Center for Mental Health Services
National Advisory Council
Washington, D.C.
DIRECTOR'S REPORT
June 1999
Since the National Advisory Council met in December, the Center for Mental Health Services (CMHS) has both launched new efforts and made significant progress with continuing efforts to provide mental health services that meet the wants and needs of people with mental illness and their families. Here are some of the highlights:
- CMHS played a lead role in the development of new objectives in the Mental Health and Mental Disorders Chapter in Healthy People 2010.
- CMHS released Mental Health, United States, 1998, a current overview of the status of mental health services.
- The Emergency Services and Disaster Relief Program, now in its 25th year of service, responded to the tornadoes in Oklahoma and Kansas and to the shootings at Columbine School in Littleton, Colorado.
- The Homeless Programs Branch received the Secretary’s Award for Distinguished Service for its Access to Community Care and Effective Services Support (ACCESS) Project.
- The Office of External Liaison’s (OEL), SAMHSA's National Mental Health Information Center, unveiled a new Web site design to make the site more user-friendly and visually appealing.
Several high-profile activities currently underway, including the Surgeon General’s Report on Mental Health, the White House Conference on Mental Health, and the HHS Secretary’s expressed desire for one of her two FY2001 initiatives to be on Mental Health, indicate that the mental health field is receiving growing attention.
The 1998 Congressional appropriation of $40,000,000 to CMHS provided an excellent opportunity to develop the integrated continuum of prevention, early intervention, and treatment services called for by Congress, clinicians, researchers, and other advocates of effective and appropriate mental health services for children with emotional and behavioral disorders who are at risk of violent behavior. With this funding, two major grant programs were launched, the interdepartmental
Safe Schools/Healthy Students Initiative and the School Action Grant Program.
Surgeon General Dr. David Satcher has made mental health one of his top initiatives. The
Surgeon General’s Report on Mental Health, which Dr. Satcher has embraced, presents an extraordinary opportunity for CMHS 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 effective, appropriate service delivery systems that enhance mental health treatment for millions of Americans in their own communities.
CMHS’ work abroad has helped to generate increased international attention on mental health. CMHS has forged new relationships and new program opportunities with the Pan American Health Organization. CMHS provided training to Kenyans to help those traumatized by the embassy bombing. CMHS continues discussions with our mental health counterparts in Russia, as part of a larger Departmental and government-wide initiative, and continues to educate visitors from other countries about how the U.S. delivers mental health services.
And here at home, the White House has renewed its focus on mental health. On June 7, 1999, Mrs. Tipper Gore convened a White House Conference on Mental Health. CMHS helped to set the cornerstone for the messages of this conference which are that mental health services work; that education, employment, and housing are both sought after and possible goals for people with mental illness; and that the stigma associated with mental illness must end. CMHS also worked with the office of Mrs. Gore to assist in preparations for the conference.
LEGISLATIVE UPDATE
Reauthorization
In early May, legislation was introduced to reauthorize the Substance Abuse and Mental Health Services Administration (SAMHSA) through 2002. The bill (S.976), entitled "The Youth Drug and Mental Health Services Act," has a strong youth focus. It authorizes SAMHSA’s Children and Violence Program, creates a new authority for youth treatment, and focuses on the needs of children with parents who are substance abusers. In addition, the legislation implements proposals to give States more flexibility in the use of block grant funds with accountability based on performance. The bill also consolidates the discretionary grant authorities to give the Secretary more flexibility in responding to persons who need mental health and substance abuse services.
With Senate markup of the legislation on the horizon, possibly in late June, SAMHSA staff continues to provide legislators with the appropriate information. Topics of ongoing discussion include: whether States that receive substance abuse block grants must have a planning council, whether the legislation should contain a confidentiality provision, whether a state P & A program should be informed when a death has occurred, whether the homeless provisions included in the bill should be changed, whether the legislation should include provisions for substance abuse and mental health services treatment for teens, whether religious organizations should receive Federal funds for substance abuse treatment, whether future funding for the CMHS Block Grant should be earmarked for a subset of people with mental illness, whether the bill should address the needs of those with co-occurring mental health and substance abuse disorders, and whether substance abuse and mental health services should be mainstreamed into primary health care.
CMHS staff continue to work with members in the House with regard to reauthorization. However, Congressman Bliley, Chairman of the House Commerce Committee, has shown no interest either in holding a hearing or in introducing legislation to reauthorize SAMHSA programs.
