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
An Update on Mental Health System Transformation
Meeting of the CMHS National Advisory Council
Rockville, MD
February 16, 2005
PowerPoint version
Attached is the text prepared for delivery; however, some material may have been added or omitted at the time of delivery.
[SLIDE 1. Title slide]
An Update on Mental Health System Transformation
Meeting of the CMHS National Advisory Council
[SLIDE 2. Leading the Change]
We have begun the process of transforming the Nation’s mental health care system through direct and deliberate efforts to leverage Federal resources and programs.
[SLIDE 3. Goal 1]
CMHS Activities
National Anti-Stigma Campaign
- Initiated the National Anti-Stigma Campaign in October 2004 to increase public awareness, promote recovery, and encourage help-seeking behavior across the age span. Campaign will include a wide range of national media.
Elimination of Barriers Initiative (EBI)
- Eight pilot States have developed strategic marketing plans for disseminating anti-stigma messages to the public. The States have also recruited and trained teams of public speakers to give anti-stigma/anti-discrimination presentations.
- Developed and distributed bilingual print materials, training curricula, and television and radio public service announcements.
ADS Center
- Held 11 training teleconferences on stigma reduction.
[SLIDE 4. Goal 1, cont.]
CMHS Activities
The National Strategy for Suicide Prevention
- Collaborating with Federal partners to develop the framework for the National Action Alliance for Suicide Prevention.
- Through the Suicide Prevention Resource Center, facilitating the development of suicide prevention plans in all 50 States. Held two regional conferences to assist States in suicide prevention planning.
- Finalized an interagency agreement with the Indian Health Service to fund the development of a culturally competent, community suicide prevention toolkit for use in the American Indian/Alaska Native (AI/AN) community.
[SLIDE 5. Goal 1, cont.]
CMHS Activities
Strengthening Medicaid's Role in Mental Health Care
- Compiled comprehensive statistics on Medicaid mental health services for all 50 States.
- Developed profiles of Medicaid mental health services in all State Medicaid programs, including managed care.
- Created technical assistance papers that publicize examples of best and promising State practices.
- Conducted a national study of how States administer the Pre-admission Screening and Resident Review (PASRR) program.
- Developed and assessed a State program to improve the maintenance and availability of Medicaid eligibility for institutional residents returning to the community.
- Sponsored the October 2004 Invitational Conference on Medicaid and Mental Health Services.
[SLIDE 6. Goal 2]
CMHS Activities
Systems of Care, Individualized Plans
- Organized four symposia and three trainings on implementing local systems of care, as well as a national System of Care Research Conference focused on the role of systems of care in transformation.
- Convened the fourth policy academy to help States design and implement new child mental health policies.
Individualized Recovery Planning for All
- Convened a national consensus conference on recovery in December 2004 to develop a uniform definition of recovery and a strategic plan on how this definition can be applied in policy and practice.
[SLIDE 7. Goal 2, cont.]
CMHS Activities
Consumer-Operated and Peer Support Services
- Established five national technical assistance centers to give help and advice to peer-operated services.
- Publishing self-help guides to recovery, a manual for States on implementing peer support specialist services in their State mental health systems, and a training guide that identifies self-help skills and strategies.
The Consumer Direction Initiative
- Convened the Consumer Direction Initiative Summit where consumers and other stakeholders developed recommendations for a SAMHSA action plan for a more consumer-directed approach in behavioral health care services.
Documenting Recovery
- Supported development and distribution of Inside Outside: Building a Meaningful Life After the Hospital—a film that tells the stories of eight individuals who made the transition from psychiatric hospitals or nursing homes to successful community living.
[SLIDE 8. Goal 2, cont.]
CMHS Activities
Community Mental Health Services Block Grants
- For the first time, included 10 National Outcome Measures in the block grant application guidance and instructions for FY 2005-2007. Accountability will now be measured by the outcomes of services as determined by the collection of standardized data from the States.
