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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This Web site is a component of the SAMHSA Health Information Network. |
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PROGRAM ACTIVITIES AND INITIATIVESCMHS Office of the Director CMHS Director Bernard S. Arons, M.D., addressed a variety of mental health audiences throughout the country, including:
Dr. Arons' speech to the National Advisory Committee on Rural Health in Washington, D.C., on February 8, 2000, was published in the April 1, 2000 issue of Vital Speeches of the Day. Vital Speeches is a biweekly publication that is well-known in the speech writing community as "the best thought of the best minds on current national questions." It is a resource found in thousands of public, college, and high school libraries throughout the country and frequently prints speeches delivered by the U.S. President, Congressional leaders, and Cabinet officials, as well as heads of major corporations and think tanks. Office of the Associate Director for Medical Affairs The HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study, being conducted by eight study sites and one coordinating center, is entering its third year. With six agencies contributing more than $6 million per year, this study is the first Federal effort to examine the efficacy and cost-effectiveness of integrated care models for persons diagnosed with HIV/AIDS, mental health disorders, and substance abuse disorders. Each study site's integrated care intervention addresses local variations in available and accessible services for the study population. Multi-site study recruitment began in March 2000, following a start-up phase that focused on the development of a multi-site research design, refinements to local study designs, assessment instrumentation, administration protocol, and interviewer training and certification. In addition to the multi-site study, each individual site is conducting a "local" study that employs "optional" assessment instrumentation to address site-specific research questions. Sites that began enrolling participants in March are currently engaged in the first of four 3-month follow-up assessments. In addition to demographic information, the initial baseline assessment battery includes-but is not limited to-the Structured Clinical Interview for DSM-IV (SCID) to determine the mental health and substance abuse diagnoses used for study eligibility; the ASI-Lite (alcohol and substance use); the Brief Psychiatric Rating Scale (BPRS)(mental health functioning); and the SF-36 (health functioning). Eligible study participants are given a random assignment to a treatment or control condition. Select participants are also being chosen by random assignment to provide urine samples for validating self-report data on alcohol and substance use. Most of the study sites have expanded outreach and recruitment efforts to identify sufficient numbers of triply diagnosed individuals. Very preliminary data suggest a lack of mental health services among participants, as well as inadequate coordination of HIV/AIDS primary care, other medical care, mental health, and substance abuse services. A Steering Committee representing the Federal sponsors, study sites, coordinating center, and consumers, was established as the decision-making body for the study. The inclusion of a consumer liaison to coordinate the gathering and sharing of information among the consumers involved across the eight study sites is an innovative aspect of the study. In addition, each site has its own consumer advisory board and one active consumer representative in the study. Consumers have provided assistance with participant outreach and recruitment strategies, as well as input on the feasibility and acceptability of the assessment instrumentation. All consumer representatives attend one steering committee per year. During Year 3, the number of study participants will increase, and initial data are expected to yield descriptive findings on accrued baseline and follow-up status of participants. Office of Managed Care In July 2000, CMHS and the Center for Substance Abuse Treatment (CSAT) released the results of a major study on health care spending, National Expenditures for Mental Health and Substance Abuse Treatment, 1997. The study presents estimates of national spending on health care services related to the diagnosis and treatment of mental health and substance abuse (MH/SA) conditions from 1987 through 1997. This is the second in a series of planned reports to provide periodic updates of national expenditures for MH/SA treatment. The report addresses key questions, such as how much is spent in the United States to treat MH/SA disorders, how expenditures are distributed by payer and type of provider, how spending has changed from 1987 to 1997, and how MH/SA expenditures compare to those for all U.S. health care. The study examines expenditures for two sectors of providers - specialty MH/SA providers and non-specialized general health care providers who also deliver MH/SA services. Estimates are presented for MH, SA, MH/SA combined, and all health care expenditures. A prime objective of this project was to devise estimates over a 10-year span that could be compared with spending on all health care services within the United States. Therefore, to estimate MH/SA treatment expenditures, the project used data and methods that the the Centers for Medicare and Medicaid Services (CMS) uses for estimates of national health care expenditures. The CMHS Office of Managed Care has also published several reports on managed behavioral health care within the last few months. Five are Government reports: Annotated Bibliography for Managed Behavioral Health Care: 1989-1999; Civil Commitment under Medicaid Managed Care; Contracting for Public Mental Health Services: Opinions of Managed Behavioral Health Care Organizations; Preventive Interventions under Managed Care: Mental Health and Substance Abuse Services; and School-based Mental Health Services under Medicaid Managed Care. In addition, the following three recent articles appeared in peer-reviewed journals or publications:
