This Web site is a component of the SAMHSA Health Information Network
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This Web site is a component of the SAMHSA Health Information Network. |
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DIVISION OF KNOWLEDGE DEVELOPMENT AND SYSTEMS CHANGEAsian Americans and Pacific Islanders (AAPI) CMHS has completed its FY 2001 plan to implement Executive Order 13125 to increase the participation of Asian Americans and Pacific Islanders (AAPI) in Federal programs. CMHS has proposed a meeting on AAPI children with serious emotional disturbances; an AAPI Community Action Grant initiative; a dialogue between representatives of managed care organizations and the AAPI community; and a collaborative study with the Bureau of Primary Health Care of the Health Resources and Services Administration (HRSA) on the integration of mental health with primary health care for AAPI populations. A new organization, the National Asian American Pacific Islander Mental Health Association has been formed. It is a membership organization for AAPI mental health providers, consumers, families, researchers, advocates, and administrators. The association was created in response to a key recommendation made at the CMHS AAPI Mental Health Summit, held in July 1999, to discuss ways for CMHS to be more responsive to the mental heath needs of AAPI populations. The new national organization has identified six primary areas of focus, including research/evaluation, data collection, consumer/family involvement, capacity building, cultural competence, and sustainability. Planning has begun for a national AAPI consumer meeting to be held one day prior to the Alternatives 2000 meeting. The meeting is designed to engage immigrant and limited English proficient AAPIs who have had limited previous exposure to existing CMHS consumer programs. The primary goals of the meeting are to create a dialogue among these AAPI populations, other mental health consumers of color, and the CMHS consumer technical assistance centers. In early August 2000, CMHS staff chaired a public policy workshop at the Asian American Psychological Association and delivered a presentation on translating research into practice. CMHS staff shared the podium with the Executive Director of the White House Initiative on AAPIs, the Deputy Director of the National Institute of Mental Health, and a representative from Georgetown Medical School. The Special Programs Development Branch of the Division of Program Development, Special Populations and Projects also has undertake several projects directed toward the AAPI population, which will be detailed in that section of this report. Child, Adolescent and Family Branch Health Care Reform Tracking Project The Health Care Reform Tracking Project has been completed, and the project's final report has been published. The Project, which began in 1995, was a 5-year effort designed to track and analyze the impact of public sector managed care reforms on children and adolescents with behavioral health disorders and their families. The project involved two State surveys to identify and describe managed care reforms and two impact analyses based on in-depth site visits to a selected sample of States. Ten States, including Rhode Island, Arizona, Connecticut, Delaware, Iowa, Massachusetts, North Carolina, Oregon, Utah, and Washington, participated in the first impact analysis, completed in 1997. The analysis involved an in-depth study of managed care reforms on youngsters with serious emotional and substance abuse disorders and of systems of care serving these youngsters and their families. Data was collected through telephone interviews and on-site semi-structured interviews with multiple groups of key stakeholders, including representatives of State children's mental health agencies, State substance abuse agencies, State Medicaid agencies, families, other child-serving systems, managed care organizations, providers, and advocates. More than 75 individuals in each State were interviewed. The assessments and perceptions of these stakeholders comprise the primary source of data for the impact analysis. When considering the analysis findings, it should be noted that many remaining systemic problems related to serving children and adolescents existed prior to the advent of managed care. Meetings and Conferences The Child, Adolescent and Family Branch and the National Association of State Mental Health Program Directors (NASMHPD) held a 1-day meeting on developing partnerships for youth with serious emotional disturbances as they transition to adulthood. The meeting brought together a group of national experts representing families, providers, government representatives, and youth to identify ways for State mental health agencies to develop and strengthen partnerships with other agencies and individuals to improve mental health services for young people making the transition from the children's service system to the adult service system. Approximately 50 individuals attended the meeting at the Academy for Educational Development Conference Center in Washington, D.C. A joint meeting of the nine Circles of Care grantees and the seven Child Mental Health Initiative tribal grantees was held in June 2000. Meeting participants discussed continuing development of the Intertribal Voices of Children and Families, a new organization of tribal parents of children with emotional