Remarks by
H. Stanley Eichenauer
Deputy Executive Director
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
MacArthur Foundation Mental Health Grantees Meeting
Washington, DC
September 14, 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]
Good afternoon.
Indeed, it is an honor to be with you today. The John D. and Catherine T. MacArthur Foundation has earned the respect and admiration of all of us over the years. I’m proud of your work… your leadership… your commitment… your resourcefulness… and your success in making a difference in the lives of millions of people around the world. Thanks for including the Substance Abuse and Mental Health Services Administration in this meeting.
Kathryn Power, the Director of SAMHSA’s Center for Mental Health Services, addressed this meeting last year and regrets that her schedule makes it impossible for her to accept your kind invitation again this year. It has been my pleasure to have worked very closely with Kathryn during the past two years in addressing the goals and recommendations articulated by the President’s New Freedom Commission on Mental Health. All who know her can attest to her strong values… her intense commitment… and her extraordinary energy.
{SLIDE 2. Katrina]
It is impossible to engage in any conversation in the wake of Hurricane Katrina without acknowledging… and honoring… the hundreds of thousands of people whose lives have been shattered… whose family members have been lost… whose houses and other material possessions have been destroyed. The extent of the devastation seems unimaginable. And the impact upon those who suffer almost certainly will be severe and long-lasting.
I appreciate your conversation at the very beginning of your time together today about constructing and participating in a meaningful response to this tragedy. At SAMHSA we want to be a partner with you, and so many others whose hearts have been touched by the suffering they have seen. We want to help people solve problems… we want to strengthen the resilience of those who have become victims… we want to sustain the mental and emotional health of all who are suffering so much. We sending money and we’re sending people… clinicians who are skilled in crisis intervention and counseling…physicians who can administer medication… and others to support State officials in assessing need, managing triage and planning for long-term recovery. We intend to be involved over the long-haul paying special attention to the mental health concerns of the victims, rescue workers and emergency personnel.
{SLIDE 3. Website and phone number]
The long road leading to restoration will require the earnest effort of thousands. To assist in identifying and coordinating these resources, SAMHSA has created a website (https://volunteer.hhs.gov) and established a toll-free telephone number (1-866-KAT-MEDI). Please help us identify non-Federal health care professionals and others who can assist in this massive restoration effort.
{SLIDE 4. Vision of the Commission]
In the wake of Katrina, especially, it is very clear that people on the Gulf Coast and across America will need the very best mental health we can possibly provide. We simply cannot afford to take our eye off the prize, the realization of the vision articulated by the President’s Commission on Mental Health. Let’s review it again.
A future when everyone with a mental illness will recover
A future when mental illnesses can be prevented and cured
A future when mental illnesses can be detected early, and
A future when everyone with a mental illness at any stage of life has access to effective treatment and supports.
We must keep our eyes firmly fixed on the prize as we operationalize transformation… as we move from goals and recommendations in a report to embracing a new reality.
Since Kathryn Power, Director of the Center for Mental Health Services, spoke to you at last year’s mental health grantee meeting, transformation has been happening. Together, we have made real and steady progress. Mental health care in America is being transformed.
{SLIDE 5. Quote—Harry Millner]
Perhaps our activity and achievements to-date in our quest for transformation can be summed up best in a popular motivational quote by Author Harry Millner.
“All progress occurs because people dare to be different.”
Transformation is being driven by mental health organizations and professionals—like many of you in this room—who dare to be different. Transformation is being accelerated by those who are unafraid to take risk… unafraid to try new services… unafraid to engage with consumers and families in very different and creative ways… unafraid to reframe problems in different ways to surmount challenges… unafraid to fully define, embrace, and practice recovery values and principles and share the vision of hope.
{SLIDE 6. Federal Partners Workgroup]
In the Federal government, we have come together in an unprecedented collaboration to transform mental health care. This collaborative includes 14 agencies and offices within the Department of Health and Human Services, along with eight other Departments and the Social Security Administration. I think this is a very impressive list of Partners already and it continues to grow as people recognize a shared responsibility to promote the mental health of Americans.
