This Web site is a component of the SAMHSA Health Information Network

This Site Mental Health at HHS All Mental Health

Children's Mental Health Consumer/Survivor National Strategy for Suicide Prevention School Violence Prevention Managing Anxiety Surgeon General's Reports What's New Mental Health at The Department of Health and Human Services Funding Information Calendar of Events Mental Health Links Mental Health Dictionary Español

printer friendly page e-mail this page bookmark this page shopping cart  current or new account

This Web site is a component of the SAMHSA Health Information Network.

Summary of Meeting

Ramada Inn, Rockville, MD
September 26 – 27, 1996
DAY ONE

Welcome

In opening remarks, Bernard S. Arons, M.D., then Director of the Center for Mental Health Services (CMHS), commented that although the meeting attendees understand that each of the 17 research, training, and technical assistance centers fulfills a compelling need, Congress does not. Congress is likely to ask CMHS to demonstrate how these numerous centers are meeting the field's needs, increasing collaboration, and reducing duplication of effort.

Individuals and organizations that benefit from CMHS research, training, technical assistance, and information center activities must be made aware, Arons said, that CMHS either developed or funded the knowledge and information they receive.

"Few in the field and even fewer in Congress know about the valuable work we are doing and our impact on the mental health system," Arons said. And "the bottom line is that this lack of awareness jeopardizes not only the future of CMHS, but the future of our programs and our activities - including the TA centers."

How the National Mental Health Information Center Can Better Serve the Research, Training, and TA Centers

An important step to increase collaboration, decrease duplication of effort, and get the word out about CMHS' important work, Arons emphasized, is to make the most efficient use of its information center resources, such as the Congressionally mandated SAMHSA's National Mental Health Information Center. Arons announced that all publications, reports, videos, and other items produced with CMHS support are to be made available through the Information Center. This policy change will:

• Maximize CMHS' limited resources;
  
• Allow TA Centers to focus on conducting research, training, and technical assistance;
  
• Reduce TA Centers' time "stuffing envelopes;"
  
• Provide customers better access to a broader, more comprehensive range of information;
  
• Educate policymakers and the field about the outstanding work CMHS supports; and
  
• Increase backing for CMHS and its work.

Arons challenged the TA Centers to aggressively pursue new, collaborative relationships among themselves - "relationships that place less emphasis on protecting turf and more emphasis on using resources more wisely."

Presentations by Research, Training, and Technical Assistance Centers

Representatives from the TA Centers and the Information Center described each project's mission. Following is a synopsis of their presentations:

• The National Mental Health Consumers' Self-Help Clearinghouse provides on-site consultation on issues such as managed care, fundraising, and service system improvement. One-quarter of its efforts go into information and referral services and library research. It conducts national conferences and is developing a World Wide Web site and Listserv (electronic mailing list).
  
  
• The National Resource Center on Homelessness and Mental Illness, operated by Policy Resource Associates, Inc., provides technical assistance and knowledge development to grantees of the CMHS Homeless Programs Branch. Its focus is in the areas of systems integration, housing, mental health services and other supports for homeless people who have serious mental illnesses. Activities include providing and arranging on-site consultation, conducting training institutes, responding to non-routine requests for substantive information, developing workshops on emerging issues in the field, and commissioning papers on related topics. New knowledge and information on homelessness and mental illness is disseminated through a period bulletin, Access; annotated bibliographies; a toll-free telephone number; a World Wide Web site; and a list of national organizations concerned with mental health, housing, and homelessness.
  
  
• The Boston Center for Psychosocial Rehabilitation is a link between the mental health field and the rehabilitation community. It uses NARIC (the clearinghouse on rehab information) to help reach a broad audience. The Center develops materials, conducts national conferences, and convenes workshops on issues such as employment intervention and wellness in mental health. It also publishes the journal Psychosocial Rehabilitation.
  
  
• The Research and Training Center for Children's Mental Health targets the gap between what is known and what is done - its challenge is to translate knowledge into action. It conducts longitudinal studies, evaluates managed care organizations, and provides leadership training.
  
