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
7th ANNUAL DR. LONNIE E. MITCHELL
NATIONAL HBCU SUBSTANCE ABUSE CONFERENCE
NAVIGATING NEW PATHWAYS IN ADDRESSING SUBSTANCE ABUSE AND MENTAL HEALTH CHALLENGES:
INVESTING IN MENTAL HEALTH TRANSFORMATION
BALTIMORE, MD
April 20, 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/Cover]
She has always been at the top of her game.
In high school, she led her team to four consecutive State championships. By graduation, she averaged 25 points per game and was recruited by the Nation’s leading colleges. At the University of Tennessee, she led the Lady Vols to three national championships. As a professional, she was selected first-overall by the Women’s National Basketball Association’s (WNBA) Washington Mystics, and named Rookie of the Year in 1999. ESPN named her Female Athlete of the Year. And for three seasons, she led the WNBA in major categories, including scoring, and rebounding—becoming a three-time all-star.
[Slide 2/Chamique Holdsclaw collage]
Everything Chamique (sha-meek-wah) Holdsclaw touched turned to gold.
So it was shocking to many—including Chamique (sha-meek-wah), herself— when last year, just as she seemed poised to take her professional team to the next level, her life took a dramatic and unexpected turn. She found that she no longer had the desire to play basketball—a love that once motivated her daily. In fact, she didn’t want to get out of bed.
The public face of her professional success hid her private pain—most sorely, how the loss of the grandmother who raised her had deeply affected her. Fortunately, after Chamique (sha-meek-wah) became increasingly distressed—missing work and personal commitments—she found the courage to seek help, and was diagnosed with and treated for depression.
As Chamique’s story came to light late last year, I was struck by the thought that though she is only 27…and has many games ahead of her…this may prove to be one of her most dramatic victories: a story of recovery.
You, too, may have read and taken interest in Chamique (sha-meek-wah) Holdsclaw’s career, and in this latest chapter of her life. We are all rooting for her…and importantly for the millions more people like her that we do not know by name. Today, I would like to share with you the progress that is being made toward a wholesale systems transformation…a journey down a promising pathway that we can travel together to make Chamique’s story of recovery the ultimate—and expected—success story for so many others like her.
First, let me say how pleased I am to join Beverly Watts-Davis in representing the Substance Abuse and Mental Health Services Administration (SAMHSA) in this opening plenary for the 7 th Annual Lonnie E. Mitchell HBCU Substance Abuse Conference. Some of you may have been here last year when I spoke as part of a Federal panel for HBCU and faith-based collaboration. To be here again this morning, and to have the opportunity to speak with so many enthusiastic students—young people who we will soon welcome as esteemed colleagues to the field—as well as to dialogue with the researchers, educators, and staff that are guiding you to your goals, is a privilege that I do not take lightly.
I think it is important that we take a moment to recognize that significant change has already started to take shape in the substance abuse and mental health fields—the kind of fundamental change I spoke about just one year ago. In years past, the theme of “mental health challenges,” would not have been included in a conference targeted toward substance abuse treatment and prevention professionals, educators, and students. I know I speak for my colleagues at the Center for Mental Health Services (CMHS) when I say how happy we are to see…and to be part of…the various workshops on this week’s agenda related to mental health issues. As never before, I believe we all recognize the importance of looking at the individuals we serve as a whole person—healing the mind, body, and spirit—as one.
[Slide 3/Statistics]
Our efforts to work together in new ways could not come a moment too soon…current statistics are startling. The top 3 leading causes of disability worldwide are behavioral disorders—mental illnesses, alcohol, and drug use disorders. One in five Americans—44 million adults and 14 million children—live with mental disorders. Nearly 15 million people have a substance use disorder alone, while 4 million people have co-occurring mental and addictive disorders. The prevalence and incidence of these disorders is a public health priority.
Today, as many of you prepare to embark on your careers, I would like to talk with you about a vision for the future of behavioral health—a future that beckons you to become part of the changes that are underway…a future that calls on you to invest inmental health transformation.
