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Center for Mental Health Services
National Advisory Council
Washington, D.C.
DIRECTOR'S REPORT
December 1997

As the Center for Mental Health Services (CMHS) celebrates its fifth year of leading Federal Government efforts to support and advance mental health service delivery systems throughout the country, it is undertaking a number of major projects in addition to its other responsibilities. Chief among them are the Surgeon Generals Report on Mental Health, "Walk the Walk: For Lives Touched by Mental Illness," and a far-reaching collaboration with Russia regarding disaster mental health.

The high profile of Surgeon General’s reports presents CMHS with an excellent opportunity to focus public attention on promoting mental health, ending the stigma associated with mental illness, encouraging early recognition and intervention for mental health problems, and promoting innovative service delivery systems that enhance mental health treatment for millions of Americans in their own communities.

In keeping with the CMHS mission to reach the public with important information about mental health and mental illness, CMHS is planning a 1-mile walk in Washington, D.C., on Saturday, May 2, 1998. The goals of "Walk the Walk" are to dispel negative preconceptions about people with mental illness through education, gain equal treatment for people with mental illness, and celebrate mental health.

The honorary co-chairs for the "Walk" are Donna Shalala, Secretary of the Department of Health and Human Services, and Tipper Gore, Mental Health Advisor to the President. The special project directors are Patricia Kempthorne, a member of the Congressional/ Cabinet Spouses Forum on Mental Health, and Ellen Pena, wife of the Secretary of Energy.

And, as world peace increasingly depends on economic and social stability, CMHS is expanding its vision to collaborate with Russia. Secretary Shalala and Russian Health Minister Demitriva identified both disaster mental health and the treatment of depression in primary care settings as new areas of potential collaboration during the semi-annual meeting of the Gore-Chernomyrdin Commission last February.

The Russians are proud of their rapid and comprehensive immediate disaster health response capacity, including psychiatric interventions. They are eager to benefit from the work CMHS has done regarding training and longer range mental health recovery intervention models.

In September 1997, Drs. Thom Borneman and Brian Flynn, Deputy Director of CMHS and Director of the CMHS Division of Program Development, Special Populations and Projects respectively, as well as Drs. Regier and Lozovsky from the National Institute of Mental Health, traveled to Moscow to explore the potential for such a collaboration. Drs. Blorneman and Flynn addressed disaster mental health, and Drs. Regier and Lozovsky focused on depression. This successful meeting resulted in a significant list of collaborative areas.

The next step of this collaboration is a visit from a group of Russian representatives from the Health Ministry as well as EMERCOM (the Russian equivalent of the U.S. Federal Emergency Management Agency). CMHS is in the process of planning this phase, which includes both meetings in the Washington, D.C. area and visits to active disaster crisis counseling sites.

Other important activities are highlighted in this report and additional information is available from CMHS offices.

Legislative Update

Reauthorization

Although both chambers of the 105th Congress (the House Commerce Committee, Subcommittee on Health and the Environment, and the Senate Committee on Labor and Human Resources, Subcommittee on Public Health and Safety) convened hearings on SAMHSA reauthorization last summer, no further action has occurred since then.

SAMHSA would like reauthorization for the four formula grant programs, including the CMHS Projects for Assistance in Transition from Homelessness (PATH) program, the Comprehensive Community Mental Health Block Grant, and the Protection and Advocacy (P&A) program.

These programs include provisions for a smooth transition of the CMHS Block Grant programs into performance partnerships. Performance partnership block grants would consolidate 12 required State plan criteria for community mental health services into 5, and would reduce the number of mandatory requirements for substance abuse plans. Other discretionary CMHS grant authorities were proposed to be consolidated into one Knowledge Development and Application (KDA) program for mental health.

The KDA program redirects the focus of SAMHSA discretionary grant programs from supplementing and building services to a targeted approach to developing and applying knowledge in service systems at the State and local levels.

Neither chamber is likely to take up SAMHSA reauthorization when Congress resumes in January.