  
• The Evaluation Center @HSRI is a "virtual" center; that is, it doesn't try to answer all the questions but instead provides referrals to evaluation experts. It has four key programs: consultation, which takes a case management approach to answering questions; evaluation using consumer evaluators; topical evaluations, including the various Toolkits; and training conferences/meetings. New programs focus on evaluating managed behavioral healthcare; multicultural issues and rural issues in mental health evaluation; and multi-site outcome data.
  
  
• The National Research Training Center on Psychiatric Disability is jointly funded by CMHS and the National Institute of Disability Research. It focuses its research on employment and rehabilitation, systems change, and service enhancement. It also develops culturally sensitive assessment tools. Its philosophy is KIS - Keep It Simple. It designs products that can be used without special training. Materials are free of charge, or for a nominal charge, and it provides free technical assistance over the phone. It already has collaborated with other TA Centers such as HSRI, the Psychosocial Rehabilitation Center, and the Self-Help Clearinghouse. It is developing manuals on topics such as training for consumers who want to lead HIV+ support groups, an outcome protocol for consumer-run services, and conflict resolution.
  
  
• The Center for Support of Mental Health Services in Isolated Rural Areas (Frontier) actually is a consortium that develops and synthesizes knowledge on mental health and substance abuse issues in isolated rural areas (fewer than seven people/square mile). Their work revolves around: what's going on, what's needed, what's being done, and what could improve. They share information on what's known through letters to the field, workshops, and telephone services.
  
  
• The National Resource Network on Child and Family Mental Health provides technical assistance to 22 grantees engaged in creating comprehensive, community-based, culturally appropriate services for children with SED and their families. It has three hubs - urban, rural, and small cities - with directors to assist the grantees. Primary funder is CMHS, with additional support from the Department of Education and National Center on Child Abuse and Neglect.
  
  
• The Advocacy Training and Technical Assistance Center (ATTAC) provides expertise and legal support for individual rights as well as to protection and advocacy (P&A) systems, and client services. The TA Center provides P&A services to any person with a disability, not just those with a mental disability. Another thrust is performance-based outcome measures. All services must be coordinated with its three funders: CMHS, the Administration on Developmental Disabilities and the Rehabilitation Services Administration.
  
  
• The Research and Training Center on Family Support and Children's Mental Health focuses on three activities: research, training, and dissemination. Research concentrates around family participation at the policy level as well as in services, family and out-of-home care, and professional education. Trainings revolve around issues such as family/professional collaboration, cultural competence, and promoting family participation. Dissemination efforts include a World Wide Web site, electronic bulletin board system, national conferences, and operating a national clearinghouse with a toll-free number for the Federation of Families. Its main challenge is to push current practice, which lags behind knowledge, and support change. Co-funded by NIDRR and CMHS.
  
  
• The Evaluation Center at Judge Baker's Children's Center is at the end of its 3-year contract. The project investigated three aspects of the children's mental health system: interagency involvement; systems change; and intense, integrated family involvement. It also focused on two knowledge issues: to broaden the perception of evaluation as an integral, developmental part of a program; and to develop capacity through workshops and training. The Center worked with program administrators to develop various technical assistance briefs and manuals, such as how to assess consumer satisfaction, fundraising for evaluation, and worksheets and critical reviews. It is completing a series of publications.
  
  
• Advocates for Human Potential provides technical assistance to the States and at the local level to PATH program grantees. This TA Center has nudged State and local providers to form networks. Creating this collaboration has been a challenge. But leadership from CMHS and the TA Center - as well as the convergence of massive changes in both policy and funding - have pushed States to work together. The TA Center has developed three curricula: strategic planning, outcome measures, and co-occurring disorders. It conducts site visits, training conferences, and an annual meeting.
  
