3Behavioral Health: A National Priority 3SAMHSA’s Mission: Reduce the impact of substance abuse and mental illness on America’s communitiesBehavioral health is essential to healthPrevention worksTreatment is effectiveSAMHSA is the Federal agency dedicated to reducing the impact of substance abuse and mental illness on America's communities. We do this through a public health approach.Virtually every family and 1 in 5 adults is affected by either a mental illness or addiction.50% of all lifetime cases of diagnosable mental illnesses begin by age 14, and 75% by age 24.One in 12 adolescents, ages 12 to17, experiences a significant depressive episode each year.Catching mental health problems early can also prevent other health problems. For example, kids 12 to 17 with depression are 2xs more likely to drink or use drugs for the first time.There is a 5-year window of opportunity, during which we can help young people with mental illnesses avoid moving to co-occurring substance abuse.WE CANNOT DO THIS EFFECTIVELY WITHOUT A STRONG BEHAVIORAL HEALTH SURVEILLANCE SYSTEMPeople recover
4SAMHSA’S Strategic Initiatives 4AIM: Improving the Nation’s Behavioral Health (1-4)AIM: Transforming Health Care in America (5-6)AIM: Achieving Excellence in Operations (7-8)1. Prevention2. Trauma and Justice3. Military Families4. Recovery Support5. Health Reform6. Health Information Technology7. Data, Outcomes & Quality8. Public Awareness & SupportOutlined yesterday at Administrator Hyde’s presentation – Never hurts to emphasize their importance and their tie in to the HHS strategic goals.You also heard Pam talk of core functions of SAMHSA within the confines of some internal and external constraints. SAMHSA’s not only a grant maker but also providing – (1) Leadership and voice; (2) Data/Surveillance; (3) Practice Improvement through TAs, information sharing, evaluation, services research and metrics; (4) Public Awareness and Education; and (5) Regulation and Standard Setting.
5SAMHSA Core Functions Leadership and Voice Data/Surveillance Practice Improvement -- Technical Assistance, Quality Measures, Evaluation/Services ResearchPublic Awareness and EducationGrant-makingRegulation and Standard Setting
6Office of Policy, Planning and Innovation OPPI Vision: Better Behavioral Health through Policy and InnovationOPPI Mission: To develop, coordinate, and communicate SAMHSA policy to improve behavioral health in America’s communitiesBehavioral Health is Essential to Health.Prevention Works. Treatment is Effective. People Recover
8Division of Regional and National Policy Liaison Anne HerronDirectorRegional Policy Liaison TeamTeam LeadNational Policy Liaison BranchVacantBranch ChiefRegion 1 – A. Kathryn PowerRegion 2 – Dennis O. RomeroRegion 3 – Jean BennettRegion 4 – Stephanie McCladdieRegion 5 – Jeffrey CoadyRegion 6 – Michael DuffyRegion 7 – Laura HowardRegion 8 – Charles SmithRegion 9 – Jon PerezRegion 10 – David DickinsonBrian Altman - LegislativeSheila Cooper – Senior Advisor for Tribal AffairsWinnie Mitchell – International OfficerTerri Spear – Emergency Response CoordinatorStephanie Weaver – National Guard LiaisonGeretta Wood – Advisory Committee OfficerVacantProgram Management AnalystVacantStaff Assistant
9Division of Regional and National Policy Liaison – Regional Team Represent SAMHSA leadership in the RegionsProvide SAMHSA staff with “eyes and ears” out in the RegionsEstablish working relationships with:Regional representatives of OPDIVS (HRSA, ACF, CMS) and internal staff divisions (e.g., ASFR and OASH.State authorities for mental health and substance abuse, provider groups, city and county level health departments.Coordinate support for State implementation of health reform.Coordinate, as needed, implementation of SAMHSA Strategic Initiatives and technical assistance within the regions.Help States to coordinate resources across SAMHSA to address emerging needs.Administrator Hyde talked about the expectations from the RAs:Help translate vision, mission, SIs, vital few, theory of change, priorities, etc. in interactions with other OPDIVS and with stakeholdersListen & convey to headquarters & other OPDIVS what’s working; what isn’t; and how to improveFacilitate problem-solving re grants, policies, systems, programs; assist stakeholders to get what they needHelp prevent surprisesHelp arrange technical assistance – directly or through SAMHSA staff or contractorsCollaborate with HHS colleagues in regional offices to advance HHS goals and assure behavioral health issues are included