Appropriations

The FY 1998 spending bill that provides funding for CMHS appropriates over $451 million to the Center. This represents an increase of more than $6 million above the President’s FY 1998 budget request. Funding for Children’s Mental Health Services increased by more than $3 million, and the PATH program received an additional $3 million. The KDA program, P&A program, and State block grants remain at FY 1997 funding levels.

Center for Mental Health Services FY 1998 Budget
(Dollars in Thousands)

Final Rule: Protection and Advocacy for Mentally Ill Individuals Act of 1991

The final regulations for the Protection and Advocacy for Individuals with Mental Illness (PAIMI) Act of 1991 appeared in the Federal Register dated October 15, 1997 (Vol. 62, No. 199, pp. 53548-53471).

These regulations govern activities carried out by P&A systems under the PAIMI Act. The regulations include: definitions; basic requirements to determine eligibility for and use of allotments; grant administration; eligibility for protection and advocacy services; annual and financial status reports; requirements regarding program facilities; and records and confidentiality.

Key provisions of the Final Rule include:

• Defines terms related to P&A programs--such as care or treatment, facilities, and legal guardian.
• Stipulates that P&A staff shall have access to the records and documents they need to carry out their duties.
• Stipulates that P&A staff shall have access to facilities and residents to investigate alleged incidents of abuse or neglect when such an incident is reported; when there is probable cause to believe such an incident occurred; or when there is imminent danger of serious abuse or neglect.
• Limits tenure on P&A governing board and PAIMI Advisory Council to no more than four years and restricts reappointment for a two-year period.
• Requires the PAIMI Advisory Council to include at least one family member who is the primary caregiver for a minor child or youth who receives or has received mental health services.

PAIMI Site Reviews

During the last six months, monitoring and technical assistance site reviews of PAIMI programs were conducted in Alabama, Indiana, Kentucky, Ohio, and Virginia (joint review with a representative from the Administration on Developmental Disabilities).

Center Director’s Meetings

Dr. Arons spoke at several meetings over the fall and is scheduled to address many groups in the coming months. Among these was the Behavioral Healthcare Tomorrow’s "National Dialogue Conference" in September. Dr. Arons’ keynote address was entitled "Beyond Parity: Ending Discrimination Against the Uninsured." Approximately 2,000 leaders and decision makers from all sectors of the behavioral healthcare industry attended.

In October, Dr. Arons delivered a keynote speech at the second National Consumer, Family, and Advocate Leadership Conference on State Health Care Reform and Managed Care. The conference brought together all major groups concerned about consumer and family issues in managed behavioral health care. The conference provided up-to-date training on health care reform and managed care, with particular emphasis on contracting issues and contracting language, to leaders in State coalitions who represent all major constituency groups of the National Managed Care Consortium.

Dr. Arons also gave a speech in October before the American Psychiatric Association’s Institute on Psychiatric Services. His speech was entitled, "Longitude, the Millennium, and the Future of Psychiatry." In a separate speech at the conference, Dr. Arons addressed clinical approaches to working with people who are homeless and mentally ill. The event is supported annually by CMHS and is designed to encourage psychiatric residents to consider a career in community psychiatry, especially focusing on consumers with serious mental illnesses. More than 150 persons were enrolled for the day of special training.

Also that month, Dr. Arons gave the opening remarks at the "Mental Health Research in the 21st Century: Cross-Cultural, Multicultural, and Culturally Competent Perspectives" meeting.

In November, Dr. Arons gave the keynote address for the "Mental Health Leadership in Transition: A National Summit for State Public Mental Health Commissioners, Academic Psychiatrists, and Consumer Advocates," sponsored by the National Mental Health Association, National Association of State Mental Health Program Directors, and American Association of Chairmen of Departments of Psychiatry. He also gave remarks at the unveiling of the "Drawing on Strengths" poster at the Federation of Families for Children’s Mental Health Conference.