Appropriations
The President’s budget request for SAMHSA for FY 2000 is $2.6 billion, an increase of over $138 million, or 5.6% over the FY1999 appropriation. The budget request includes an increase of $5 million for the PATH Homeless Program and $70 million more for the CMHS Block Grant Program. In mid-May, SAMHSA learned that the request for reprogramming $3.1 million from Knowledge Development and Application (KDA) to Program Management was approved by both the House and Senate Appropriations Committees.
Center Director’s Activities
CMHS Director Bernard S. Arons, M.D. delivered a number of speeches to a variety of mental health audiences throughout the country. Presentations included a keynote address on the CMHS school violence prevention program for the first annual Public Policy Institute of the National Association of School Psychologists, remarks on Native American Circles of Care for the Federal/National Partnership for Children’s Mental Health, and the commencement address for the Advocacy Unlimited graduation ceremony.
An article by the Connecticut Assistant Mental Health Commissioner that ran in the Hartford Courant quoted several points from Dr. Arons’ commencement address and referred to the event as "one of the most significant, emotionally uplifting, and rewarding graduation ceremonies I have ever experienced."
Dr. Arons will deliver the keynote address for the Asian American and Pacific Islanders National Mental Health Summit on July 10, 1999. The Summit, which continues until July 12, will focus on the mental health issues in Asian American and Pacific Islander communities and ways to improve mental health service delivery to this multi-cultural and multi-ethnic population. The meeting will also examine ways to address the unmet mental health needs of those with limited English proficiency.
PROGRAM ACTIVITIES AND INITIATIVES
Associate Director for Medical Affairs
CMHS continues to play the lead role in collaborating with six Federal agencies to study an integrated approach to mental health, substance use, and primary medical HIV/AIDS treatment.
Office of Managed Care
The Office of Managed Care is undertaking numerous activities as a follow-up to its landmark study on parity for mental health and substance abuse benefits released last year. New projects include case studies of employers and HMOs with comprehensive mental health and substance abuse benefits; an exploration of ways for employers to improve benefit plans while not implementing full parity; and examination of the impact of the Vermont parity law. Based on knowledge learned from these efforts, the Office of Managed Care continues to produce managed care and mental health information for mental health professionals, decision makers, and the public.
Office of External Liaison
From January to June 1999, Office of External Liaison (OEL) proactive media outreach efforts resulted in more than 25 articles, columns, and op-eds about CMHS initiatives in trade publications and major media outlets such as
The Washington Post, The Chicago Sun-Times, the Wall Street Journal and
Time magazine. Articles about CMHS activities are currently being developed by writers for
The Chicago Tribune and Good Housekeeping magazine.
Media
Since January 1999, CMHS Director Bernard S. Arons, M.D. and other CMHS office/division directors and branch chiefs were featured on more than a half-dozen radio interviews and three television interviews including a nationally syndicated television news show.
In January, local television station WRC-TV, the NBC affiliate, interviewed Dr. Arons about depression screening as part of the station’s news programming about its "4 Your Health and Fitness Expo." As a result of OEL outreach efforts, WRC selected the CMHS exhibit and depression screening booth as one of only four exhibits to be chosen for news stories. More than 150 exhibits participated in the Expo attended by more than 70,000 individuals.
On March 11, 1999, the national syndicated news magazine, "Fox Files," aired Dr. Arons’ interview with reporter Catherine Crier. Dr. Arons discussed current federal efforts to study restraint and seclusion.
On March 12, 1999, OEL’s Information Center toll-free telephone number was featured at the end of NBC’s, "Back to Bedlam," a one-hour special television documentary, hosted by Geraldo Rivera, that examined conditions in the nation’s mental health clinics. In anticipation of an influx of calls following the show, Information Center staffed the phones that evening and fielded a steady stream of calls from across the nation from viewers eager to learn more about mental health issues and CMHS.
Also in early March, Wall Street Journal (circulation of 1.74 million) columnist Marilyn Chase interviewed Dr. Arons about how primary care physicians are paying more attention to the mental health needs of their patients as a result of the rise of managed care.
