1. Transforming the Mental Health System COSIG States Meeting Bethesda, MD December 16, 2004 COSIG States Meeting Bethesda, MD December 16, 2004 A. Kathryn Power, M.Ed., Director Center for Mental Health Services

2. 2 COSIG States: Transforming the Way Our Nation Addresses Co-occurring Disorders

3. 3 Defining Transformation Transformation: \n (15c) from the Latin roots to change TRANS (across) and FORMA (shape). 1: a change in form, appearance, nature or character 2: the process of doing so.

4. 4 The SAMHSA Matrix

5. 5 The Goals of a Transformed System Goal 1 Americans understand that mental health is essential to overall health Goal 2 Mental health care is consumer and family driven Goal 3 Disparities in mental health services are eliminated Goal 4 Early mental health screening, assessment, and referral to services are common practice Goal 5 Excellent mental health care is delivered and research is accelerated Goal 6 Technology is used to access mental health care and information

6. 6 Goal 4: Early Mental Health Screening, Assessment, and Referral to Services Are Common Practice Recommendations 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 4.3—Screen for co-occurring mental and substance abuse disorders and link with integrated treatment strategies 4.4—Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and support

7. 7 A community approach to preventing and treating illnesses. Its premise is that caring for the health of an individual protects the community, while—in turn — caring for the health of a community protects the individual— with society at large reaping the overall rewards. The Public Health Model

8. 8 Estimated Prevalence of Co-occurring Disorders  Fifty percent of homeless adults with serious mental illnesses have a co- occurring substance abuse disorder  Sixteen percent of incarcerated individuals have severe mental and substance abuse disorders  Among detainees with mental disorders, 72 percent also have a co-occurring substance abuse disorder

9. 9 Mental Illnesses and Substance Use Disorders Persons with mental illnesses Percent of persons with mental illnesses who also will develop a substance use disorder Up to 50% Co-occurring disorder

10. 10 Substance Use Disorders and Mental Illnesses 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%

11. 11 COSIG Data and Performance Measures  Percentage of clients in mental health and substance use programs with symptoms of the corresponding co-occurring problem  Percent of treatment programs that—  Screen for co-occurring disorders  Assess for co-occurring disorders  Provide treatment to clients through collaborative, consultative, and integrated models  Percentage of clients who experience reduced impairment from their co-occurring disorders following treatment

12. 12 Hope…is a search for freedom, both a freedom of the body shackled by disease and a freedom of the spirit to assert its dignity, of having some level of control over one’s life.... To hope under the most extreme circumstances is an act of defiance that permits a person to live his life on his own terms. It is part of the human spirit to endure and give a miracle a chance to happen. Jerome Groopman, M.D. The Anatomy of Hope