Program Activities and Initiatives

Office of the Director

Associate Director for Medical Affairs

The HIV/AIDS Program launched a new initiative to help change high-risk behaviors associated with the rising number of adolescents/young adults and women becoming infected with HIV/AIDS. The goals of the "HIV/AIDS High-Risk Behavior Prevention /Intervention Model for Young Adults/Adolescents and Women" program are to design and test short-term prevention and intervention strategies as well as to identify the best methods to help young people and women use those strategies. CMHS will work with the coordinating center, Research Triangle Institute, NC, and the seven study sites. The first grantee meeting was held on November 20-21, in Virginia.

Office of Managed Care

Jeffrey Buck, Ph.D., participated in the September Behavioral Healthcare press conference on parity in Washington, D.C. His presentation was entitled, "Federal and State Legislative Update: Issues and Trends in Parity."

Hard copies of the study entitled "An Evaluation of Contracts Between State Medicaid Agencies and Managed Care Organizations for the Prevention and Treatment of Mental Illness and Substance Abuse" are available for distribution through SAMHSA's National Mental Health Information Center at 1-800-789-2647. The study represents a review of Medicaid "comprehensive-risk" agreements that were in effect and proposals that were being considered in the latter half of 1995 in 36 States and the District of Columbia.

The Office continues its work in a number of areas, such as contracting with the George Washington University Center for Health Policy for ongoing analyses which include annual reports on all Medicaid managed care contracts; developing technical assistance guides for providers, public purchaser, and consumers that address contract negotiation; supporting a project that will produce a series of legal briefs over the next two years on procurement, contracting, and contract execution; and producing a series of in-depth specialty reports on contracting issues.

Division of Knowledge Development and Systems Change

The Division placed new emphasis on knowledge application through the Community Action Grants. This program helps communities build consensus and eliminate traditional barriers to service system change. Grantees will be implementing best practices such as: assertive community treatment; wraparound services for children; various police sensitivity training interventions; family psychoeducation; elderly outreach; and supported education.

In November, the Division co-sponsored a meeting with NIMH to launch a CMHS/NIMH joint project. This project will use CMHS grant sites as laboratories to study the effectiveness of a number of promising treatments in real world settings.

These awards and activities help round out the KDA portfolio and create a comprehensive program of knowledge development in service system evaluation research.

Child, Adolescent, and Family Branch

The Branch initiated a major new program with the Indian Health Service to assist Native American Tribes as they develop systems of care for children in their own communities. Individual Tribes will use their own expectations for desirable treatment outcomes. This is the largest Federal mental health initiative to support Native Americans.

The national education campaign, CARING FOR EVERY CHILD’S MENTAL HEALTH: Communities Together, received second place in the Blue Pencil Competition of the National Association of Government Communicators for the brochure, "Your Child’s Mental Health: What Every Family Should Know." This is a competition for all Government communicators, including Federal, State, and local agencies.

In addition, MetLife’s brochure, "About Your Child’s First Day at School," will include the campaign’s statement that a child’s mental health is as important as physical health. The brochure will be issued during the summer of 1998 and will be distributed free of charge.

The campaign generated articles or notices that ran in daily and weekly newspapers that reached an estimated 190 million readers. An additional 18 million readers were reached through similar articles that ran in trade publications.

In supporting the 22 grantees of the CMHS Comprehensive Community Mental Health Services for Children and Adolescents with Serious Emotional Disturbances and Their Families Program, the campaign provided technical assistance in communications to at least 13 special events; 20 newsletters, news releases, brochures, and other publications; and 6 statewide or citywide collaborative efforts.

In collaboration with organizations affiliated with the CMHS Comprehensive Community Mental Health Services for Children and Adolescents with Serious Emotional Disturbances and Their Families Program, the campaign trained more than 400 participants in a strategic communications planning process; trained 50 participants in the use of an educational videotape; and fostered the use of campaign elements by 16 local mental health advocacy organizations.

The campaign exhibited at the annual meetings of the American Academy of Family Physicians, American Academy of Pediatricians, American Public Health Association, National Association of Elementary School Principals, National Association of Secondary School Principals, National Mental Health Association, and Federation of Families for Children’s Mental Health.