OEL faxed a letter and fact sheet about CMHS’ "Safe Schools/Healthy Students Initiative" to news outlets across the nation in response to the tragic shootings in Littleton, Colorado. Media outlets that responded included National Public Radio’s "All Things Considered" and
The Washington Post. The Post invited Child and Adolescent Family Branch Chief Gary DeCarolis to interact with its readers on its April 23, 1999, on line "Health Talk," hosted by Health Editor Abigail Trafford. Ms. Trafford highlighted De Carolis’ comments and insights in her column entitled, "Angry Youths Need Early Aid," that ran in the Post’s April 27 special Health section.
On May 11, 1999, The Chicago Sun-Times (circulation of more than 500,000) published an op-ed written by OEL Director Curtis R. Austin, which highlighted CMHS efforts to address the mental health needs of older Americans and cited May as both Mental Health Month and Older Americans Month.
Time magazine (4.2 million paid subscribers) cited CMHS funding of crisis counseling for victims in the wake of federal disasters in its May 17, 1999 issue.
CMHS efforts led to placement of Dr. Arons as the sole guest on local NBC affiliate WRC-TV’s half-hour news show, "Viewpoint," which aired Sunday May 16, 1999. Dr. Arons discussed the progress that has been made in the mental health arena over the past 50 years, noting that this May was the 50th anniversary of Mental Health Month. His remarks included progress in medical advances for mental illness, as well as successful efforts to reduce the stigma associated with mental illness.
On May 27, 1999, Dr. Arons was a featured panelist on WAMU.88.5 FM, discussing the reintegration into society of people with mental illness. Hosted by Kojo Nnamdi, the live show, called "Public Interest," was aired through National Public Radio to listeners across the nation, who phoned in questions that sparked a discussion about a host of issues revolving around stigma and the obstacles that people with mental illness face in their efforts to reintegrate into society.
Consumer
The OEL Consumers Affairs Office is working on a number of activities to reduce stigma. Efforts include: the production and distribution of an anti-stigma poster; the establishment and oversight of a SAMHSA-wide Anti-Stigma Work Group to address the issue of stigma in the mental health and substance abuse arenas; the production of a video, "Stigma…in Our Work, in Our Lives," created by the Anti-Stigma Project of On Our Own of Maryland, Inc., a State consumer organization; the development of bilingual radio PSAs for distribution to Spanish-speaking radio stations; and the development of a guidebook for addressing stigma in the media.
The Consumer Affairs staff continue to manage and participate in the SAMHSA-wide Consumer Bill of Rights Work Group to implement a plan for promoting the President’s Advisory Commission Consumer Bill of Rights and Responsibilities. A major activity of this group is the development and distribution of publications that explain the Consumer Bill of Rights and Responsibilities and give exemplary practices for implementing them. Staff has also provided leadership in developing a CMHS position on recent Congressional privacy proposals.
Consumer Affairs staff are working on developing a CMHS privacy position. Three privacy bill are currently pending in Congress.
CMHS is currently working with a Planning Group of representatives from national consumer organizations to assist in the development of a Consumer Subcommittee to the CMHS National Advisory Council. The group has met via teleconferences and is planning an in-person meeting this summer.
Consumer Affairs – in its continuing efforts to promote and elicit consumer involvement and expertise – plans to convene regional mental health consumer meetings in San Francisco and New York City. The office is also planning a consumer/psychiatric nurse dialogue and a consumer/social worker dialogue within the next few months. Consumer Affairs staff also continue to facilitate networking efforts begun last year with the People of Color Consumer Network and the Older Adults Network.
In addition, Consumer Affairs staff are managing the production of a number of projects including a guidebook on self-care and recovery, a managed care grievance and appeal procedures guide, an arts in recovery manual, a "how to hold dialogues" manual, a monograph on the needs of consumers who are gay/lesbian/bisexual/transgender, and a training video for residents of psychiatry programs designed to improve communication and therapeutic partnerships with consumers.
SAMHSA's National Mental Health Information Center
In April 1999, the Information Center unveiled a new web site design to make the site more user-friendly and visually appealing. The new design is easy to navigate and provides quick access to state resource guides for mental health services, mental health fact sheets and publications to download or order, links to mental health resources on the Internet, grant funding opportunities, and a searchable calendar of mental health conferences and events.
New and improved sections include: a Newsroom of the latest mental health articles updated each business day, a Kids Area, a section featuring Spanish-language publications and links, and searchable databases. A scrolling banner announces the latest publications, events, and news from CMHS. The entire Web site is searchable by keyword with a ranking system for results.