  
• The National TA Center on Children's Mental Health primarily is involved in developing culturally competent and child/family-centered systems of care. To that end, it provides training and technical assistance, forges coalitions, fosters collaboration, and works to build consensus. Family involvement is through the Federation of Families. Its research center is involved in a healthcare tracking reform project and teasing apart the impact of managed care on systems of care. Its data resource bank includes best practices, materials/documents, and consultants.
  
  
• The National Empowerment Center is operated by and for consumer/survivors. Its main focus is to provide information about basic issues of survival - e.g. , jobs, paying for medicine, getting to and from the therapist. Another mission is to help consumers/survivors regain the "spirit that was wrung out of" them as a result of their experiences with the mental health system, notably hospitalization.
  
  
• The National Technical Assistance Center (NTAC) has four constituent groups: States, State Mental Health Planning Councils, consumers, and families. Planning is NTAC's primary activity. For example, it identifies innovative programs/practices and helps individual States adapt them, prepares States to respond to disasters, provides needs assessment, and conducts surveys. Among other activities, NTAC offers a consultant data base various publications and reports, and workshops.
  
  
• The National GAINS Center for People with Co-Occurring Disorders in the Justice System is operated by Policy Research, Inc. It is a national locus for the collection and dissemination of information about effective mental health and substance abuse services for people with co-occurring disorders who come in contact with the justice system. GAINS gathers information designed to influence the range and scope of mental health and substance abuse services in the justice system, tailors these materials to the specific needs of localities, and provides technical assistance to help them plan, implement, and operate appropriate, cost-effective programs.
  
  
• SAMHSA's National Mental Health Information Center was established by Congress to assure widespread dissemination of mental health information to States, educational agencies and institutions, treatment and prevention service providers, consumers and their families, and the general public. To that end, the Information Center has a toll-free telephone number, a Post Office box, a World Wide Web site, and an electronic bulletin board system. As a result, the Information Center has reached more than 54,000 people since it was started as a pilot project in 1995. In regard to assisting the TA Centers, the Information Center can provide a database of 2,000 mental health organizations, handle time-consuming inquiries from the general public, and offer direct mailing services. The Information Center can further promote the TA Centers through articles in the Information Center Bulletin, linking to their electronic pages at the Information Center Web site, and disseminating TA Center publications and materials in an organized and strategic fashion.

Consumers As Customers

Each of the three presenters hammered home the necessity to involve consumers in any mental health project, whether it's a publication or a change in policy. Representation is tokenism, they said. Consumers must be involved - and have a vote - at every step of the way.

Joe Rogers, Executive Director for Programs, National Mental Health Consumers' Self-Help Clearinghouse, described the consumer/survivor movement as a growing force that's entirely grassroots - there are no national offices or chapters. The Clearinghouse works with more than 500 groups. He urged planners to act on the fact that all products must involve consumers, not just during the review process but also to conceive and shape products. He reminded project directors that finding consumers should be easy through avenues such as the Clearinghouse directory. He also recommended that service providers help program and policy planners contact consumers. In addition, he asked that funding be shaped to include honoraria for consumers. Participation often means taking an unpaid vacation day, a hardship consumers can ill afford, Rogers said.

Laurie Ahern, Director of the National Empowerment Center, similarly urged all government mental health agencies - whether at the local, State, or Federal level - to involve consumers from the get-go. No one knows better what works, she said, than those who have been through the system. She also noted that consumers often are afraid of bureaucracy and have a hard time becoming engaged in services. She cited the work of consumer Jean Campbell, Ph.D., at the Missouri Institute of Mental Health: 47% of people who have been institutionalized are afraid to go back. Ahern recommended that all drop-in centers offer computer workstations with Internet access.

Sylvia Caras, guest speaker and owner of MADNESS, pointed out that her electronic mailing list has 300 subscribers in 10 countries and receives, on average, 80 messages a day. Addressing the issue of consumer involvement, she urged planners to ask consumers of mental health services three questions: What do you want? Did you like what you got? What should be done next and how would you like to participate? She also noted that the Information Center could do many things for consumers, such as training to improve media representation of people with serious mental illness, announce job listings as well as sample resumes, post success stories and information about reasonable accommodations under the ADA, explain HUD housing information, and model values that reflect respect for consumers. Emphasizing the last point, Caras said the Information Center needs to make consumers feel that "the customer is always right." She also noted that the Internet levels the playing field, but illiteracy prevents many consumers from getting the information they need. She recommended that community mental health centers make computers available to consumers between 5 p.m. and 6 a.m.