The "Voices of Strength: An Inside Look at Children’s Mental Health" video premiered to a standing ovation at the national Site Director’s Meeting in Baltimore, MD, in April.

The campaign’s family brochure, "Your Child’s Mental Health: What Every Family Should Know," and the teen brochure, "You and Mental Health: What’s the Deal?," were featured in 5,000 World Mental Health Day kits distributed worldwide. In addition, the Information Center responded to 2,600 requests on child and adolescent mental health. "You and Mental Health: What’s the Deal?" was the most requested campaign publication.

The "Children’s Campaign" section of the Information Center World Wide Web site received 7,800 hits.

Community Support Program

In collaboration with consumer affairs staff, CSP is developing a series of consumer-directed initiatives to pave the road to recovery from mental illness. Collectively, the projects represent what consumers have informed CMHS is important to facilitate recovery.

CSP developed the Case Management Practice Guidelines for Adults with Serious and Persistent Mental Illness in collaboration with the National Association of Management. These guidelines define and describe case management.

Homeless Programs Branch

Grantees of the Access to Community Care and Effective Services and Supports (ACCESS) program are helping to improve the quality of life for their clients. Compared to "control" communities, communities that use a range of integrated services show gains in their clients’ housing stability, employment, psychiatric functioning, health status, and abstinence from substance use.

The Projects for Assistance in Transition from Homelessness developed two curricula (Implementing Intervention for Homeless Persons with Co-Occurring Disorders and Planning for Funding) that await final SAMHSA clearance prior to publication. Advocates for Human Potential provided technical assistance on these projects.

The grantees involved in evaluating housing models for persons with serious mental illness convened their first meeting on December 3-5, in Washington, D.C. They met to assess the differential effects of at least three housing models on consumer stability in housing, access to services, and quality of life indices.

Division of Program Development, Special Populations and Projects

Community Mental Health Centers Construction Monitoring Branch

Staff monitored over 200 CMHC Construction Grantees to ensure that the five essential mental health services (inpatient, outpatient, partial hospitalization, 24-hour emergency care, and consultation and education) were being provided in compliance with the terms of their grants. Monitoring efforts included the over 60 onsite visits and distribution of 200 annual self-certification surveys.

Staff monitored over 900 recipients of NIMH/CMHS clinical training stipends to ensure that they were meeting their service payback obligation by performing mental health services to underserved populations in designated manpower shortage areas.

Staff initiated negotiations with the Department of Veterans Affairs to transfer the responsibility for care of four Merchant Seamen from SAMHSA to the VA. The applications to obtain care and treatment for these Merchant Seamen under VA coverage are being processed.

Emergency Services and Disaster Relief Branch

Thirty-four States contacted ESDRB about crisis counseling programs following major natural disasters declared by the President. Twenty-five States had active programs funded at over $14 million.

ESDRB coordinated a collaborative effort between North Dakota, South Dakota, and Minnesota to provide more effective services.

Emergency coordinators in State Department of Mental Health Agencies attended a week-long workshop that provided training in the use of streamlined application materials developed by ESDRB. The Branch also helped lead a special workshop on the crisis counseling program for the Federal Emergency Management Agency staff.

Special Projects Development Branch

The Faith Community Activities component of the Branch provided leadership in identifying the critical issues for enhancing the accessibility and acceptability of services to members of faith communities. It developed two contracts:

• "Faith Community Partnerships in Response to Emergencies and Disasters" to examine the role of the clergy and other leaders of the faith community in providing crisis mental health services during a variety of emergencies and disasters; and
• "Models of Faith Community Partnerships" to identify critical elements of successful partnerships between mental health service providers, consumers, and families with the faith community.

The Minority Mental Health Program convened a series of work group meetings to develop cultural competence systems and clinical standards, guidelines and competencies for African American, Asian, Pacific Island, Latino, and Native American populations. It also convened a work group to enhance the Mental Health Statistical Improvement Program (MHSIP) Consumer-Oriented Report Card. Staff provided technical assistance and knowledge dissemination at a number of national and State conferences, meetings, and workshops on mental health care delivery to ethnic minority populations.

