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
Cross-Systems Collaborations: Catalysts for Transforming Behavioral Health
American College of Mental Health Administration Summit
March 16, 2006
Santa Fe, NM
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/Cover
Good morning, and welcome everyone. It is always a pleasure to be back in Santa Fe. It’s also a pleasure to join all of you for this intense 3-day dialogue about the importance of cross-system collaboration in the transformation of our behavioral health system.
I say “intense,” because what lies ahead of us—conversations about change…about tearing down existing assumptions and learning how to work with each other in bold, new ways—is “get-your-feet-wet-and-your-hands-dirty” kind of work. I underscore “cross-system” collaboration, because it will take all of us…from every sector, from inside and outside the circle of mental health…to create a national mental health system that delivers real hope to the citizens it serves.
I salute Sandy Forquer (For-ker) and the members of ACMHA for reaching out across Federal, State, and local governments…for reaching into every human service system…to help each one understand its stake in America’s mental health. As I look around this room, I see that ACMHA’s investment in these efforts is paying dividends. You have brought together the largest crowd in the history of the Summit…including at least 30 representatives from other systems of care. This is the fuel that what will drive mental health transformation forward!
ACMHA is a true vanguard of transformation. “Thank you,” for keeping the focus on transformation for the last 3 years…and for continuing to fan the flames of transformation today. Special thanks, too, to Arthur Evans and Mike Hogan for everything you have done…and continue to do…to make this Summit such a productive and enlightening experience. When this meeting adjourns, I am confident that each of us will be transformed…and ready to return to our communities with clarity of vision, understanding, and the renewed energy needed to move the vision to action.
Vision, energy, and action will be critical to our continued success. One of my colleagues likes to say, “Collaboration is a contact sport.” Those of you who have already begun to explore the kind of cross-system collaborations that are the catalysts for transformation understand this sentiment all too well. The process of linking governments, disciplines, and entire systems is fraught with budget constraints, political barriers, and obstacles that can seem insurmountable.
Yes, the complexities of collaboration are great. But, in these tough fiscal times...in these times when the human costs of untreated mental illnesses and substance use disorders are growing exponentially... cross-system collaboration is an absolute necessity.
Why? The reasons are both simple and profound—people with mental disorders have a vital role to play in our families, our neighborhoods, our communities, and our country. But, these individuals have complex and multiple needs...needs that no one agency, no one organization, no one system can meet on its own. As a result, the speed and extent of transformation hinges on how well we all work together for change. The more we collaborate, the more we help.
We must work together to put children and their families, adults, and older adults with mental illnesses at the center of a comprehensive, coordinated, quality-driven mental health care system. And we must do it now—in spite of the fact that domestic spending is down everywhere and resources are shrinking…even though the ranks of those in need are expanding everyday. Today, more than ever, cross-system collaboration is the only way to truly serve those who need us most.
Fortunately, as Irish author Jonathan Swift says, “Necessity is the mother of invention.” I am pleased to be here this morning to say: Necessity is giving life to countless innovative and transformative collaborative partnerships across the many organizations and systems that touch the lives of mental health consumers.
In Washington and in States and communities across America, I am seeing agencies, organizations, and individuals—in mental health, substance abuse, primary health, justice, child welfare, housing, and labor organizations...at the Federal, State, and local levels...in the public and private sectors—striving to find creative and effective ways to reach across their priorities to serve the needs of people. And, they are succeeding!
The transformative power of collaboration is catching on everywhere…on every level…in every sector! This morning, I would like to tell you about some of the exciting developments that are taking place among the Federal partners as we advance the transformation agenda at the national level. The level of enthusiasm I have witnessed has been absolutely incredible!
Many of you may know that last year SAMHSA and its Federal partners took a critical step toward moving transformation from the vision outlined in Achieving the Promise—the final report of the President’s New Freedom Commission on Mental Health—to its reality.