difficulties initiated in partnership with the Federation of Families for Children's Mental Health in Spring 2000. The Circles of Care program and the Child Mental Health Initiative support the development of projects to improve services to children with serious emotional disturbances and their families in Native American and Alaskan Native communities. In July 2000, the Child, Adolescent and Family Branch sponsored a discussion group in Kansas City, Missouri, to solicit input from adolescents and family members concerning potential enhancements and improvements to future Guidance for Applicants for the Statewide Family Network and Support grants. The Statewide Family Network program provides grants to develop statewide family networks that strengthen the ability of families to participate in mental health service planning on behalf of their children. The Child, Adolescent and Family Branch collaborated with the U.S. Departments of Justice, Interior, Housing, and Transportation, the Indian Health Service, the Center for Substance Abuse Prevention, and the Center for Substance Abuse Treatment to develop a conference for tribal leaders on promising practices to reduce problem behaviors. The conference was held in September 2000. Publications CMHS has published the first three volumes of the 2000 series of Promising Practices in Children's Mental Health. Volume titles are:
The Promising Practices series was developed by grantees funded by the CMHS Comprehensive Community Mental Health Services Program for Children and Their Families. Through this series, CMHS is disseminating findings and lessons learned from the grant program about how to support and serve children with serious emotional disturbances and their families. Community Support Programs Branch Interagency Partnership to Enhance Services for Older Americans CMHS is partnering with CSAT, the Department of Veterans Affairs (VA), CMS, and HRSA on a 4-year program to bridge mental health, substance abuse, primary health care, and aging. Although older adults are the fastest growing vulnerable population with MH/SA disorders, they tend to receive these services through primary care settings, rather than specialty MH/SA providers. The purpose of this program is to evaluate alternative models of delivering and financing MH/SA services for older adults through primary health care. Participating study sites include a variety of primary health care providers, including public community health clinics, Veterans Affairs clinics, private managed care environments, and groups practice settings, all situations in which referrals to MH/SA services are feasible approaches. Each site will compare outcomes of making referrals to speciality MH/SA services outside the primary care setting with outcomes of providing MH/SA services within primary care settings. SAMHSA is funding the program's coordinating center at Harvard Medical School and six study sites. Three of these six sites are also HRSA Community Health Centers and receive additional service enhancement funding from HRSA. The VA is funding an additional five VA study sites, following the same protocol, and a coordinating center at the Miami VA Medical Center. The program, therefore, has a total of 11 study sites in eight States throughout the country. The intervention, begun in March 2000, is expected to screen more than 50,000 individuals 65 and older for MH/SA problems in primary settings. Those in need of services will receive treatment either within the primary care setting or through referrals to specialty MH/SA services outside the primary care setting. Since the program began in September 1998, more than 1000 participants have been enrolled. The Harvard Coordinating Center has facilitated five steering committee meetings and numerous committee conference calls. The committee process has resulted in agreement on a battery for screening/assessment and outcome instruments and methods to be pilot tested in primary care settings with older adults, as well as agreement on a detailed and comprehensive outline/format for describing the process evaluation for each clinical site. Criminal Justice Diversion Program Criminal Justice Diversion Program Multi-Site Study The Criminal Justice Diversion Program multi-site study is in its third year. More than 2,000 subjects are enrolled in the study, and data collection is proceeding. The program has nine sites across the country, plus a coordinating center (Research Triangle Institute) and a technical assistance center (GAINS). The program's ninth steering committee meeting was held in Miami, Florida, in April 2000. A new steering committee chair was selected, and subcommittees were formed on both pre and post booking. Baseline data collection ended on May 31, 2000, and data analysis has begun. Final data collection is expected to end on May 31, 2001, and information about the data will be available within 6 months of that date. Several States have made significant strides in effecting systems change in their local communities, including New York, Tennessee, Hawaii, and Arizona. Based on the success achieved by the Memphis Crisis Intervention team, more than 25 cities have expressed interest in replicating the program. The GAINS Center has provided detailed reports in its publications of systems change work being done in Eugene, Oregon; Tucson, Arizona; and Wicomico County, Maryland. The program has also led to new collaborations