The panel discussion generated several dissemination and outreach ideas, including:

• A youth forum on the Information Center BBS
  
• A forum on the Information Center BBS for all TA Centers to engage in dialogue and brainstorm about where to put limited resources;
  
• A TA Center Listserv; and
  
• A Listserv for kids/teens.
  

Joe Rogers suggested that electronic capacity be viewed as an ADA access issue. He also noted that "Zines" (online magazines) are a viable form to disseminate information. In addition, he mentioned that people need to see and value a program before they will lobby Congress for support. Rogers brought up the issue of division of labor. The Clearinghouse wants to maintain its own constituency, he said, and the Information Center should disseminate information to Mr. and Mrs. America.

Deirdre Oakley, M.A., Homelessness Prevention Program Coordinator with the National Resource Center on Homelessness and Mental Illness, suggested that the Information Center could handle routine inquiries, whereas the TA Centers should handle those that require expertise. Reinforcing that perspective, Steve Leff, Ph.D., Director/Principal Investigator for the Center for Evaluation of Adult Mental Health Systems, commented that those who use the TA Centers have different needs, so it makes sense to have the Information Center staff network among the TA Centers and refer callers to the appropriate Center.

Continuing on the issue of access to information and who disseminates what, Quinn Rossander, a consumer in the audience, argued for duplication. He used the analogy of his grandmother who could never find her reading glasses, and as a consequence, missed out on a great deal of useful information. That is, until she came up with the simple solution of putting a pair of reading glasses in every room.

Lisa Swanberg, M.S.L.S., Project Director for the Information Center, reiterated the Information Center's ability to promote the TA Centers through activities such as the Information Center Bulletin and conferences. Speaking from the audience, Gary DeCarolis, M.Ed., CMHS Child, Adolescent & Family Services Branch Chief, suggested the Information Center produce a brochure highlighting just what the TA Centers do and distribute it widely.

Someone suggested conducting a survey of the TA Centers to create a directory that would describe each one's audience and materials. It could be used to pinpoint gaps and pick up on redundancy. Vicki Smith, M.A., Project Director for the Advocacy Training and Technical Assistance Center, argued that a survey wouldn't do the job because "a form can't pick up on values."

Another suggestion was to train the Information Center's information specialists to become "authorities" on particular TA Centers. Steve Leff countered that the information specialists really don't need to know much about the TA Centers. Focus should be on results - the TA Centers' most important/impressive accomplishments have been over the last six months to a year.

HHS INFORMATION DISSEMINATION AGENDA: USING THE INFOBAHN TO TRANSFER KNOWLEDGE

Mary Jo Deering, Ph.D., Director of Health Communication and Telehealth Staff, Office of Disease Prevention and Health Promotion, DHHS, reviewed ideas on how to arrange information in a non-categorical way so it can meet many needs.

Deering recommended that the 33 Federal information clearinghouses should be organized as "omni-directional, user-driven" resources. Although Federal Web sites are improving, she said, most so far have failed in this regard. Rather than being designed with the customer in mind, most were designed by someone within an agency, from an agency perspective. For example, Federal Web sites often feature an "organizational structure," something no one outside the agency is interested in. As a result, Federal Web sites often are referred to as "shovel ware."

Deering invited everyone to attend the "Partnerships for Networked Consumer Health Information" conference at the Georgetown University Conference Center, April 14 - 17, 1997. The conference will focus on topics such as new technology and applications, quality and effectiveness, implications for public health and managed care, trends in self-care and self-help, and policy and regulatory issues. For more information, FAX a request to 202-462-9043.