For the first time ever, key Federal agencies are recognizing their shared stake in mental health, and are uniting behind a belief in recovery. In response to the Commission’s call, this group is focused upon eliminating fragmentation and barriers to services that now exists among Federal agencies. We must transform the current maze of services, treatments, and supports into a seamless mental health care delivery system. Consumers and families living with mental health problems have complex and multiple issues that cut across Departments, agencies, and systems.
{SLIDE 7. Federal Action Agenda]
A key by-product of the Federal Partners Workgroup is the first Federal Mental Health Action Agenda {Hold up the Federal Action Agenda.} which was just released two months ago. We have copies available for each of you. The Action Agenda is tangible evidence of how we will move from a vision of transformed mental health care to a reality. It identifies 70 time-limited, realistic steps that we, in the Federal government, will be taking over the next year to respond to the goals and recommendations of the Commission. This Action Agenda is our pledge to Congress, to our citizens, to the people we serve… that we intend to act and to be held accountable for the actions we take in transforming mental health care.
{SLIDE 8. Principles]
The Federal Action Agenda was built around the same five principles that guided the work and the vision of the President’s New Freedom Commission on Mental Health {pause to read from slide}
- Consumer opportunities for a full life in the community;
- Models of comprehensive, community-based care;
- Maximization of existing resources;
- Use of research findings to influence service delivery; and
- Promotion of innovation, flexibility, and accountability at all levels of government.
{SLIDE 9. Federal Executive Steering Committee]
Perhaps as important as the Federal Action Agenda itself is the commitment to mental health transformation made by a score of key leaders in the Federal government. Twenty-two Assistant Department Secretaries and agency heads have agreed to serve on the Federal Executive Steering Committee. This Committee will identify and eliminate barriers to effective mental health care. Most importantly, this Committee will give general direction, monitor and report on the Federal government’s progress in transforming mental health care in America. It is assumed the Committee members will make certain that their agencies commit the resources needed to keep transformation moving forward.
{SLIDE 10. Collaboration]
I am quite pleased the partnership that has blossomed among so many Federal Departments over the past two years and the document that has been produced to chart our work. But perhaps most importantly, we have created a precedent. The cross-agency collaboration that is occurring among the Federal folks provides a model for what should be expected and demanded at every level of the system—especially at the State level. It is at this level where transformation really comes to life. This is level where the greatest opportunity exists to make a real difference in the mental health care available to millions of American adults and children. As Kathryn has said many times, States are the centers of gravity for transformation.
And it is gratifying to report that States across the country are seizing opportunities to advance transformation. Almost every State Mental Health Agency has adopted a recovery mission statement and is working to develop recovery-oriented services. Nearly every State has initiatives to ensure that individualized, person-centered treatment plans are implemented to meet each consumer or family’s unique needs. More than half of the State Agencies are developing a Comprehensive State Mental Health Plan that spans multiple State agencies. Thousands of organizations in the private sector—from insurers to advocacy groups to corporations—are also joining in the effort. People with different perspectives are talking with each other. Silos are being replaced by collaboration. This is transformation in action.
{SLIDE 11. MHT-SIGs]
Transformation is being supported in still another way by the Federal government, again in partnership with select States. This past April, we announced the State Incentive Grants for Mental Health Transformation Program, or the “mental health SIGs.” SIG grants provide seed money for the States to use to make systemic changes, with the changes based on the State’s own vision of a comprehensive mental health system. We will be awarding six grants, totaling nearly 19 million dollars in funding, by the end of this month. Increased funding for a second round of grants is included in the President’s proposed budget for the next fiscal year.
Of course, it is important that all States, not just the six grantee States, transform the services in their jurisdiction. To facilitate this critical process, we are providing the States with additional consultation and technical assistance. Together with the National Governors Association’s Center for Best Practices, we are conducting four regional meetings called “ Transforming State Mental Health Systems.” These meetings are designed to bring together teams of individuals capable of leading transformation efforts in their States, such as cabinet-level members of the State government. The first such regional meeting was held in Chicago three months ago. The remaining regional meetings will be held over the course of a year, with the next meeting being later this month in Los Angeles.