[Slide 4/NFC Report]
Through system transformation, SAMHSA/CMHS is harnessing the power of collaboration to eliminate the disparate systems serving consumers to create a single entryway to better care. It is the Final Report of the New Freedom Commission on Mental Health that provides the impetus for…and presents extraordinary new opportunities to create…the seamless system of behavioral health care necessary for our work to affect the lives of those among us who most need these services.
As some of you may know, in 2002, the New Freedom Commission on Mental Health was charged with studying our national mental health care system and directed to make recommendations for immediate improvements…ways to prevent more people from falling through the cracks in care. About a year and a half ago, the Commission released the landmark report, Achieving the Promise: Transforming Mental Health Care in America. The Report reaffirmed the urgent need to improve services for culturally diverse populations and moved the issue to the forefront of the national agenda. Achieving the Promise also observed that racial and ethnic minorities remain seriously under-represented in the core mental health professions…and that many mainstream providers are inadequately prepared to serve culturally diverse populations.
Declaring that our mental health system is disconnected and struggling to meet the needs of the consumers and families it serves…and that the time has long passed for yet another piecemeal approach to reform…Achieving the Promise reached a bold conclusion: we must fundamentally transform our Nation’s approach to mental health care.
This point is certainly not “news” to many in the African-American community—consumers, educators, researchers, and providers who have worked tirelessly to do more—often with much less. The good news is that change is here. But, if we are to have the impact that we know is needed to make a difference within this community, and others, we also need your expertise…your insight… and your experience.
The assignment of transforming mental health across the entire United States is no less than monumental. Fortunately, Achieving the Promise provides us a vision of transformed mental health care with goals and specific recommendations for achieving this vision. What will it look like when these goals are realized? Our transformed national system will be focused on recovery and self-determination. It will uphold the dignity of every individual.
Transformed . Focused on recovery. These are two extremely powerful concepts. Because they are the heart that pumps blood to our shared vision, I want to spend a few moments on each of these ideas.
[Slide 5/Transformation]
Transformation is revolutionary. It implies profound change—not at the margins of a system, but at its very core. Transformation assumes the need for a fundamental shift to another level of thought and action. In transformation, new sources of power emerge. New competencies develop. We look at opportunities and challenges, with the bright eyes of a child…as we are seeing them and all of their possibilities for the first time. We look for what we can do now that we couldn’t do before.
[Slide 6/Recovery]
Recovery is the journey through which lives are transformed. It does not necessarily mean “cure.” Recovery is a process...a continuum of personal achievements as each person moves toward his or her greatest potential. Perhaps the most compelling element of a recovery-focused system is the belief that people with mental illnesses can take charge of their own lives, their own wellness, and their own care. This single belief has extraordinary implications for transforming mental health care. It demands change—from Federal and State agencies, to the provider, to the people we serve and their families. Each of us must have the capacity, as well as the willingness, to become equal partners in a systemic change in our approach to determining care.
[Slide 7/Goals]
The hope for and the promise of recovery fuels this transformation. A consumer-centered, recovery-focused system in which all Americans will share equally in the best available services and outcomes— regardless of race, gender, ethnicity, or geographic location. There are six goals for achieving this vision—
- Americans will understand that mental health is essential to overall health.
- Mental health care will be consumer and family driven. An individualized plan of care will be in integral part of the approach.
- Disparities in mental health services will be eliminated.
- Early mental health screening, assessment, and treatment will be common practice.
- Excellent mental health care will be delivered and research will be accelerated.
- Technology will be used to access mental health care and information.
These goals, and the specific recommendations that accompany them, are the priorities…the driving force behind all of the current decision-making at SAMHSA/CMHS…and in the behavioral health field. These goals will provide the roadmap for our combined efforts to advance transformation across the behavioral health field.