The Information Center continues to grow. Nearly 20,000 people per day access mental health information on the Informtion Center Web site. Monthly figures are also on the rise. During one recent month, nearly 50,000 individuals contacted the Information Center via various channels including the Web site, toll-free telephone number, e-mail, and fax. This March the Information Center distributed more than 32,000 publications.
DIVISION OF KNOWLEDGE DEVELOPMENT AND SYSTEMS CHANGE
Child, Adolescent and Family Branch
The CARING FOR EVERY CHILD’S MENTAL: Communities Together campaign reached a new stage of development with the launch of a full-scale social marketing campaign.
The Branch initiated a Native American Children’s Mental Health Program, called Circles of Care, to provide planning assistance for improving services to children with serious emotional disturbances in Native American communities.
CMHS staff traveled to Santiago, Chile, April 9-17, 1999, to meet with key players in the mental health system. CMHS staff assisted Chilean colleagues in developing a logic model, list of key outcomes as identified by multiple stakeholders, list of promising practices, and suggestions for a specific evaluation of the Children’s Unit at the Felix Bulnes Cerda Hospital. These products are aimed at generating enthusiasm for evaluating mental health services at the Chilean Hospital.
Community Support Programs Branch
CMHS funded 31 Community Action Grants in FY1998, including 11 under a special Hispanic Initiative. Among the exemplary practices funded are integrated mental health and substance abuse services, wrap around services for emotionally disturbed children, supported employment models, law enforcement training, consumer leadership training, assertive community treatment for high-risk clients, a program for volunteers working with persons with mental illness, strengths-based case management, integrated services for homeless individuals, family education about mental illness, gatekeeper programs for at-risk elderly, and a program for adults with mental illness who are deaf. It is expected that 25-30 new awards will be made in FY 1999.
In FY 1998, SAMHSA launched a 4-year program to study the delivery of mental health/substance abuse services for older adults through primary care systems and evaluate models to improve service delivery. The program is comparing the costs and outcomes of treating clients in a primary care setting versus referring clients to outside mental health specialists. Five Federal agencies are working closely together on this program to bridge the gaps between mental health, substance abuse, primary health, and aging.
The Criminal Justice Diversion Multi-site Study is in its second year, and data collection is proceeding with over 500 subjects enrolled. There are nine sites across the country, plus a technical assistance center and a coordinating center. The program held its sixth steering committee meeting April 12-16, 1999, in Tucson, Arizona. At the meeting, a template was approved for process evaluation, final plans for a cost benefit analysis were approved, preliminary descriptive findings were presented from the cases enrolled, and a consumer subcommittee was formed. Sites that have made particularly significant strides in effecting systems change in their local communities include New York City, Memphis, and Hawaii. The program has resulted in new collaboration between the New York District Attorney’s office and the New York Mental Health Court clinics. A mayoral report from the Commissioner of health was issued, and legislation is being written by the New York State Senate to fund an integrated MIS system. In Memphis, the Crisis Intervention Team Program has been so successful that more than 25 cities have expressed interest in replicating the program.
The Branch is playing a key role in an initiative to study ways of creating integrated treatment systems for women with mental health and substance abuse disorders who are victims of violence. The first steering committee meeting for the Women and Violence Project was held in January 1999, and the second meeting was held in early May. Topics covered at the second meeting included the overall process evaluation, the role of consumers throughout the project life cycle, and clarification about including children of the women in the study. The next steering committee meeting is scheduled for July 12-14 at the Bethesda Hyatt.
CMHS’ work with the National Association of State Mental Health Program Directors on women and violence has resulted in the unanimous adoption of a "Position Statement on Services and Supports to Trauma Survivors." Implementation of this statement in the States will be an important contributing factor to the progress of the 14 study sites participating in the Women and Violence study.
A "Mothers in Recovery" Day is being planned by the three Women and Violence grantees located in Massachusetts. The focus of this day-long event will be on mothers who are recovering from the impacts of violence against them, as well as the co-occurring disorders of mental illness and substance abuse. The event is designed to bring consumers and community programs together on all three issues and to educate legislators on the interrelatedness of the disorders. A number of state and city government agencies and consumer and family groups are co-sponsoring the event, and media outreach is underway to national, state, and local outlets.