The Rural Mental Health Program provided leadership in identifying and responding to the critical issues for enhancing the delivery of acceptable services for people who live in rural areas. In addition to attending and sponsoring a number of national and State conferences, the program:

• Convened work groups through the National Rural Mental Health Association to develop managed care contract guidelines for purchasers, providers, and consumers of managed mental health care services in rural areas;
• Formed an interagency agreement with the Office of Rural Health Policy, HRSA, to examine the role of telehealth in the delivery of services in rural area; and
• Collaborated and participated in an intergovernmental meeting on the uses of telehealth to provide services in rural and isolated areas.

The CMHS Healthy People 2010 work group continues to refine its objectives and has asked to meet with its counterpart at NIMH on a regular basis.

Two Professional Services contracts began in September: the American Orthopsychiatirc Association will formulate a definition of children’s mental health; Research Policy, Inc.

will explore using the information dissemination and translation model developed by the GAINS Center.

The Refugee Mental Health Program engaged in a number of education, training, and conference activities such as:

• Assisting State and local government agencies to develop and integrate mental health services within the existing framework of the primary health care system, and national resettlement agencies and their affiliates to develop grant applications for mental health and community services proposals;
• Designing and conducting 2-day regional workshop on mental health issues for refugee service providers in Denver, CO;
• Assisting the University of Wisconsin, Department of Arts and Sciences, Continuing Education Branch, with the development and support of a conference that will address health and mental health issues of Hmong refugees;
• Working closely with several ORR grantees, including newly funded programs to help them develop and implement effective programs for refugees;
• Conducting several in-service training and workshops for mental health counselors, school personnel, and other health professionals to familiarize them with mental health issues that affect the adjustment and successful resettlement of refugee groups;
• Assisting the New York Department of Social Services, Bureau of Refugee and Immigration Affairs, to develop a regional conference on refugee health and trauma issues;
• Making presentations at national conferences, meetings, and workshops such as the Office of Refugee Resettlement (ORR), Administration for Children and Families, Technical Assistance Conference in Miami, the Second Annual Conference of the commissioned Corps Readiness Force, and the Florida Refugee Task Force Meeting; and
• Assisting the National Institute of Mental Health (NIMH) to develop a national conference on mental health services intervention and research issues related to trauma and torture.

Office of External Liaison

OEL is taking the lead to organize "Walk the Walk: For Lives Touched by Mental Illness," scheduled for May 2, 1998, in Washington, D.C. The "Walk" is co-sponsored by a number of organizations, such as the American Psychiatric Association, the National Mental Health Association, and The National Alliance on Mental Illness. Thousands of people are expected to participate in this 1-mile walk. Donna Shalala, Secretary of the Department of Health and Human Services, and Tipper Gore, Mental Health Advisor to the White House, are honorary co-chairs.

The publication Managed Mental Health Care: What to Look For, What to Ask received a Merit Award from the National Mental Health Information Awards in the consumer decision-making information class. It was among 900 entries.

Eleven stories appeared in trade or association publications as a result of OEL media outreach efforts to commemorate the fifth anniversary of CMHS.

SAMHSA's National Mental Health Information Center continues to grow. As of September 30, 1997, the Information Center answered more than 26,000 requests for information, either by telephone, mail, FAX, or e-mail. In addition, the Information Center BBS reported over 91,000 log-ons, the World Wide Web site recorded over 150,000 hits, and the Information Center distributed more than 100,000 publications.

The Information Center has added a full-time staff member to provide further support to the CMHS Office of Managed Care and to act as a liaison between CMHS and grantees studying managed care activities. The Information Center has also redesigned its World Wide Web site. The new site map has more graphic images, is crisper, and easier to use.