Slide 2/Federal Partners
As part of an unparalleled commitment to collaborate to change the status quo, SAMHSA—along with agencies from nineFederal Departments—has released the Federal Action Agenda—the roadmap that will guide our steps as a nation toward this wholesale transformation. This Action Agenda identifies the first, time-limited, realistic steps that the Federal partners—across all of the key health and human services agencies—can take during the next year to move transformation forward. I have copies of the Action Agenda available for you today ( HOLD UP COPY ). Please read it and share it with your colleagues as you develop your transformation agendas.
This document is our pledge to take action. And we have done just that. We have launched the Federal Executive Steering Committee on Mental Health —a group of 21 Assistant Secretaries and Deputy Commissioners representing nine Federal Departments and Agencies , along with thirteen agencies and offices within the Department of Health and Human Services.
This Steering Committee demonstrates commitment to transformation at the highest levels. It provides direction to, and monitors, the Federal government’s process of transforming mental health care in America. The members are charged with identifying and eliminating regulatory and funding barriers to promote access to effective services for consumers.
Slide 3/Federal Executive Steering Committee
Currently, the Committee is overseeing the creation of 15 cross-agency workgroups that will focus on mission critical issues…issues like suicide prevention, integration with primary care, financing, employment, disaster response, and others… issues that resonate with each of the partner agencies.
This is a particularly salient point…and a critical lesson in collaboration that warrants further discussion. The success of the Federal collaboration hinges, in part, on the fact that we have carefully picked partners who have common interests. Finding the common ground is critical to engaging partners from diverse professions, disciplines, and systems. Finding the common ground is essential to motivating partners to apply their unique skills and passion to address common needs.
We have had real success finding the common ground among our federal partners. Now, we are beginning to reap the fruit of this synergy. With senior representatives from every human services agency in the same room…around the same table… ground-breaking , transformative conversations are taking place.
Department of Defense Deputy Assistant Secretary, Dr. David Tornberg, set the tone for our work at the very first meeting of the Executive Steering Committee. Rather than focusing solely on the challenges DoD is facing to address the mental health needs of returning veterans, Dr. Tornberg called on all of the Federal partners—across all of the people-serving agencies—to work together to improve the lives of some 2.1 million individuals who have been impacted by the war…the veterans, and their spouses, and the children who are trying to cope with the transitions, adjustments, and losses they face.
Dr. Tornberg challenged us to look at behavioral family health…to treat the whole family. That means interfacing with schools and, too often, with the juvenile justice system to help children who are having trouble coping with family stresses. It means ensuring that screening for drug and alcohol abuse occurs in primary health settings, to help spouses whose fear and loneliness may have led to substance use problems. This kind of thinking about the urgent need for an integrated approach to care is, indeed, transformative!
Importantly, this is not just another philosophical discussion. The Federal partners are taking action to make these changes happen… now!
One notable example: The Department of Labor and the Social Security Administration are partnering to address one of the Federal Executive Steering Committee’s top priorities for 2006—employment and transition. Through the Joint Disability Program Navigator Initiative, DOL and SSA are collaborating to provide mental health consumers that receive Social Security disability benefits with a “one-stop” resource for the many programs and services that affect successful employment. Navigator program sites offer a “navigator”…a real, live, person who facilitates coordination of services and helps consumers move through the process. SAMHSA is ensuring that mental health information is incorporated into training for the program staff. This is a groundbreaking effort! Working together, these partners are providing a route to employability…and to recovery! This is transformation in action!
Federal partners from across the human services arena are coming together to ask and answer critical questions: How can we break down the silos? How can we integrate services in a more proactive, holistic, and measurable way?
Through these collaborative discussions and activities, we are literally changing the way we think about…and go about…providing care. In doing so, we are embedding these new approaches…these new shared values…into the very fiber of how we work together. In doing so, we ensure that this work will go on…beyond the tenure of the officials who currently lead each of these Departments and Agencies.