10Regional Administrator Roles Help translate SAMHSA mission, vision, strategic initiatives, theory of change and priorities in interactions with other HHS Operating Divisions and stakeholdersListen and convey to headquarters and other HHS Operating Divisions what’s working, what isn’t and ways to improve
11Regional Administrator Roles Collaborate with HHS colleagues in regional offices to advance HHS goals and assure behavioral health issues are includedAssist stakeholders to get what they need – facilitate problem-solving regarding grants, policies, systems and programsHelp arrange technical assistance
12Region 1 Profile Maine 1,328,361 35,385 Augusta 4.7% 14.1 StateJointPopulationSq. MilesCapitalMI /SA PrevalenceSuicide RateMaine1,328,36135,385Augusta4.7%14.1New Hampshire1,316,4709,350Concord4.6%11.7Vermont625,7419,615Montpelier13.0Massachusetts6,547,62910,555Boston4.2%7.7Connecticut✔3,574,0975,544Hartford4.4%8.6Rhode Island1,052,5671,545Providence7.2%.10.7
13Mental Health Continuum Positive Mental Health: Mental Health Problem: Mental Disorder:High-level capacity of the Disruption in interactions Medically diagnosable illnessindividual, group, and between individual, group,, that results in significantenvironment to interact & and environment, impairment of cognitive,to promote well-being, producing a diminished affective, or relational abilitiesoptimal development, and state of positive mental healthuse of mental abilitiesMental Health ContinuumMental Health Status ContinuumMental Health Care ContinuumEnhancing Health: Primary Prevention: Early Recognition Treatment andPromoting optimum Addressing risk factors and Intervention: Rehabilitation:mental health, e.g., job vulnerable groups, Detecting a problem Interventions tosatisfaction, resilience, e.g., coping skills for or illness at an early reduce symptoms ofself-esteem, people who are stage and increasing an illness, diminishand social skills, improving unemployed, home visits access to effective disability, and improveaccess to income for families experiencing treatment quality of lifeseparation or divorceSource: Scanlon, K., Williams, M., & Raphael, B. (1997). Mental Health Promotion in NSW: Conceptual framework for developing initiatives. NSW Health Department, Sydney, Australia, p.94
14SAMHSA’s Theory of Change 14Surveillance and Evaluation
15The Ten Drivers & Determinants Of Change Surveillance – What Is So, How Much Needs To Be DoneModels of Change – What and HowImplementation Planning and DeliveryLegal and Regulatory ChangeMetrics For Measuring and Managing Quality, Quantity and Cost6. Infrastructure Development 7. Financing 8. Provider Education/ Training of Workforce 9. Public Education/Political Support 10. Evaluation
16Primary and Behavioral Health Care Integration (PBHCI) Purpose: To improve the physical health status of people with serious mental illnesses (SMI) and co-occurring SMI and substance use disorders by supporting community-based efforts to coordinate and integrate primary health care with mental health services in community-based behavioral health care settingsObjectives: To better coordinate and integrate primary and behavioral health care resulting in improved access to primary care services; improved prevention, early identification and intervention to reduce the incidence of serious physical illnesses, including chronic disease; increased availability of integrated, holistic care for physical and behavioral disorders; better overall health status of clients.
17Primary and Behavioral Health Care Integration (PBHCI) Services Provided: Facilitate screening and referral for primary care prevention and treatment needs:Provide and/or ensure that primary care screening, assessment, treatment and referral be provided in a community-based behavioral health agencyDevelop and implement a registry/tracking system to follow primary health care needs and outcomesOffer prevention and wellness support servicesEstablish referral and follow-up processes for physical health care requiring specialized services beyond the primary care setting
19Key Drivers of a Transformed Health System Components: wellness across the lifespan; trauma informed care; involvement of individuals in recovery; integrated health care Strategies: financing; collaboration; data; workforce; technology Health care that is person-centered, recovery focused, and quality driven rooted in practices that drive outcomes.
20QUESTIONS?? A. Kathryn Power M.Ed. Regional Administrator-Region 1 Substance Abuse and Mental Health Services AdministrationU.S. Department of Health and Human ServicesJFK Federal Building15 New Sudbury Street, Room 1826Boston, MA 02203