Progress is being made each day. States across the country are developing and implementing model Comprehensive State Mental Health Plans. Federal partnerships and collaborative activities are coming together to break down silos. Prototypes for Individualized Plans of Care (IPC) that will address the unique needs and concerns of every person with a mental illness are being identified. Every success…large and small…brings us closer to realizing these goals.
[PAUSE]
What does this all mean to you? Simply put—opportunity.
As the lead agency in mental health transformation, SAMHSA is making a committed and significant investment of resources, time, and energy to changing the Nation’s mental health system. With change, comes the exciting window of opportunity to embrace new ways of thinking…of collaborating…of implementing. I want to take a few moments to share with you just some of the emerging opportunities connected to the goals and priorities of a transformed mental health system…opportunities for you to invest your time and talent in ways that can make all the difference.
[Slide 8/Goal 1]
Goal 1 of Achieving the Promise is a central tenet of a transformed system. It calls for a holistic approach to care. This goal tackles a number of complex issues, including the ignorance and discrimination that often prevents people from getting the care they need—a serious challenge often experienced by providers and consumers in the African-American community. Goal 1 also calls for swift action to prevent suicide. Suicide is an issue that may strike many in this audience close to home—it is the third leading cause of death for African-American youth ages 15-24 (CDC, 2004)—and the second leading cause of death for all college students (Haas, et al., 2003). The rate for African-American college students is currently unknown.
SAMHSA/CMHS is working in support of the Garrett Lee Smith Memorial Act introduced by Senator Gordon Smith (R-OR) in memory of his son who committed suicide in 2003. Passed by the U.S. Congress last September, the Garrett Lee Smith Memorial Act contains provisions from the Campus Care and Counseling Act developed by the American Psychological Association (APA)…and will make a significant difference in the lives of hundreds of young people across our nation by establishing critical and much-needed mental and behavioral health services to students on college campuses.
Further, the Garrett Lee Smith Act acknowledges the significant toll that mental and behavioral health problems can take on a student's ability to succeed in college. A majority of the funds authorized in the bill are dedicated to statewide Youth Suicide Early Intervention and Prevention Strategies that you can become part of locally…in your communities. HBCU’s are an invaluable partner to ensure that suicide among African-American students is studied and addressed with the urgency it deserves, by helping to fill-in the gaps in research that exist.
America 's communities are rich with diversity. Racial and ethnic minorities make up more than one quarter of the American population, and by 2025, will account for more than 40% of all Americans. Unfortunately, the number of trained minority mental health providers and services researchers is not increasing at the same rate—only about 10% of mental health providers are ethnic minorities—increasing the disparities currently found in the system.
[Slide 9/Goal 3]
Goal 3 goes to the heart of this critical issue. Our objective is to develop a workforce that has been trained and is supported through a competency-based approach to eliminate disparities in mental health care. We also want the workforce to respond to and shape an environment that supports recovery. This means facing the barriers to care for underserved populations in the current mental health system head-on and providing consumers from all populations with the culturally competent services they need. Our long-term goal is to develop a National Strategic Plan to eliminate disparities entirely.
As I look around this room, I am optimistic about the outlook for developing a workforce that helps achieve this goal. However, we cannot simply be content with the talented group here that is here today…and currently on your campuses. We must continue to interest and attract African-Americans to careers in the mental health field…and we must nurture their gifts.
At SAMHSA, we intend to expand and educate the workforce so that it can respond adequately to the mental health needs of underserved populations. We have proposed an entire portfolio of activities to address issues such as cultural competence, public education, and the adaptation and evaluation of innovative, evidence-based practices that reflect and embrace cultural diversity.
[Slide 10/Workforce Initiatives]
I’d like to call your attention to a few of our workforce initiatives and encourage you to avail yourselves of the programs and services we offer in this area…specifically—
- In partnership with the National Association for Equal Opportunity in Higher Education (NAFEO), SAMHSA offers internships for students from HBCU’s that provide the opportunity to gain valuable work experience in support of their coursework.
- The SAMHSA Minority Fellowship Program invests $3 million in training fellowships through the American Psychiatric Association, American Psychological Association, the Council of Social Work Education, and the American Nurses Association to facilitate the entry of minority students into careers in mental health and substance abuse services.