Office of External Liaison SAMHSA's National Mental Health Information Center The Information Center continues to expand its outreach to those seeking information on mental health and mental illness. Information Center staff responds to more than 4,000 requests for information each month received via mail, telephone, fax, e-mail, and the web site. Information specialists respond to an average of approximately 180 calls per day during normal business hours. Most callers find out About Us either through the telephone book or the Internet. The majority of requests for information continue to come from the general public and mental health professionals. Educators and treatment facilities/programs also log a significant number of requests. Over the past several months, most requests have been for information relating to funding/grants, child/adolescent mental health, and stigma. Each month, the Information Center distributes approximately 30,000 publications on diverse aspects of mental health and mental illness. Most frequently requested publications include: Community Youth Mental Health Promotion & Violence/Substance Abuse Prevention Partnership Grants; the Your Child's Mental Health: What Every Family Should Know brochure; the Nurturing Your Child's Mental Health bookmark; and the CMHS Publications Catalog. The Information Center web site continues to be a popular resource for persons seeking information on mental health and mental illness, with the home page receiving nearly 20,000 hits each month. The following quotes are examples of feedback that the Information Center has received from users during the past several months:
Throughout May 2000, the Information Center web site was highlighted as a resource for learning more about coping with mental illness in promotions for "Titus," a Fox Television show that portrays one family's struggles with mental illness. As a result, more than 1,400 users linked to the Information Center web site from the Fox Television web site. The Information Center web site is being featured as a mental health link on web sites of an increasing number of organizations and online resources, including:
The list of awards for the Information Center web site also continues to grow. In May 2000, the site was highlighted as an HMS Beagle Web Pick. HMS Beagle is a biweekly Webzine of articles, debates, reviews, and editorials for biomedical researchers. Beagle Web Picks are featured on the Webzine's home page to direct users to quality web resources. In June 2000, the Information Center web site received the Hardin MD Clean Bill of Health Award, an award given to the "best of the best" psychiatry and mental health sites. Also in June, the Information Center received the PsychWatch Featured Site Award and was on a list of Featured Sites published in the June 10 issue of the PsychWatch Newsletter, which reaches more than 12,000 mental health professionals in approximately 75 countries worldwide. The Information Center was also a recipient of the Editor's Choice Award from HealingWell.com., a community information and resource site on diseases, disorders, and chronic illnesses that includes medical news, articles and information, community message boards and chat rooms, books, patient stories, and links to disease-related web sites. The Editor's Choice Award is presented to health web sites that exhibit (1) exceptional web design, (2) reliable and quality health information on disease and disorder topics, and (3) patient accessibility and support. Consumer Affairs Formation of Consumer/Survivor Subcommittee In early August 2000, CMHS announced the formation of a Consumer/Survivor Subcommittee to provide guidance and feedback to the CMHS National Advisory Council on mental health-related activities and policies. The new subcommittee is comprised of consumers and survivors who have received mental health services and is designed to promote consumer/survivor participation in the deliberations of the Advisory Council. It will serve as a fact-finding body that reports on specific needs, issues, and concerns from the perspective of people living with mental illness. The subcommittee is an extension of CMHS' continuing efforts to involve consumers/survivors at every level of the mental health system. A planning group of national consumer/survivor leaders, convened by CMHS, developed a set of eligibility requirements and criteria to select a pool of culturally and geographically diverse candidates to represent the needs of the consumer/survivor group as a whole. The nomination and review process produced 100 nominations and took two years to complete. The new subcommittee has 10 members who will serve staggered three-year terms. The subcommittee will meet with the CMHS National Advisory Council three times a year. Information Dissemination Activities A summary report of the Consumers and Social Workers in Dialogue meeting, held November 1999 in Washington, D.C., has been completed. Designed to explore methods of partnership building, the meeting was part of a series of dialogues supported by CMHS. Twenty social workers and mental health consumers shared experiences and opinions in an effort to foster understanding and respect between consumers and social workers. Meeting participants developed recommendations for CMHS, social workers, and consumers on improving therapeutic relationships and systems of mental health care. A new publication, Consumer/Survivor-Operated Self-Help Programs: A Technical Report, was recently released. The report provides a retrospective review of the mental health consumer/survivor movement, descriptions of 13 Federally funded consumer/survivor-operated service programs in the 1980's, and cross-site findings and recommendations to improve consumer/survivor-operated service efforts. In mid-August, CMHS released a new training video, Partners in Recovery: Creating Successful Practitioner-Consumer Alliances, aimed at improving therapeutic relationships between mental health providers and recipients of mental health services. The 18-minute video is a compilation of interviews with mental health providers and people living with mental illness, who describe what does and doesn't work in building constructive relationships. The video was designed as a training tool to encourage professionals to look for ways to improve their communications and relationships with mental health consumers. It covers concepts that are basic to the development of the therapeutic relationship, including recovery, consumer