Diversion from the Criminal Justice System
Alternatives to Restraint and Seclusion
- Pilot tested a seclusion and restraint training manual in two psychiatric hospitals in Connecticut and Nebraska. This publication will be ready for distribution and use in early 2005.
- Supported a State Incentive Grant program to address the reduction and elimination of seclusion and restraint.
[SLIDE 9. Goal 3]
CMHS Activities
Workforce Development
- Supported four grantees in the third year of the Workforce Training Grants to Reduce Racial and Ethnic Disparities in Mental Health Services program in implementing and evaluating new training programs for providers who serve Asian American and Pacific Islander, Latino, African American, and other ethnic minority populations.
- Expanded the National SAMHSA Minority Fellowship Program to increase the number of fellows, the amount of their stipends, and the breadth of their training to cover mental health and substance abuse (including co-occurring disorders).
Mental Health HIV Services Collaborative Program
- Expanded HIV/AIDS-related mental health services to 20 African American, Hispanic/Latino, and other ethnic communities through community-based, culturally competent treatment.
[SLIDE 10. Goal 4]
CMHS Activities
Youth Violence Prevention
- Advanced the CMHS anti-bullying campaign, 15+ Make Time to Listen…Take Time to Talk, by producing a prime-time television program and public service announcements. The campaign won several National Health Information Awards.
Integrating Mental Health and Substance Abuse Treatment
- Administered the Co-Occurring State Incentive Grants (COSIG) program. 11 States have received grants.
Cross-Training for Transformation
- Sponsored the first National Policy Academy on Co-Occurring Mental and Substance Use Disorders in April 2004 where team members from 10 States worked on action plans and strategies for integrating substance abuse and mental health services.
[SLIDE 11. Goal 4, cont.]
CMHS Activities
Older Adults
- Supported nine Targeted Capacity Expansion grant sites’ efforts to implement evidence-based programs and respond to the needs of older adults by such means as providing mobile services, screening those receiving home-delivered meals, and incorporating culturally relevant practices.
Primary Care Research in Substance Abuse and Mental Health Services for the Elderly
- Rolled out 6-month outcome findings of the PRISM-E study, a multisite study developed to compare the effectiveness of service delivery models that treat older adults with mental health and substance abuse problems in primary care settings vs. enhanced specialty settings.
State Plans for Healthy Aging
- Held a policy academy on “Rebalancing Long-Term Care Systems Toward Quality Community Living and Healthy Aging,” where eight State teams worked on plans to enhance services for older adults by maximizing consumer choice, improving access to home and community-based services, and reducing long-term case bias and costs.
[SLIDE 12. Goal 5]
CMHS Activities
National Evidence-Based Practices (EBP) Project
Evidence-Based Practices Grants
- Nine States began projects funded by State Training and Evaluation of Evidence-Based Practices grants. Each State selected one of the six EBP implementation resource kits and initiated training and evaluation in two or more communities.
- Another nine States began planning funded by CMHS/NIMH State Implementation of Evidence-Based Practices II: Bridging Science and Service Grants. An additional set of these planning grants, as well as grants to carry out research about implementing evidence-based practices, was announced in FY 2004 for funding in FY 2005.
[SLIDE 13. Goal 5, cont.]
CMHS Activities
Workforce Development and Transformation
- In partnership with the Annapolis Coalition on Behavioral Health Workforce Education, coordinated SAMHSA’s investment of $1 million in a national behavioral health workforce development strategy.
Trauma Research
- Launched a Women and Trauma Service Resource Center to offer States technical support for delivering gender-specific, consumer-based, consumer-driven, trauma-informed care.