- The recently announced HBCU National Resource Center (HBCU-NRC) outreach is part of SAMHSA's Infrastructure Grants program, which provides funds to increase the capacity of mental health and substance abuse service systems to support effective programs and services. The National Resource Center will be dedicated to 3 goals: (1) establishing a national network of HBCU’s to facilitate collaboration among the 104 HBCU institutions, and increase communication and access beyond campuses; (2) supporting culturally appropriate prevention and treatment services for persons with substance use disorders and mental illnesses on HBCU campuses; and (3) facilitating the design of accredited courses, minors/majors and undergraduate and graduate degree programs that adapt State requirements and encourage student interest in substance abuse and mental health.
I encourage you to visit our Web site—www.samhsa.gov—for more information on all of these programs.
With your input, we can build a workforce that is also diverse in the types of issues it addresses. We need you to tell us the unmet needs you see…the gaps that must be filled to ensure we can effectively meet the needs of underserved consumers.
[Slide 11/Goal 5]
As reflected in Goal 5, one of the underlying principles of Achieving the Promise is that the mental health system must identify programs, services, and models that work…and replicate these practices. We have a two-part strategy for this priority, called the Science-to-Service Initiative. The first is to expand the number and distribution of evidence-based practices available through the National Registry of Evidence-Based Programs and Practices. The second is to implement additional strategies to ensure that States and providers can implement and sustain more widespread use of the practices.
We collaborate with the National Institute of Mental Health (NIMH) on the Outreach Partnership Program, a nationwide initiative to enlist national and state organizations in partnerships to help bridge the gap between research and clinical practice by disseminating the latest scientific findings, informing the public about mental disorders, alcoholism, and drug addiction, and reducing the stigma and discrimination associated with these illnesses.
[Slide 12/EBP Resource Kits]
You can help us identify and adopt evidence-based practices that are effective and relevant to the behavioral health needs of minority consumers. As part of our National Evidence-based Practices Project, we are funding development of a series of EBP Implementation Resource Kits. These kits are evaluation versions. University researchers can become involved in this effort by assessing these EBP's for their relevance for people with co-occurring mental disorders and substance abuse disorders. Moreover, educators can review and evaluate proposed training curricula. You can provide SAMHSA with the feedback we need to make the toolkits and practices successful from your important perspective.
By definition, transformation involves collaboration across systems...across populations. For transformation to take shape, every sector of the behavioral health care community must be represented—in formal leadership positions—as well as more informally through “thought leadership.” You are leaders in your field. Transformation presents a tremendous opportunity for you to lead others in bringing about the changes we seek.
We do share a common vision. And we can build on this vision. Our work has many intersects. We can build together to work towards the goals we share—in 2005 and beyond.
Your perspective is invaluable. I brought with me today copies of the Executive Summary of Achieving the Promise, as well as a transformation briefing document we call, Transformation Trends. I urge each of you to pick up these materials and read them. Today is really about us moving forward as sincere partners in this work.
[Slide 13/MHST]
Researchers , access these resources as a new pathway to evaluation initiatives. Faculty, consider these documents as a fresh approach to preparing your students to enter the professional ranks. Students, employ these materials as a pathway for planning your future.
As part of a rich network of rising and promising professionals, you can help us create a picture of what a transformed system should look like from your lived experiences…and from your desire to help change the world for the better. Your voices are crucial to the transformation process, because recovery is not one size fits all.
It is the deeply personal nature of the recovery journey that makes your leadership so critical to SAMHSA. In order to create a recovery focused mental health system that will serve all Americans, we need to better understand how to serve the needs of ethnic and minority consumers. You are the experts. Together we can build a system that is enriched by the unique strengths, cultural traditions, beliefs, and value systems of all Americans.
Together , we can return the millions of people in Chamique’s (sha-meek-wah’s) shoes to the top of their game.
Thank you.
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