between the New York District Attorney's office and the New York Mental Health Court clinics. The New York State Senate is also drafting legislation to fund an integrated Management Information System. Services for Persons with Mental Illness in Jails and Prisons The CMHS Division of Knowledge Development & Systems Change (DKDSC), along with DOJ and the Council of State Governments, are planning a series of meetings regarding legislative consideration of the development of new models of care for persons with mental illness in jails and prisons. DKDSC staff will participate in a conference planned for early 2001 on incarcerated mothers and fathers and common issues for these populations. The impetus for this conference came from a newly-developed HHS workgroup established by the Assistant Secretary for Planning and Evaluation (ASPE) to address these issues. DOJ's National Institute of Corrections has also begun a project on incarcerated mothers and children that draws heavily on CMHS initiatives in its implementation. Women and Violence Study All 14 sites in the Women and Violence Study applied for Phase II of the project, and reviews were conducted in mid-July 2000. The study is designed to develop effective integrated systems for treatment and care of women who are victims of violence and have co-occurring mental health and substance abuse disorders. Research has shown that existing health care systems are not prepared to address the issues relating to co-occurring disorders in women, including family violence and the effects on children. The Women and Violence Study is expected to generate valuable knowledge on the confluence of violence and co-occurring mental health and substance abuse disorders affecting women and their children. Subcommittee meetings for the Women and Violence Study have been ongoing. Plans are underway for the development of a special knowledge application initiative that encompasses all of the products that resulted from Phase I project activities. In June 2000, the CMHS DKDSC sponsored the first planning meeting with NASMHPD to kick off a regional policy development project on women and violence. Homeless Programs Branch Strategic Planning The Homeless Programs Branch is developing a strategic plan that identifies its priorities for the next 2 years. The process began with assembling a focus group representing key audiences to elicit views on current programs and new directions. Input from the focus group has helped to identify key areas and potential roles of individual Branch staff. Knowledge Development Initiative CMHS and CSAT are collaborating on the funding and administration of a two-phased, 5-year knowledge development initiative, known as the "Homeless Families Program." The initiative will document and evaluate the effectiveness of short-term intensive intervention strategies for providing mental health and/or substance abuse treatment, trauma recovery, housing, support, and family preservation services. The program will provide services to homeless mothers with psychiatric and/or substance use disorders who are caring for dependent children. During Phase I of the program, a 2-year process that began in Fall 1999, 14 study sites are focusing on population description, service enhancement, model documentation, development of a cross-site protocol, and cross- and individual-site evaluation plan designs. A coordinating center is facilitating site visits and development of the cross-site study design and evaluation protocol. The coordinating center is also providing technical assistance to sites and logistics support for grantee steering committee and consumer panel meetings. PATH Program In June 2000, the PATH program convened its biannual conference for State PATH contacts. The purpose of the conference was to provide updates and technical assistance to grantees and to offer opportunities for networking and collaboration. Collaboration with Other Federal Organizations The Homeless Programs Branch is collaborating with the U.S. Department of Housing and Urban Development (HUD) to develop a mental health action plan for people with serious mental illnesses who live in public housing or receive Section 8 rental assistance. A meeting was held in late May 2000 to define the parameters of the plan, which will address strategies at Federal, State, and local levels for providing services and supports to help people with mental illness retain housing. The Branch is also collaborating with SAMHSA and several other Health and Human Services (HHS) organizations including ASPE, the Administration for Children and Families (ACF), CMS, and HRSA on a conference to examine ways for improving access to Health and Human Services mainstream programs for persons who are homeless. The conference will take place in late summer or early fall. The Homeless Programs Branch is collaborating with the SAMHSA Homeless Workgroup to develop a strategic planning process. The SAMHSA Workgroup has been charged with developing initiatives across the three SAMHSA centers. Go To Report Page One: Year-end Report Page Two: Legislative Update Page Three: Program Activities and Initiatives Page Four: Division of Knowledge Development and Systems Change Page Five: Division of Program Development, Special Populations, and Projects Page Six: Division of State and Community Systems Develpment Page Seven: CMHS Staff Notes |
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