[SLIDE 14. Goal 6]
CMHS Activities
Technology-based Training
- Began Rural Mental Health Grand Rounds Training Series via an electronic Web cast on “Assessment and Treatment of Mental Health Issues in Primary Care Settings.” Additional topics—including youth violence prevention and screening for depression and suicide risk—will be covered and archived on the CMHS-funded Web site of the Western Interstate Commission for Higher Education (WICHE) http://wiche.edu/mentalhealth/GrandRounds
[SLIDE 15. 2005 and Beyond]
Ushering in a new age of hope and recovery for all Americans
[SLIDE 16. Transformation Action Center (TAC)]
Vision
The Transformation Action Center (TAC) will provide a cohesive, coordinated, and strategic structure for the provision of technical assistance (TA) within the Mental Health Transformation SIG program and for CMHS programs focused on assisting individuals in achieving recovery and promoting resilience. Technical assistance for the TAC will be realigned with mental health transformation priorities, including—
- Leadership/Consumer Leadership
- Comprehensive Mental Health Plans
- Individualized Plans of Care (person-directed planning approaches)
- Disparities
- Evidence-based Practices and National Registry of Effective Programs and Practices
- Workforce Development (including consumers as staff)
[SLIDE 17. Strategic Transformational Leadership]
Vision
Effective behavioral health care leadership will be developed at the State and local levels. CMHS will build and sustain this leadership by developing a support model that moves away from the “train and hope” approach.
FY 2005 Proposed Activities
- Educate individuals and groups in leadership theory and techniques.
- Maintain the network of leaders to ensure continuity of support for sustaining systems change.
- Provide access to a wide range of current leadership curricula from programs such as Harvard, the Center for Creative Leadership and the Office of Personnel Management.
- Develop consumer leadership at all levels.
[SLIDE 18. Disparities Reduction/Elimination]
Vision
Providers will become more effective in working with communities of color and racial and ethnic minorities so that they will no longer be underserved.
FY 2005 Proposed Activities
- National Strategic Plan on the elimination of disparities
- Workforce training curricula evaluation
- Workforce development task force
- Cultural competence standards and guidelines
- Behavioral health care training program assessment
- Public education program description
- Evidence-based practice adaptation and implementation.
[SLIDE 19. Science to Service]
Vision
Evidence-based treatments will be widely applied to support recovery. Consumers will have meaningful involvement in the development of these treatments.
FY 2005 Proposed Activities
- Develop four new “toolkits” related to—
- Supportive housing
- Aging
- Consumer-operated services
- Children.
- Publish an implementation guide on supported education.
- Offer technical assistance for implementation of EBPs and individual care plans.
[SLIDE 20. Individualized Plans of Care (IPC)]
Vision
Every adult with a serious mental illness and every child with a serious emotional disturbance will have a consumer- and family-directed IPC that promotes resilience and recovery.
FY 2005 Proposed Activities
- Development of prototypes of IPCs for adults and children
- Contractor review of existing models and best practices
- Strategy and consensus meetings with stakeholders
- Dissemination and technical support for prototype care plans.
[SLIDE 21. Model Comprehensive State Mental Health Plans]
Vision
State plans will create an extensive and coordinated system of services and supports that enable each person to attain an optimal level of self-care, interpersonal relationships, employment, and community participation.
FY 2005 Proposed Activities
- Develop a Model Plan template through collaboration with NASMHPD, consumers, and other stakeholders.
- Make Model Plan available for States when the Mental Health Transformation SIG awards are made.
[SLIDE 22. Workforce Development]
Vision
An ethnically and racially diverse workforce, including consumers as staff, will be trained and supported in evidence-based practices, and will respond to and help shape a mental health policy and practice environment that supports recovery.
FY 2005 Proposed Activities
- Develop a draft national strategic plan with consumers and key constituents.
- Provide technical assistance to the field.
- Develop toolkits for field use and to monitor progress and evaluate success.
[SLIDE 23. Final Slide]
We are asking ourselves each day, "What have I done today to make sure that all people with serious mental illnesses in America have a greater hope of recovery?"
That's really what transformation is about!
|
