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

Transformation Update
Meeting of Former Commissioners of the President's New Freedom Commission on Mental Health

March 29, 2006
Washington, DC

Good afternoon. I represent the Substance Abuse and Mental Health Services Administration, or SAMHSA. We are the Federal agency charged by President Bush, through the U.S. Department of Health and Human Services (HHS), to create a new reality in mental health care.

And what is this reality? It is the one envisioned by the New Freedom Commission in its final report: a future in which mental illnesses can be prevented and everyone with a mental illness will recover.

SAMHSA is moving toward this reality through mental health transformation. This is the name we have given to our initiative to introduce fundamental change in the way mental health services are perceived, accessed, delivered, and financed in this country. Our approach is based, in part, on the lessons learned by our defense department. This department has successfully transformed itself into a 21st century fighting force, just as we have to transform those who are engaged in combating mental illnesses.

Vice Admiral Arthur Cebrowski headed up the Pentagon's Office of Force Transformation until cancer led him to retire last year. This is the advice he handed out to those who would lead transformation.

“Be bold,” he said.“….Pick up the things that look really hard. Other people will have done everything else.” “Be fast, he added. “No transformational leader ever looks back and regrets moving too fast.”

SAMHSA’s agenda for mental health transformation is bold. At the Federal level, we have engaged nine departments and 13 agencies within HHS to carry out a collaborative Federal action agenda. Why this broad-based coalition for mental health? Look at our prisons, our homeless shelters, and our child welfare system. Look at our returning war veterans. The burden of mental illnesses…and the responsibility for protecting mental health and promoting recovery…crosses all organizational boundaries.

SAMHSA is demanding unprecedented collaboration, accountability, and leadership from those involved. Just recently, we convened a Federal Executive Steering Committee to guide and monitor the Federal Government’s process of transforming mental health care. Who’s on this committee? ― Twenty-one a ssistant secretaries and deputy commissioners representing the nine Federal departments and agencies. We have charged these senior-level individuals with promoting consumer access to effective services by identifying and eliminating regulatory and funding barriers within their organizations.

SAMHSA also is proceeding rapidly to facilitate and compel transformation by the States. The greatest opportunities for change lie at the State level, where the decisions about funding and service availability are made. We have been urging the States to take bold action at their level…and we’re backing up our efforts with funding and technical assistance.

Last September, SAMHSA awarded more than 90 million dollars to seven States to help them develop the infrastructure needed to support the systemic changes that are called for…such as linking State mental health programs together with those conducted by the education and justice systems. We are supporting State efforts through our new Transformation Action Initiative, which will broker technical assistance to help them meet the priority needs of their constituents.

We will not stop with these seven States nor will we wait for additional funding to promote State-level transformation further. We will use the experiences of the seven grant States to inform other States on which strategies work best in developing comprehensive service systems. Together with the National Governors Association, we will continue to host regional meetings. Last year, we began to meet with teams of senior State officials to help them assess their mental health systems and to adjust their policy and funding priorities accordingly. We are doing more than calling for change by the States: we also are ensuring that they have the strategic tools and leadership that will make change possible.

Exceptional skills are required by those who would create a new order in mental health services. Admiral Cebrowski, in his advice to transformational leaders, shared this strategy. “Be specific,” he charged. “If you lack specificity, your subordinates will be able to change your message to suit their own purposes.” At SAMHSA, we are modeling the behavior that we want others throughout the mental health system to adopt. Think of it as radiant leadership: changing ourselves first as a way to inspire others to make similar changes.

We are in corporating the concept of recovery in every aspect of our work. We have declared 2006 as the Year of the Consumer. We are surrounding ourselves with images of mental illnesses…and recovery. SAMHSA currently is hosting a traveling exhibit by photographer Michael Nye. The exhibit, called Fine Line: Mental Health/Mental Illness, is a documentary of voices, stories, and portraits of individuals living with mental illnesses. In this manner, we are driving ourselves to experience deep personal change in our own attitudes and beliefs about mental illnesses and the journey of recovery. Why do we do this? ― So that every person within SAMHSA has the necessary courage and conviction to move from old methods to bold actions.

One of our most important activities both internally and externally has been to change the language of mental health. As Admiral Cebrowski noted, “Language conveys culture….You cannot expect old language to carry new ideas.” We have launched a national anti-stigma campaign to educate Americans about mental illnesses and recovery and to encourage those who need help to seek it. We have created the Voice Awards program to recognize writers and producers of television, radio, and film whose words portray individuals with mental illnesses with dignity and respect. The new language we recognize speaks of hope…and recovery.

I’m proud to say that SAMHSA’s own voice is being heard. We recently received the only Community Service Emmy that the National Academy of Television Arts and Sciences awards each year. Our “15+ Make Time to Listen―Take Time to Talk…About Bullying” multimedia campaign was selected from among hundreds of entries as the best example of outstanding messages and services for our communities.

SAMHSA also convened a national panel to develop a consensus statement outlining the principles of consumer-driven recovery…what it means and how it can become real in practice. We recently released a draft statement. The language of this statement will be just as important to changing the attitudes, values, and beliefs of consumers as it will be to changing those of program administrators and providers. Consumers are the reason for the difficult but necessary work of transformation. They, too, must be ready to change and willing to risk because it is their needs, their expectations, and their potential that should shape the new reality of mental health care.

Each of the activities I’ve described represents profound change within those who are affected. In an essay entitled “Reflections on ‘Deep Change,’” Tom Merrick of the Maryland Department of Disabilities explored the concept of recovery as it applies to consumers and to a mental health system undergoing change. He wrote, “In many respects, recovery, as experienced by the mental health consumer, can be viewed as a kind of personal transformation, while a broadly brushed picture of system transformation can be viewed as recovery; that is, the recovery of a system that is badly out of alignment with current changing realities.”

Our goal at SAMHSA is to realign our national expectations of mental health care. We are transforming our mental health system so that its reality matches the reality of about 20 million Americans who currently have a diagnosable mental illness. Recovery is a real possibility, but it hinges on the ability of these consumers to obtain the necessary services when and where they need them.

SAMHSA and its Federal, State, and private-sector partners have made tremendous progress in transforming mental health care. The programs and policies that SAMHSA has been promoting are those meant to embed transformation across and within the mental health system. And yet, m any issues remain unresolved, many collaborations have yet to be formed, and much work lies ahead.

We must seize the many opportunities for progress that exist. Transformation equals vision plus belief plus action times continuous quality improvement, squared. The New Freedom Commission gave us a vision. Now it is up to the rest of us to complete the equation so that we will maintain the current momentum for change. SAMHSA will continue to motivate, facilitate, and compel change across the mental health system. But we need your support. I urge every organization and individual in this room to join us in achieving the promise of a system that offers hope in recovery and a life in the community for everyone. Thank you.