Community Support Programs Branch

History

The Community Support Programs (CSP) was initiated in 1977 as a Federal response to the problems of deinstitutionalization and inadequate community treatment and support services for individuals with serious mental illness. Highlights of the 30 year CSP history include:

Helping states and communities move resources from institutions to the community;
Establishing community support systems (a network of services and supports focusing on empowerment and leading to recovery);
Promoting the concept of a learning community that has served as a model for other Federal, state, and community initiatives;
Collaborating with other Federal agencies to affect knowledge dissemination and systems change;
Establishing the first peer-run national conference for consumers and the first self-help technical assistance centers run by peers;
Leading the development and application of new knowledge about service systems improvements; and by
Facilitating the implementation of best practices through consensus building and infrastructure development.

Community Support System (CSS)

A key component to the CSP approach is the concept of a community support system (CSS) which recognizes that traditional mental health services are not enough and that services such as housing, income maintenance, medical care, and rehabilitation are also essential. The CSP ideology included the CSS as the approach but further represented a philosophy about the way that services should be delivered. This ideology recognized that people with mental illness were people with basic human needs, rights, privileges, and opportunities. The CSP philosophy emphasized consumer self-determination and normalized services and settings. It recognized that services should be consumer-centered, flexible, and empowering.

Learning Community Conferences (LCCs)

The Community Support Program as reflected in the work of the CSP Branch originally focused on building networks at national, state, and local levels. A series of national learning community conferences (LCCs) helped to organize and nourish the networks. The CSP Branch also helped support the development of a national advocacy organization of families that ultimately became the National Alliance for the Mentally Ill (recently changed to the National Alliance on Mental Illness). Mental health consumers became involved in national LCCs, regional CSP conferences, and, then, in their own national conference (Alternatives) starting in 1985.

The earliest CSP Branch funding efforts were contracts with state agencies either to:

Demonstrate innovative community support and rehabilitation programs, or
Implement strategies to change state mental health systems to embrace rehabilitation and community support efforts.

These efforts were followed by a series of modest 5-year grants to states focused on systems change. Most of these grants were funded at less than $300,000 per year. By 1985, all the states, the District of Columbia, Puerto Rico, and the Virgin Islands had received CSP grants.

Rehabilitation Research and Training Centers (RRTCs)

Since it’s inception, the Community Support Program has fostered collaboration with a number of Federal agencies to focus their attention on individuals with psychiatric disabilities. A Memorandum of Agreement between the National Institute of Mental Health and the Rehabilitation Services Administration (RSA) was begun in 1979. It continues today in the form of an agreement between the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Center for Mental Health Services (CMHS) and the National Institute on Disability and Rehabilitation Research (NIDRR). It is under this agreement that the CSP Branch collaborates with NIDRR to co-fund two Rehabilitation Research and Training Centers (RRTCs) focused on psychiatric disabilities.

Demonstration Programs

During the late 1980s, the CSP Branch launched demonstration grants focused on:

Individuals who were homeless and mentally ill,
Older adults with mental illness problems, and
Individuals with co-occurring mental illness and substance abuse disorders.

These were the first demonstration grants ever initiated by the Federal government in these areas. Demonstration grants were also initiated addressing psychosocial rehabilitation, assertive community treatment, and crisis intervention programs. At about the same time a special grant program was started that provided support to statewide consumer and family groups. All of these efforts were conducted through grants to state mental health agencies.

Technical Assistance Centers (TACs)

In the 1990s, the CSP Branch continued to assist consumers and families to develop effective organizations and participate in state planning and policymaking activities. These activities were done through grants that were awarded directly to these organizations. The CSP Branch also provided the first funding for consumer-run technical assistance centers (TACs) to help consumer groups across the country with self-help efforts and to promote alternative consumer-run services.

Knowledge Development and Application (KDA)

From the late 1990s to 2001, a major focus of the CSP Branch was on knowledge development and application (KDA). Under the KDA initiative the CSP Branch was able to integrate much of the knowledge gained about changing practice into a series of multisite studies to test the effectiveness of important programs and practices affecting adults with serious mental illnesses.

These studies concentrated on the following:

Supported employment programs,
Services for older adults
Jail diversion programs,
Managed care initiatives, and
Consumer-operated service programs.

Lessons learned from the KDA programs led to developing a number of evidence-based toolkits that are widely used around the nation. It also led to targeted capacity expansion (TCE) grant program initiatives. These initiatives focused on providing services for older adults with emotional, mental health, and substance use problems and diverting individuals with mental illness and substance abuse from jail. These programs continue today.

Community Action Grants (CAGs)

A very successful CSP Branch initiative during 1999-2004 was the Community Action Grant (CAG) program. CAGs provided organizational sponsors (mental health associations, Alliance for the Mentally Ill groups, consumer groups, states, communities, and others) with the opportunity to lead the implementation process for a best practice. The grants focused on consensus building and infrastructure development (Phase I) and help with implementation (Phase II). There were 132 CAGs awarded during the life of the program. Many of these resulted in implementing emerging, best, and evidence-based practices.

As the Community Support Program and the CSP Branch celebrates its 30th year as a Federal initiative, it continues to take on the challenge of systems change focused on recovery. Many of these efforts are now carried out through the Mental Health Transformation State Incentive Grant (MHT SIG) Program — CMHS’s flagship program. Information on the MHT SIG and other current CSP Branch initiatives can be found on this web site.