# Presentation: 906796

##    Transforming Mental Health Care in     America        September 29, 2004

**A. Kathryn Power, M.Ed., Director**
**Center for Mental Health Services**

## Mental Illness and Substance Abuse

**Persons **
**with  **
**mental **
**illnesses**

**Percent of persons with mental illnesses **
**who also will develop a substance use disorder**

**Up to **
**50%**

**Co-occurring**
**disorder**

## Substance Abuse and Mental Illness

**Source:  *****Serious Mental Illness and Its Co-Occurrence With Substance Use Disorders*****, ****Substance Abuse and Mental Health Services Administration** **(2004).**

- Persons with a substance use disorder

- Adults with mental illnesses

**20.4%**

- All persons

- Adults with  mental illnesses

**7%**

## Integrated Treatment for Co-occurring Disorders

**Nationally**
**(1)**

**12%**

**22%**

**Percent of persons**
**receiving care who receive integrated treatment **

**Sources:  (1) *****Serious Mental Illness and Its Co-Occurrence With Substance Use Disorders*****, ****Substance Abuse and Mental Health Services Administration** **(2004);**
**(2) *****The State of Mental Health Services in Kentucky*****, National Alliance for the Mentally Ill (2004).**

**Kentucky **
**(2)**

## Illness Management and Recovery
Medication Management Approaches in Psychiatry
Assertive Community Treatment
Family Psychoeducation
Supported Employment
Co-occurring Disorders: Integrated Dual Diagnosis Treatment

**Medication Management Approaches in Psychiatry**
**Assertive Community Treatment**
**Family Psychoeducation**
**Supported Employment**
**Co-occurring Disorders: Integrated Dual Diagnosis Treatment**

**Implementation Resource Kits**
** ****www.mentalhealth.samhsa.gov**

## The Commission’s Vision

*We envision a future when everyone with a mental illness will recover, a future when mental illnesses can be prevented or cured, a future when mental illnesses are detected early,**** ****and a future*

- New Freedom Commission
*Achieving the Promise*

*	**when everyone with a mental illness at any stage of life has access to effective treatment and supports—essentials for living, working, learning, and participating fully in the community.*

## Goal 1

**Recommendations**
**1.1 ****— ****Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention**
**1.2 ****—**** Address mental health with the same urgency as physical health**

**Americans Understand that Mental **
**Health Is Essential to Overall Health**

## Goal 2

**Recommendations**
**2.1 ****—**  **Develop an individualized plan of care for every adult with a serious mental illness and child with a serious emotional disturbance**
**2.2 ****—**   **Involve consumers and families fully in orienting the mental health system toward recovery**

**Mental Health Care is Consumer and Family Driven**

## Goal 2

**2.3 ****—**  **Align relevant Federal programs to improve access and accountability for mental health services**
**2.4 ****—**  **Create a Comprehensive State Mental Health Plan**
**2.5 ****—**  **Protect and enhance consumers’ rights**

**Mental Health Care is Consumer and Family Driven**

## Goal 3

**Recommendations**
**3.1 ****—** **Improve access to quality care that is culturally competent**
**3.2 ****—** **Improve access to quality care in rural and geographically remote areas**

**Disparities in Mental Health Services are Eliminated**

## Goal 4

** ****4.1 ****—** **Promote the mental health of young children**
**4.2 ****—**  **Schools should have the ability to play a larger role in mental health care for children**

**Goal 4**

**Early Mental Health Screening, Assessment, and Referral to Services are Common Practice**

## Goal 4

**4.4 ****—** **Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and support**

**Goal 4**

**Early Mental Health Screening, Assessment, and Referral to Services are Common Practice**

## Goal 5

**5.1 ****—**  **Accelerate research to promote recovery and resilience and, ultimately, to cure and prevent mental illnesses**
**5.2 ****—**  **Advance ****evidence-based practices**** (EBPs) using dissemination and demonstration projects and create a public-private partnership to guide their implementation**

**Goal 5**

**Excellent Mental Health Care Is Delivered and Research Is Accelerated**

## Goal 5

**5.4 ****—** **Develop the knowledge base for...  **
**Eliminating mental health disparities**
**Assessing long-term effects of medications**
**Reducing impact of trauma**
**Improving acute care**

**Goal 5**

**Excellent Mental Health Care Is Delivered and Research Is Accelerated**

## Goal 6

**Recommendations**
**6.1 ****—**  **Use health technology and telehealth to improve access and coordination of mental health care, especially for Americans in remote areas or in underserved populations**
**6.2 ****—**  **Develop and implement integrated electronic health record and personal health information systems**

**Technology Is Used To Access Mental Health Care and Information**

## Federal Action Agenda

**Responds to each of the 6 goals and    19 recommendations from *****Achieving the Promise***
**Establishes time-limited, realistic priorities for year 1 of a 5-year arc for transformation **
**Will be updated annually**

**Federal Action Agenda**

## Federal Partners Workgroup

_**Human Services**_**	****	****       **_**Other Federal Partners**_
**AoA****	****	****NIH/NIDA****	****       Department of Education**
**ACF****	****	****NIH/NIMH****	****       Department of Housing ****	****	****	****	****	****	****and Urban ****	****	****	****	****	****	****Development**
**	****	****	****	****	****	****   ****	****    **
**AHRQ****	****	****OS/ASPE****	****       Department of Justice**
**CDC ****	****	****OS/OCR****	****       Department of Labor**
**CMS ****	****	****OS/OD****	**** ****	****       ****	****	****	****	**** ****	****OS/OPHS****	****       Social Security ****	****	****	****	****	****	****Administration**
**	**** ****	****	****	****   **
**HRSA****	****	****SAMHSA ****	****       Department of Veterans **
**IHS****	****	****	****	****	****Affairs**** **
** ****	****	****	**** ****	****	****	****	****	**

**Federal Partners Workgroup**

## SAMHSA’s National Registry of Effective Programs and Practices (NREPP)             	http://modelprograms.samhsa.gov 

**(as of as of August 2004)**

## Evidence-based Practices Project

**National EBP Center (NASMHPD National Research Institute)**

**EBP Implementation Resource Kits (Dartmouth-led Consortium)**

**National   Demonstration Project**
**  ****(IN, KS, MD, NH, NY, OH, OR, VT)**

## www.nri-inc.org/CMHQA/CMHQA.cfm 

**www.nri-inc.org/CMHQA/CMHQA.cfm**

## Science-to-Service Cycle

## Principles of Transformed Service Delivery

**Services and treatments are be consumer- and family-centered**
**Care focuses on increasing a consumer’s ability to successfully cope with life’s challenges, on facilitating recovery, and on building resilience—not just on managing symptoms**

## “The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew, and act anew.” 

***Second Annual Message to Congress***
**December 1, 1862**

*“**The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew, and act anew.”*

## T = (V + B + A)  (CQI)2

**T = (V + B + A) ******** (CQI)****2**

**Transformation ******** **
**(Vision ******** Belief ******** Action) ******** **
**(Continuous Quality Improvement)****2**

## The future is not something we enter.  The future is something we create. 

***The future is not something we enter.  The future is something we create.***** **
**Leonard Sweet**

**Thank you.**