At the broadest systems level, there are several possible national healthcare systems. Hypothetically, there might be a free-market approach to healthcare, in which there would be little or no government regulation. No country has implemented such a system, and even if it were possible, it is not clear that burnout risk to healthcare providers would be reduced. More familiarly, the socialized medicine approach is implemented in many parts of the world. Such a system, in which the government provides healthcare, free to the patient and paid for by taxes, has many well-known pros and cons. The hybrid system, as seen in the United States, combines elements of the free-market and the socialized medicine approaches, and also has its pros and cons. There is growing interest in so-called universal healthcare, which tilts the hybrid system a bit more in the direction of socialized medicine. As with the other national system options, there is no clear-cut impact on burnout with universal healthcare. At present, no existing national healthcare system is structured to reduce burnout among healthcare providers.

Burnout among physicians and other healthcare providers is a crisis of epic proportions, both in the United States and in other countries as well. Of the many negative outcomes of this stress-related syndrome – and there are many – medical error is especially troubling. Doctors and others who are experiencing the syndrome are more likely to make mistakes, which can be fatal. Potential solutions to reducing the risk of burnout include individual strategies for stress management, team-based strategies for mutual support, and profoundly impactful systems-based strategies at the level of the local organization and more broadly at the national/governmental levels. The adaptive improvement model (AIM) provides a simple, user-friendly structure for identifying burnout-reduction actions aimed at individual, team, or system levels. More broadly, capturing and learning from the lessons of the pandemic will help all of us be more resilient when that immediate crisis is finally past, and we are into the “next normal.”

The chapter will cover possible ways to ensure universal health access for people with psychosis, primarily through a comparison between the USA and Denmark healthcare systems. The chapter will discuss the utility of employing national clinical treatment guidelines, treatment rights, treatment packages, supervision, and fidelity rating when ensuring high quality treatment for psychosis. Denmark is one of many developed nations whose healthcare and sociopolitical contingencies support a completely different approach to psychosis compared to the USA. Incarceration, barriers to care, and health outcomes in the USA demonstrate an inarguably inadequate approach to psychosis. Based on the same evidence, other nations built imperfect but substantially more effective approaches. By illustrating a Scandinavian approach to psychosis and its successes and pitfalls, we highlight the feasibility of effective support and recovery for people with psychosis, as well as the necessity of long-term investments in citizens’ health and learning from successes and failures.