The second issue of the Information Center Bulletin newsletter is at the Government Printing Office and will soon be available for distribution. Three brochures, Mental Health Information for Caregivers, Mental Health Information and Resources on Grief, and Holding Up Half of the World: Women’s Mental Health are awaiting final clearance prior to publication, as are 12 fact sheets that comprise a "consumer kit" including topics such as "How to Choose the Right Mental Health Therapist," "Paying for Mental Health Services," and "Know Your Rights."

Major Projects for Next Quarter

CMHS and its sister Centers (Center for Substance Abuse Prevention and Center for Substance Abuse Treatment) are collaborating on the 4-year Starting Early Starting Smart initiative. Twelve new grantees will receive $6.1 million: five are in primary care service settings, such as public and private health care programs, and seven are in early childhood service settings. A coordinating center will work with the individual programs to collect and analyze data. The sites will study two questions:

• Will integrated services increase access to substance abuse and mental health services?
• Will integrated services improve outcomes for children and families?

These grants will enable families to come to places where they already receive help or services, and provide them with substance abuse and mental health services in familiar environments. Starting Early Starting Smart is a public/private collaboration between The Annie E. Casey Foundation’s Family Program and SAMHSA. Other program supporters are the U.S. Department of Education, the Health Resources and Services Administration, and the Administration on Children and Families.

Office of the Director

Surgeon General’s Report on Mental Health

The CMHS Office of the Director is devoting considerable time and effort to the forthcoming Surgeon General’s Report on Mental Health. This report will include:

• A careful assessment of the state-of-the-art knowledge;
• A landmark publication on the topic; and
• A public document that does not, in whole or part, belong to any author other than the Surgeon General.

SAMHSA and CMHS will be working in partnership with the National Institute of Mental Health and involving other National Institutes of Health agencies. The overall goals are likely to be directed at shedding light on the stigma associated with mental illness and to normalize the topic for the general public. SAMHSA expects to illustrate the diverse ways in which mental illness appears in everyday life, similarities to physical illnesses, the value of prompt and appropriate treatment, and the positive consequences expected from intervention.

Division of Knowledge Development and Systems Change

Child, Adolescent, and Family Branch

The Comprehensive Community Mental Health Services Program for Children and Their Families is providing $8 million for nine new children’s mental health grants. The grants will be used to implement and study a broad array of managed care approaches to community-based and family-focused services for children with serious emotional disturbance and their families. These grants will enable local communities to integrate child- and family-serving agencies—including health, mental health, substance abuse treatment, child welfare, education, and juvenile justice.

Community Support Program

The new $5 million Criminal Justice Diversion Program will evaluate the relative effectiveness of a variety of pre- and post-booking police and criminal justice intervention models for individuals with co-occurring serious mental illness and alcohol or other drug use disorders. It is a 3-year, multisite study. The CMHS GAINS (Gather, Assess, Interpret, Network, and Stimulate) Center is providing technical assistance for this project. The program held its first Steering Committee meeting in November.

Office of Managed Care

In collaboration with the Center for Substance Abuse Treatment, the Office has undertaken two major projects: Intelligent Benefit Design for MH/SA Services and Design and Administration of Comprehensive MH/SA Insurance Benefits. The first project will provide four reports related to mental health and substance abuse benefits in private health insurance and Medicare. The second project will provide information and recommendations related to comprehensive mental health and substance abuse benefits in insurance plans.

Organizational/Personnel Updates

Ms. Teddi Fine joined CMHS in September to serve as the Special Assistant to the Director. The former Senior Advisor for Special Projects at the PHS Office on Women’s Health, Ms. Fine brings expertise in the areas of mental health, aging issues for women, print communications, and public relations. Ms. Fine also spent a dozen years with the American Psychiatric Association, first as Associate Director Government Relations, and later as Assistant Director for Science Policy in the APA Office of Research.

Interagency Agreements and Memoranda of Understanding

The Refugee Mental Health Program and the Office of Refugee Resettlement, Administration for Children and Families, will provide technical assistance and consultation on refugee mental health and social adjustment issues to States and resettlement agencies nationwide.