{SLIDE 12. TAI]
Another new initiative currently underway is our Transformation Action Initiative or “TAI.” The goal for TAI is to identify ways to make it easier for the States and other stakeholders to navigate among technical assistance efforts. Once a State has identified its priorities for transformation, we want to make sure it has full and immediate access to whatever assistance is available. And grantees will have much more control in identifying and accessing TA resources. In addition, we are exploring how to use technology in broader and more innovative ways to increase access and delivery of support services.
We will pilot our TAI efforts through the six awardees of a mental health SIGs. We are asking these States to do something that is rather revolutionary—to unite all of their State agencies involved with adults, families and children behind a common vision of mental health care as it should be! These States have an unprecedented opportunity to be leaders in collaborative transformation. What they learn can help speed the pace and extent of transformation by others across the country.
{SLIDE 13. NOMs]
With the emphasis on positive outcomes for consumers, we have incorporated National Outcome Measures, or “NOMs” for mental health into our State mental health block grant reporting requirements. And now, we are looking at how we can build the NOMs into all of our discretionary grant programs. Better measures of program effectiveness are increasingly important. We are accountable both for the services we provide and the results we achieve.
{SLIDE 14. NASC]
As you know, a major barrier to recovery is the stigma and discrimination experienced by those who have mental illnesses. Last October, we launched the National Anti-Stigma Campaign, or NASC. NASC is a 3-year effort to educate Americans about mental illnesses and recovery and to encourage those who need help to seek it. The first year focused upon research and developing an outreach strategy, NASC conducted an expert symposium on stigma and discrimination, held an agency kickoff meeting, and held the first meeting of the campaign workgroup. NASC expects to have public service announcements and other materials ready for media release before the end of this year.
{SLIDE 15. Voice Awards]
Coupled with the public education effort is an effort to influence the influencers. A part of this effort is directed at the Nation’s entertainment industry. In July, SAMHSA hosted the first-ever Voice Awards in Los Angeles, California. The purpose of the awards was to honor people in the industry who have created positive, accurate and dignified portrayals of people with a mental illness. Among the awardees was Actress Brooke Shields who has remained a staunch advocate for mental health treatment even as her personal struggle with post-partum depression has become fodder for a public debate about psychotropic drugs.
The media attention generated by the awards ceremony has presented an excellent opportunity to educate the public about mental health, mental illness, and recovery. Fact is replacing myth; understanding is replacing fear. Thousands of Americans—on Capitol Hill, in Hollywood, and communities nationwide—are raising their voices on behalf of mental health transformation. We are moving closer to a time when we can prevent mental illnesses from occurring and when anyone with an illness will be able to seek treatment—willingly, openly, and with hope in recovery.
{SLIDE16. Transformation Equation]
Yes, we have made progress over the past year; but transformation is a long-term process with continuous action. Kathryn often speaks of the transformation equation. Transformation requires vision plus belief plus action . . . multiplied by continuous quality improvement. We must continuously ask ourselves if the resources and services we provide are effective and meeting the mark. We must continuously seek to improve. We must continuously make progress.
{SLIDE 17. Quote]
As the Irish novelist and poet Oscar Wilde wrote, “true progress is to know more, and be more, and to do more.” Catastrophic events often propel us to do more…and to do it better. We have seen this throughout our Nation’s history. We saw it in the response to 9/11 and we are seeing it now in the response to the enormous devastation cause by Hurricane Katrina.
So I encourage you to read this first Federal Action Agenda, learn what is happening in States and local communities across America, and be in every sense a “transformation agent.” I encourage you to dare to be different…to make a difference…to do more.
We have begun the journey. People in the Federal government, in State and local governments and many in the private sector are joining hands in a shared effort to transform mental health care. I want to thank each of you for moving together down the transformation highway.
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