Remarks by Crystal R. Blyler, Ph.D.
Science Analyst, Center for Mental Health Services
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
SAMHSA/NGA Centerfor Best Practices/NASMHPD Regional Conference
"Transforming State Mental Health Systems"
June 16, 2006
New Orleans, LA
Attached is the text prepared for delivery; however, some material may have been added or omitted at the time of delivery.
Robert Collier, the American author and publisher, wrote that “Vision reaches beyond the thing that is, into the conception of what can be.” I think that Mr. Collier short-changed vision. True vision conceives of more than what can be: it goes beyond that to conceive of what should be.
We’ve just listened to each State’s report on its vision, strategies, and action steps. What is most inspirational from these reports? It’s your vision. Your State plans are based on a vision of what mental health care should be...and will be when you achieve your goals.
In many respects, your State’s vision of transformation is driving you to rethink the whole who, what, when, where, and how of mental health care delivery for your constituents. You are, in effect, transforming your current reality of care into an entirely different reality: that is, care that is driven more by consumer needs than by bureaucratic constraints.
The work that you have accomplished during the past 2 days is commendable. Don’t think, however, that your work is anywhere close to completed. What you have done here in New Orleans laid the foundation for actions that must follow once you return home. You, as a team, may have reached a consensus on mental health transformation priorities for your State. Now you must find ways to inspire, motivate, and compel others to embrace your vision and goals.
Your next step as a State team is to guide your State in creating or strengthening the partnerships needed to achieve the goals you have set. You have the power to do this! As Kathryn Power noted in her opening remarks, each of you represents the power of one, capable of transforming minds as well as systems.
We deliberately asked the Governors to send us team members who already are leaders as well as senior members of key agencies. Because of who you are and where you sit, you are in an excellent position to raise your State’s mental health care to new heights. You can (1) make others aware of specific areas of concern in your State and (2) stress potential opportunities to address these concerns by expanding service coordination and efficiency. This meeting hopefully has helped you to clarify both the challenges and opportunities faced by your State.
Another next step is to help your State build on the knowledge gained through this meeting. Your work gives you a head start on the long-term planning and decisionmaking needed to develop or refine a comprehensive State mental health plan. Consumers and families living with mental health problems have complex and multiple issues. These issues cut across departments, agencies, and systems. A comprehensive plan will create new partnerships among Federal, State, and local governments. It will increase flexibility in resource use, establish greater accountability, and expand the array of services and supports. Its development will involve consumers and their families as the center of care. In short, such a plan will operationalize your vision of transformation!
Also, take steps to ensure that your State makes full use of resources offered by Federal agencies. Nine Federal departments, and the Social Security Administration now are members of the Federal Partners Workgroup for transformation. Individually and together, we are providing new and expanded opportunities to improve mental health care at the State level. The session you attended on “Financing Mental Health Transformation” offered a detailed looked at innovations in Medicaid.
We at the Center for Mental Health Services are doing all that is within our reach and resources to help States move toward transformation. Our most recent initiative is our State Incentive Grants for Mental Health Transformation Program. Seven States have received grants. These States will serve as test beds for ways to effectively link comprehensive services across multiple systems.
We already can look at these States and point to examples of transformation. Washington State is developing a telehealth program to reduce disparities of care and to harness the power of technology to improve access. You may recall that these are goals 3 and 6 of the New Freedom Commission report. Connecticut has engaged 14 different agencies in a memorandum of understanding to better coordinate services. Pending legislation in Ohio will provide advocates to families of children with behavioral health challenges. All of these States are helping to make care more consumer and family driven, which is goal 2. What we will learn from the first seven States to receive a transformation grant will help all States move transformation forward.
We also offer services that enable States to take a focused approach to transformation. The Center for Mental Health Services supports more than 50 technical assistance centers. These centers offer resources and training to transform service delivery in any number of critical areas, such as offering integrated treatment for co-occurring disorders or disaster planning. Make full use of these resources to achieve your transformation priorities. Let us know how else we can be your partners in transformation.
You have heard many reasons why we need to transform our mental health system. I will close by adding one more. Last June, the National Institute of Mental Health published the results of its National Comorbidity Survey Replication. According to the Survey, mental illnesses are the chronic illnesses of youth. Half of all lifetime cases of mental illnesses begin by age 14. Three-fourths of all lifetime cases start by age 24. Despite the availability of effective treatments, there are long delays—sometimes decades—between first onset of symptoms and when individuals seek and receive treatment. The consequences of untreated illnesses can be physical health problems, unemployment, homelessness, incarceration, separation from families and friends, premature death, and suicide. These consequences are too heavy a toll for our children and our society to pay.
Each of us bears some responsibility—some accountability—for resolving this national mental health crisis…and for protecting and promoting the health of this and future generations. We have a solution: to follow through on the goals of transformation and to create a consumer- and family-driven system focused on recovery. In partnership with each other and with the people we serve, we can transform the mental health care we offer to all Americans: State by State, community by community, and consumer by consumer. This vision of mental health care as it should be is ours to achieve. Thank you for participating in this meeting.
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