Remarks by
A. Kathryn Power, M.Ed.
Director
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
Community Anti-Drug Coalitions of America (CADCA)
National Leadership Forum XV
“CADCA and Coalitions: Champions for Change”
Washington, DC
January 12, 2005
Attached is the text prepared for delivery; however, some material may have
been added or omitted at the time of delivery.
CADCA AND COALITIONS: CHAMPIONS FOR CHANGE
Thank you for inviting me to participate in this forum. I always am pleased to meet with substance abuse prevention and treatment professionals, particularly when the topic under discussion is “coalitions for change.” When we consider a coalition that can help prevent drug use, we absolutely must consider a partnership between the mental health and drug prevention communities. This union recognizes the very real, very serious relationship between mental and substance use disorders. We will be more effective in preventing and treating drug use when we are more effective in preventing and treating mental illnesses, . . . and when we recognize their connectivity with one another and that recovery is achievable.
Mental and substance use disorders overlap to a dramatic degree. About 20 million American adults have a serious mental illness, such as chronic depression or bipolar disorder. These individuals are more than twice as likely to use illegal drugs as those without a mental illness. In fact, up to half of persons with a serious mental illness will develop a substance use disorder at some point in their lives.
The statistics are equally revealing from the opposite perspective. About 22 million Americans ages 12 and older have a substance use disorder. These individuals are almost three times as likely to have a mental illness as those without a substance abuse problem.
What these statistics make clear is this: Mental and substance use disorders are closely linked. We can’t say that one “causes” the other. However, we can say that persons who have either a mental illness or a substance use disorder are at high risk of developing both. Thus, particularly in an integrated, holistic approach, prevention and treatment of one becomes prevention of the other.
The prevalence of co-occurring disorders clearly signals a need for a behavioral health approach to prevention and treatment. A behavioral health approach sees individuals as whole people—it considers the individual’s unique set of risk and protective factors. It also recognizes that an addiction, similar to a mental illness, is caused by a complex interaction of psychological, biological, and environmental factors. It accepts that both mental and substance use disorders are very real illnesses—illnesses that often can be prevented and cured.
The behavioral health approach fits within an even larger approach to preventing drug use. That approach is the public health model. The public health model is based on the premise that it is better to promote health and prevent illness before an illness occurs. In terms of drug prevention, the public health model implies a continuum of behavioral health services. This continuum would include promotion and protection of mental health. It would continue through early intervention, treatment, and recovery from a mental or a substance use disorder. This continuum, in turn, implies that an entire community will work to protect its own health by protecting the health of its individual members.
Adoption of the public health model will require a major transformation in the way we work to prevent and treat mental and substance use disorders. I’m proud to say that the mental health community already has begun this process.
About a year ago, the Substance Abuse and Mental Health Services Administration accepted a charge from President Bush to transform our national mental health system. Our responsibility, with the Center for Mental Health Services as the lead agency, is to create a system that will be consumer driven and focused on recovery. Our roadmap for change is a report called Achieving the Promise: Transforming Mental Health Care in America. Copies of this report are available on the table by the entrance to this room or from SAMHSA.
The very first goal of mental health transformation is that Americans will recognize that mental health is essential to overall health. Sound mental health helps individuals build resilience to face life’s challenges. It protects individuals from developing problems such as drug use, and it can protect our communities from the staggering social costs associated with drug addiction and treatment.
Achieving the Promise lists six goals for a transformed mental health system. Please read through the report and then determine what CADCA and its members can do to help achieve its goals. Mental illnesses and substance use disorders are strongly related. Any progress we make to improve mental health care will result in better prevention and treatment of substance use. We must champion this belief. We must champion our cause for the good of all Americans. Together, we can be an incredibly powerful coalition for change. Thank you.
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