagues, and am grateful to count them among the private providers trying to make a difference in Virginia,I think it is also important to pause and re-evaluate how we're are reinforcing the barriers into systems of care.