Planning is underway for a jointly sponsored conference entitled, "Persons with Mental Disorders in the Criminal Justice System: Building on What We Know." Sponsored by the Office of Justice Programs, Department of Justice, and CMHS, the conference is scheduled for July 22-23, 1999, at the Willard Hotel in Washington, D.C. Approximately 125 Federal, State, and local policy makers have been invited, as well as practitioners, researchers, family and consumer groups, foundations, and businesses. The conference will focus on building public/private partnerships to provide an integrated Federal, State, and local response to persons with mental illness who are at risk of coming in contact with the criminal justice system.
Under partial support from a SAMHSA Conference grant, with CMHS as the lead agency, the State of Wisconsin, sponsored a "Crossroads" conference on women and violence. The conference, designed to promote and expand community-based services for persons who have experienced trauma, was held March 28-20, 1999, in Milwaukee. Five hundred people attended. As a result of the conference, a cross training manual and videotape are being produced, and extensive new networks are being established at the community level.
Training curriculums on trauma and co-occurring disorders are either currently available or under development by a number of Women and Violence grantees. Curriculums range from a minimal knowledge base that helps providers integrate trauma, mental health, and substance abuse services to a comprehensive overview of trauma, its symptoms, and impacts. The curriculums will be available for wide distribution.
Homeless Programs Branch
On May 13, 1999, the Access to Community Care and Effective Services and Support (ACCESS) Project Team received the Secretary’s Award for Distinguished Service. Approaching its final year of operation, this five-year demonstration program has produced major findings that have contributed to important knowledge about how to develop effective service systems and integrated services for homeless persons with mental illness.
DIVISION OF PROGRAM DEVELOPMENT, SPECIAL POPULATIONS, AND PROJECTS
Brian Flynn, Ed.D., Director, Division of Program Development, Special Populations, and Projects, delivered a speech at the Judge Advocate General (JAG)-Navy Conference on May 4, 1999. He spoke to the 350 JAG lawyers in attendance about "The Interface of Legal and Mental Health Issues in Disasters and Terrorist Events."
Mr. Flynn accompanied Vice President and Mrs. Gore to Littleton, Colorado, to attend memorial services and meet with the families of victims of the Columbine school shootings.
At the request of USAID, Mr. Flynn continues to assist in establishing and maintaining services to victims of the August 7, 1998, bombing in Kenya. USAID has provided $1 million for services over the next 3 years. Mr. Flynn will continue to monitor and consult to the program and will assist in orientation of new Embassy staff this summer.
CMHS continues to take the SAMHSA lead in mounting a department-wide effort focused on suicide and suicide prevention, collaborating with the Centers for Disease Control and Prevention (CDC), the National Institute of Mental Health (NIMH), and community and national organizations such as the Suicide Prevention Advocacy Network (SPAN).
Emergency Services and Disaster Relief Branch
The Emergency Services and Disaster Relief Program marks its 25th year in 1999. This partnership between CMHS and the Federal Emergency Management Agency (FEMA) recently received a Hammer award from Vice President Gore’s National Performance Review.
In FY 1998, the Crisis Counseling Program (CCP) supported 22 State projects, and approximately $10 million in grants were awarded. FEMA has created another program position to support the expanding activities of the CCP, and a new staff member is expected to be hired by August 1999. Between January and May 1999, the Emergency Services and Disaster Relief Branch set up CCPs for ten Presidentially declared disasters, including the tornadoes in Oklahoma and Kansas.
A new curriculum was developed to supplement the basic disaster mental health training held annually by CMHS and FEMA. This has led to the first advanced Crisis Counseling Program training for experienced disaster States to share advances and best practices in the field of disaster mental health response and recovery. The training is scheduled for September 1999.
The Branch provided and continues to provide consultation to the State of Colorado Division of Mental Health Services in response to the Littleton, Colorado, school shootings. Branch staff continue to consult with the Department of Education to design Project SERV, a proposal to arrange for a FEMA-like response to traumatic events in schools such as shootings.
In addition, the Branch is working with the Department of Justice Office of Victims of Crime to provide consultation on mental health services for victims of crime. Staff also supported the preparedness effort during the NATO delegation visit to Washington, D.C. in April 1999.
In September 1999, two new publications will be released: "Designing Crisis Counseling Programs for Rural Communities" and "Psychosocial Issues for Older Adults in Disaster: A Guide for Mental Health Professionals."