Slide 4/Lessons Learned
The lesson learned? When we change our expectations of what is possible, and act on those expectations, we will achieve the success we seek!
We have also learned a number of valuable lessons from our work with the 7 States that have been awarded the Mental Health Transformation State Incentive Grants, or SIGs. With these grants, SAMHSA is making a strategic investment in transformation at the State level. Over the next five years, the SIG States will begin to make the systemic changes necessary to meet complex consumer needs and foster recovery. We are asking the SIG States to do something truly revolutionary—to unite all of their State agencies involved with adults and children behind a common vision of mental health care as it should be! We recently held a meeting of the SIG grantees, during which we shared a number of insights that bear repeating.
The SIG grantees have reminded us that patience is a virtue when it comes to transformation—we have to realize that it is going to take a long time to get all of the necessary partners on board.
At the same time, we have learned, flexibility is key—you should not enter into collaborative activities with too many plans too firmly laid out.
What is the best way to get partners to the table? In our work with the SIG grantees, we have found that mental health organizations must learn to speak to the prospective partners’ agendas. We have to frame our invitations to collaborate in terms of problems we can help our partners solve. For example, if you are trying to build partnerships with criminal justice, talk about how people with mental illnesses are arrested and incarcerated in disproportionate numbers…and how many people can be helped when we use jail diversion programs, crisis intervention teams, and re-entry initiatives to divert these adults and juveniles into appropriate services.
Another successful strategy: Identify a non-mental health champion, perhaps from another State, who can come in to talk to you and your partners about why mental health is important to their work.
In our work with the SIG States, we have also seen, firsthand, the power of a facilitated process. The “policy academy” model—which brings together relevant players from different disciplines—is a very effective one. People really appreciate…and benefit from…the opportunity to get out of their “silos” and share insights and perspectives with people from outside of their circles.
A change of perspective goes to the very heart of transformation. In his book, Deep Change, author Robert Quinn says—
“Often when we evaluate a situation from a fresh perspective, it helps to clarify the actions we need to take. The resulting actions may present a series of risks. However, to initiative a deep change, we mustconfront a path littered by many risks and unforeseen challenges.”
The path of deep change is a thorny one…full of twists and turns and risks. Even though we may have our sights clearly set on a destination, we rarely know all of the steps we need to take to get there. Quinn says, “We must trust in ourselves to learn the way…to build the bridge as we walk on it. We must leap into the chasm of uncertainty and strive bravely ahead.”
At the heart of Quinn’s process for realizing deep change is the notion that we must think and behave differently as we pursue our vision…learning, and making choices, and growing along the way. Others, he says, will be attracted by our courage and motivation.
This lesson from Deep Change is perhaps the most critical lesson I have learned as I have worked to build partnerships and support for transformation across this country: We must act on our vision to transform mental health care in America …even though the demands exceed our resources…even though we cannot know before we begin whether we are on exactly the right path.
Slide 5/Quote
We must trust and believe in what we are doing in order to signal to others that the vision is worth investing in .
This is how we will build the collaborative partnerships that transformative work requires. This is how we will unite behind a belief in recovery and leverage our resources to meet the needs of the whole person…the whole community. This is how we will pool our collective intelligence and use the synergy that results to advance our shared goal—to foster lasting improvement in the lives of Americans living with mental illnesses.
I commend each of you for being here today…for recognizing and embracing the transformation agenda…and for leading the way. Your very presence here today shows your readiness to lead the change that is required to move us to a new level of care—one that is consumer- and family driven…accountable to those we serve…and focused on the goal of recovery. Each of you is a shining example of the power inherent in committed and impassioned people working together toward a common goal.
(pause)
Collaboration is a contact sport. Over the next few days, I urge you to jump in…get your feet wet and your hands dirty. Immerse yourselves in the complexities of cross-system collaboration. Prepare yourselves to go back to your communities and be a signal to others that the transformation vision is one worth investing in.Our reward: we’ll make the promise of transformation a reality for the people we serve. Thank you.
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