empowerment, information dissemination, consumers as experts, and family and peer support. CMHS worked with the Depression and Bipolar Support Alliance to develop the video, which is being distributed with an insert that provides self-evaluation and discussion questions and a list of mental health resources. Copies are available by calling the Information Center at 800-789-2647 or by visiting the Information Center web site at mentalhealth.samhsa.gov. Consumer Affairs staff worked with the Information Center to establish an online discussion forum for internet users visiting the CMHS web site. Discussions address issues related to consumer/survivor rights, children and youth, employment, and older adults. Consumer Affairs staff also collaborated with the Information Center to launch an American with Disabilities Act web page to commemorate the act's tenth anniversary. In continuing efforts to reduce the stigma and discrimination of mental illness, Consumer Affairs staff supported the National Mental Health Awareness Campaign's development of public service announcements (PSAs) to encourage young people to seek mental health services if needed. The campaign was launched on June 7, 2000, and PSAs aired on MTV, VH-1, and other cable stations. During the first 2 months of the campaign, the PSAs generated 2 million hits on the www.nostigma.org web site. A second initiative focusing on adults is currently under development and will be launched this fall. Other CMHS anti-stigma information dissemination efforts include the development of bilingual radio PSAs for distribution to Spanish-language stations, development of a new Spanish language poster, completion of a guidebook for addressing stigma in the media, and oversight of a SAMHSA-wide Anti-stigma Work Group. Outreach Efforts In August 2000, Consumer Affairs staff held a regional meeting in San Francisco with mental health consumers from California, Nevada, Arizona, Hawaii, and the Pacific Territories. Participants identified and discussed the most critical mental health needs and issues of their region. The meeting was part of a continuing effort to promote and elicit direct consumer involvement in CMHS activities. CMHS staff continue to stay involved in legislative efforts to address concerns related to restraint and seclusion. Staff consulted with CMS, the Joint Commission on the Accreditation of Healthcare Organizations, and others on the development of restraint and seclusion standards. Efforts are also underway to investigate training models. Public Affairs Since the last CMHS National Advisory Council meeting in May 2000, the Office of External Liaison (OEL) has undertaken a variety of proactive efforts to inform the public about CMHS and its programs to improve the lives of people of mental illness and their families. Following the May meeting, OEL staff issued a press release about the four newly appointed Advisory Council members and distributed it to trade press and the hometown newspapers of the four members. The Omaha World-Herald, hometown newspaper of Council member Russell D. Pierce, ran an article based on the release. During Mental Health Month in May, CMHS Director Bernard S. Arons, M.D., was interviewed about depression on News Channel 8, a cable television news station serving the greater Washington, D.C. area. In June 2000, The Times-Picayune (New Orleans, Louisiana) interviewed CMHS Child, Adolescent and Family Branch Chief Gary DeCarolis about federal grants to develop coordinated systems of care for children with serious emotional disturbances. The newspaper ran an article on June 10. In mid-June 2000, CMHS and CSAT held a joint press conference at the National Press Club in Washington, D.C. to announce a new study about mental health and substance treatment spending. The Washington Post, The Boston Globe, and several trade publications published articles about the study. Office of Policy, Planning, and Administration CMHS supported the research for a recent major study on custody relinquishment conducted by the Bazelon Center for Mental Health Law. The study was conducted in response to a growing need to educate parents and care givers about their custody rights, so they can make informed choices about available options. When seeking mental health services, parents often lose custody of their children for a number of reasons. It may be because their insurance runs outs, because they can't get treatment under Medicaid, or because they are not aware of their options. Regardless of the reason, the societal cost of custody relinquishment far exceeds the cost of adequate and preventive mental health treatment. The study led to the development of three publications. The first, Relinquishing Custody: The Tragic Result of Failure to Meet Children's Mental Health Needs, reviews state policy initiatives related to custody, including legislation to prohibit custody relinquishment solely for the purpose of accessing services; legislation to expand the system of care for children; attempts to more effectively implement the Early, Periodic, Screening, Diagnosis, and Treatment provisions of Medicaid; implementation of the Home and Community-Based Medicaid Waivers for parents who lose custody of their children; and use of the Katie Beckett Option to serve children with serious emotional disturbances. The second publication, Staying Together: Preventing Custody Relinquishment for Children's Access Mental Health Services, written in collaboration with the Federation of Families for Children's Mental Health, is a guide to help family advocates prevent custody relinquishment. The third publication, Litigation Strategies, analyzes case law that addresses the lack of access to children's mental health services. Follow-up activities to the study are continuing. CMHS will conduct a more in-depth review of States that have selected the Katie Becket Option to determine whether they are serving children with emotional disturbances. In States where these services are not being provided, an attempt will be made to figure out why. CMHS will also provide targeted technical assistance through the Bazelon Center to assist six States in assessing policy options most suitable to their individual environments. 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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