Special Programs Development Branch
The Branch worked on two major grant programs: (1) The Safe Schools/Healthy Students Initiative – a collaborative effort of the Departments of Health and Human Services, Education, and Justice – that will provide approximately 50 awards to educational authorities and their mental health and law enforcement partners to promote healthy childhood development, foster resilience, and prevent youth violence; and (2) The
School Action Grant Program – funded by CMHS and the Center for Substance Abuse Treatment (CSAT) – that will award approximately 35 grants to grantees who select an evidence-based practice to prevent youth violence and foster the healthy development of children that best meets its community’s needs, builds consensus around the practice, and implements the practice.
Approximately 2,000 Guidance for Applicants (GFA) were requested for the School Action Grants, and approximately 31,000 Safe Schools/Healthy Students GFAs were downloaded from the Department of Justice Web site. CMHS staff members are responding to approximately 30 technical questions from potential applicants per day. CMHS has received approximately 100 applications for the School Action Grants. The application process for Safe Schools/Healthy Students began mid-May 1999, and the grants are expected to be awarded by the start of the next school year.
A second collaborative effort among the Departments of Health and Human Services, Education, and Justice is the Technical Assistance Program to support the violence prevention initiative. A GFA was completed and released. The successful applicant will serve as a coordinating center for the development of community partnerships and will provide technical assistance to prevent school violence and enhance resilience. A unique component of this effort will provide assistance to applicants who are not successful in securing a grant but who want to begin to develop a violence prevention program with their own resources.
CMHS is developing an agreement with the CDC to provide a wide range of information related to the promotion of healthy child development, the fostering of resilience, and the prevention of school violence. The target audience will be organizations with a strong potential to influence children and parents, create a positive social environment, and reduce youth violence.
CMHS is also developing a broad portfolio of violence prevention technical assistance materials in the form of interactive multimedia and accompanying text user guides. These materials will be aimed at assisting elementary, middle, and high school students and their teachers and parents in developing positive attitudes, adequate knowledge, and effective skills to prevent school-based violence. Contracts have been developed but not yet awarded for the development of content for these CD-ROMS.
The Branch played a lead role in the development of new objectives in the Mental Health and Mental Disorders Chapter in Healthy People 2010, a national prevention agenda to increase the number of healthy years of all Americans. The new objectives reflect the input received during the four-month public comment period. The Branch continued to provide leadership in coordinating the last Healthy People 2000 Mental Health and Mental Disorders Progress Review.
Elzbieta Gozdziak, Ph.D., Public Health Advisor, and John Tuskan, R.N., are assisting the Office of Refugee Resettlement in their work with Kosovar refugees at Fort Dix. Dr. Gozdziak and Mr. Tuskan are helping to coordinate activities related to medical screenings for the refugees and to plan social and spiritual activities.
DIVISION OF STATE AND COMMUNITY SYSTEMS DEVELOPMENT
State Planning and Systems Development Branch
The Branch released Mental Health 1998, a current overview of the status of mental health services.
The Branch continues the State Performance Indicator Pilot Project to help States uniformly report on a number of performance indicators and measures for State mental health programs. The Project allows CMHS and the States to test and measure mental health services at the State and local levels to improve quality, accountability, and effectiveness of care.
Survey and Analysis Branch
CMHS staff traveled to Panama, April 3-10, 1999, as part of a joint effort with the Pan American Health Organization to provide evaluation support in Latin America and the Caribbean. Panama’s mental health system has undergone dramatic changes in recent years, and there is a great need for documentation and effective evaluation methods for improved planning and reporting. CMHS staff provided an initial evaluation of Panama’s national MIS system and presented the logic model as a basic method for documentation and evaluation. CMHS staff also presented information to health promotion staff on successful anti-stigma programs in the U.S., as stigma is said to be a significant issue.
Branch staff are planning an international meeting on policy analysis. This is the fourth in a series of meetings to design and begin implementing a project to examine national mental health policies in different countries. The project will look at how national mental health policies affect service delivery and organization and how clinical care and outcomes vary as a result. Participants in the meeting are currently designing the information-gathering instruments to be used in creating the international data base about mental health policies. Meeting participants are also considering the design of a policy template and technical assistance strategy for the World Bank to use with developing countries.
KEN99-0069
|