Major Meetings and Workshops

SAMHSA convened the National Conference on Women, "Cycles, Challenges, and Changes: Making a Difference in the Lives of Women, Their Families, and Their Communities," in September in Phoenix, AZ. Susan Salasin, Director of the CMHS Women’s Mental Health Program, was a presenter at a session entitled, "Intimate Outrages in Treatment: Perpetuating Violence Against Women." In addition, work coming out of the GAINS Center, a CMHS technical assistance center, was highlighted in the session, "Creating Sanctuary: Services for Women with Co-Occurring Disorders in the Criminal Justice System." Other major topics included "Establishing Gender and Culturally Relevant Service Delivery Systems," "Employee Assistance Programs for Women," "Managed Care, HMOs, and Access Issues for Low-Income Women," "Women Involved in the Criminal Justice System," and "Children’s Health Care and Childcare." Approximately 1,000 participants attended.

Office of the Director

CMHS helped plan, and Dr. Arons attended the 13th Annual Rosalynn Carter Symposium on Mental Health Policy in Atlanta, GA, in November. The purpose of the meeting was to bring together some of the key thinkers in the mental health/behavioral health field who have addressed issues of confidentiality and privacy in their respective fields. The audience included mental health experts, consumers, and concerned family members. Tipper Gore, Mental Health Advisor to the White House, addressed the meeting.

A small invitational meeting to discuss Involuntary Intervention and Coerced Treatment of People with Mental Health Disorder will meet on December 10 and 11, in Washington, D.C.

Division of Knowledge Development and Systems Change

Child, Adolescent, and Family Branch

Gary De Carolis, Branch Chief, spoke on systems of care for children and adolescents with serious emotional disturbances and their families at a number of conferences in many States throughout the Nation.

Homeless Programs Branch

Walter Leginski, Ph.D., Branch Chief, participated in the Community Team Training Institute on Homelessness in Washington, D.C. The Institute is a collaborative of the Department of Housing and Urban Development and five agencies of the Department of Health and Human Services, including SAMHSA, HRSA, NIDA, NIMH, and ASPE.

Division of Program Development, Special Populations and Projects

Special Projects Development Branch

The Branch sponsored a meeting entitled "Emotional Disabilities in Organizations with Diminishing or Limited Resources" in Washington, D.C., in October. This forum used "The Americans with Disabilities Act" as its foundation and was grounded in concrete yet varied realities of workplace life. Participants came from a broad range of disciplines such as labor and business, state and federal government, law, media, religion, and consumer organizations. A report from this meeting will be available in February 1998. It will include strategies and suggestions to accommodate people with emotional disabilities in the workplace, guidelines for advancing positive management of others, and promoting mentally healthy work environments.

Also in October, the Healthy People 2010 national work group met to develop new mental health objectives for children.

The CMHS Healthy People 2010 Coordinator represented CMHS at the Healthy People 2010 national consortium meeting in November in Indianapolis.

Division of State and Community Systems Development

Survey and Analysis Branch

Ron Manderscheid, Ph.D., convened and attended several conferences and meetings. Among them were: State Managed Behavioral Healthcare Meeting; Southern Regional Conference on Mental Health Statistics; Consortium on Practice Guidelines for Behavioral Healthcare; Meeting of Major Disability Groups at the American Public Health Association; and a meeting on the Development of Refugee Assessment Protocols in Stockholm, Sweden.

Office of External Liaison

The Consumer Affairs Specialist gave a presentation at a Consumer Self-Advocacy Training prior to the American Public Health Association conference in Indiana.

Office of Managed Care

The Office displayed an exhibit booth at the "Primary Care/Behavioral Healthcare Summit" in Chicago.

Recent and Forthcoming Publications

Buck, J.A., "Trends and Issues in Parity for Behavioral Healthcare Coverage," Behavioral Healthcare Tomorrow, 1997, 6(4), 39, 74-76.

Flynn, B., "Psychological Aspects of Natural Disasters," Journal of Renal Failure, 1997, 19(5),611-620.

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