ISMICC April Blog

- Dr David Morrissette

As we announced in our March blog, federal staff assigned to ISMICC implementation spent a day to 

hear from ISMICC members about their rationale and expectations of the recommendations and to 

prioritize recommendations for actions together. We wanted to provide you with a little more detail of 

the day’s events. 

More than 48 federal staff convened for the day to 

participate in ISMICC. In addition to the 10 named 

departments and agencies, staff from the U.S. 

Interagency Council on Homelessness and from the 

National Institute on Mental Health also attended. 

Some of you may recognize Ron Homberg (seated

in front); he observed the morning session.

The ISMICC Chair, Assistant Secretary of Mental 

Health and Substance Use Dr. Elinore F. McCanceKatz, began the panel by describing the problems 

that ISMICC was designed to address. Four 

members of ISMICC attended the meeting: Ken 

Minkoff, Conni Wells, Elena Kravitz, and David 

Covington. Their presence and their passion were 

critical to helping federal staff understand the realworld impact of the recommendations and provided 

insight into how and why ISMICC formulated them. 

Three federal ISMICC designees – John Collett 

(Department of Education), John McCarthy (Veterans 

Affairs), and Jennifer Sheehy (Department of Labor)

–described their agencies’ interest and investment in 

ISMICC recommendations. Staff were then 

convened into five Implementation Workgroups that 

corresponded with the focal areas of the

recommendations. Throughout the afternoon, ISMICC non-federal members circulated through each of 

the workgroups in 20-minute sessions to clarify the recommendations and to answer questions. 

For the rest of the day, workgroups met to develop their ongoing meeting schedule, to understand how 

participating departments’ and agencies’ missions align with some or all recommendations in the

workgroup and to agree on at least three initial priorities (listed below). Workgroups varied in size from 

nine to 16. The Data Workgroup recognized the 

interdependence of the four recommendations within the data 

subset of Focus area 1 and prioritized them. In addition, they 

committed to working with the Treatment and Recovery 

Workgroup to developing a priority research agenda for 

SED/SMI. The Access Workgroup prioritized recommendations 

that aligned with the missions of all of the participating federal 

departments. The first two recommendations reflect the core 

of an effective crisis response system and the third underscores 
the importance of taking care of our nation’s youth. The Treatment and Recovery Workgroup identified 

recommendations that were viewed as foundational to all of the others within the area of focus. They 

view the comprehensive continuum of care, as well as housing,

as critical to the ability of people with SMI and SED to recover 

and to thrive in in the community. The third priority, 

establishing screening and early intervention as a national 

expectation, was also considered one of the fundamental 

recommendations of this focus area. The Justice Workgroup 

developed a framework based on the essential theme of the 

focus area to reduce justice involvement and to bring treatment 

to people who are involved. The group prioritized 

recommendations that best fit this framework. Two other 

recommendations emerged as areas to further investigate as 

information and additional partners come to the table. The 

Finance Workgroup prioritized recommendations based on 

areas where there are already effective practices and/or 

where opportunities may exist for expansion and for better 

coordination across departments and agencies. 

Implementation Workgroups have begun meeting on their 

own in April and are discussing opportunities, within their agencies and across departments, to advance 

recommendations. 

 

Group 1 Data (SAMHSA stewards: Kirstin Painter and Christopher Jones)

1.5 Evaluate the federal approach to serving people with SMI and SED. 

1.6 Use data to improve quality of care and outcomes. 

1.7 Ensure that quality measurement efforts include mental health. 

1.8 Improve national linkage of data to improve services. 

3.8 Develop a priority research agenda for SED/SMI prevention, diagnosis, treatment, and 

recovery services. (prioritized with Group 3)

Group 2 Access (SAMHSA stewards: Richard McKeon and Steven Dettwyler)

2.1 Define and implement a national standard for crisis care.

2.2 Develop a continuum of care that includes adequate psychiatric bed capacity and communitybased alternatives to hospitalization.

2.6 Prioritize early identification and intervention for children, youth and young adults.
Group 3 Treatment and Recovery (SAMHSA stewards: Justine Larson and Cindy 

Kemp)

3.1.Provide a comprehensive continuum of care for people with SMI and SED. The group 

committed to developing a standard continuum of care for serious mental illness and serious 

emotional disturbance that includes cross-federal input.

3.2.Make screening and early intervention among children, youth, transition-age youth, and 

young adults a national expectation.

3.6 Make housing more readily available for people with SMI and SED. 

Group 3 will also pursue more information on:

 3.7 Advancing the national adoption of effective suicide prevention strategies.

Group 4 Justice (SAMHSA stewards: Larke Huang and Jennie Simpson)

4.2. Develop an integrated crisis response system to divert people with SMI and SED from the 

justice system.

4.6 Require universal screening for mental illnesses, substance use disorders, and other behavioral 

health needs of every person booked into jail.

4.8 Reduce barriers that impede people’s abilities to immediately access treatment and recovery 

services when they are released from correctional facilities. 

Group 4 will also pursue more information on: 

4.4 Establishing and incentivizing best practices for competency restoration that use 

community-based evaluation and services.

4.7 Strictly limiting or eliminating the use of solitary confinement, seclusion, restraint, or other 

forms of restrictive housing for people with SMI and SED.

Group 5 Finance (SAMHSA stewards: Chris Carroll and David DeVoursney)

5.1 Implement population health payment models in federal health benefits programs. 

5.3 Fully enforce parity to ensure that people with SMI and SED receive the mental health and 

substance abuse services they are entitled to, and that benefits are offered on terms 

comparable to those for physical illnesses.

5.5 Pay for psychiatric and other behavioral health services at rates equivalent to other health 

care services. 

As always, SAMHSA staff – including Dr. Anita Everett and I – want to thank our ISMICC members, 

federal staff, and other stakeholders for the time and talent they have invested in this enterprise.