The SAMHSA budget proposal (Budget in Brief / Full Budget) is out and the news for children's mental health services and the Child Mental Health Initiative (CMHI) is not good - The proposal calls for a 29 million dollar reduction in funding for 2013. This "savings" would be achieved through grants "coming to a natural end." This is chilling language for many reasons, which I will detail below. But for those who want to cut to the chase, here are three key points for you to share with SAMHSA and your elected representatives. Sure, there are more, but let's start with these three:
Do not curb the progress made for children with mental health needs and their families. Do not allow the hard work and years of federal investments to be lost through faulty assumptions that the states are ready and able to just pick it up from here. The impressive track record of the CMHI speaks for itself, but the work is not done. The six-year demonstration efforts of improving children's mental health services and supports through a system of care approach needs to continue in some form and not be phased out.
Heighten attention and oversight to ensure that the values and principles of a system of care approach guide implementation efforts at the state level, whatever the outcome for the final SAMHSA budget.
On average, state funding for children's mental health services amounts to a mere 22% of a states total mental health budget (click here for a closer look at the numbers). "Going to scale" will require a commitment to funding technical assistance and administrative support to help state children's mental health efforts achieve their objectives.
Making sense of it all...
Okay, now for the background, which I strongly encourage you to read. First, let's recap the rationalization for SAMHSA choosing the approach they are taking as we understand it from reading the Budget Proposal. There are three primary strategic premises in SAMHSA's approach:
Using competitive grants to identify and test innovative prevention and treatment interventions;
Leveraging state, territorial and tribal funding mechanisms to foster widespread implementation of proven practices; and
Reducing funding for tested competitive grant activities that will now be brought to scale through state-level funding streams.
Okay, got it. Makes sense, right? You give competitive grants, develop robust evaluation to test out the treatment interventions to see what works and then leverage state and tribal funding mechanisms to foster widespread implementation of proven practices. Perfect, right? In fact, the Child Mental Health Initiative (CMHI) is a great example of this very approach and in many ways is a flagship example of the importance of ensuring that the values and principles of a system of care approach drive implementation efforts.
So why should this budget proposal be a concern to us? Shouldn't we be celebrating the fact that the CMHI has done what it said it would do? Shouldn't we be rejoicing in the "natural ending" of a successful evaluation rich initiative? Well, no we should not - and here is why:
The one-year expansion planning grants that were implemented this year (as opposed to the six-year cooperative agreements that in this budget proposal will phase out) are not enough in and of themselves to do what SAMHSA has championed over the past 20 years - and that is to be the beacon of light on the importance of a family-driven, youth guided, culturally and linguistically competent approach to implementing services and supports that best meet the needs of children and youth with emotional and behavioral challenges and their families.
We have grave concern that the values and principles of a systems of care approach that SAMHSA has championed over the past 20 years will be lost in an approach that supports grant efforts coming to a "natural end." This approach makes a huge assumption that the "what works" part of demonstration grant efforts over the years have stuck sufficiently so that we can feel comfortable letting initiatives like those that are a part of the CMHI come to their "natural end." I don't think we are there yet - not even close. To declare victory and walk away from this comprehensive initiative is short-sighted.
However, SAMHSA is in a difficult position and needs our support. Cuts have to come from somewhere, that much we know. The questions we need to ask ourselves as children's mental health advocates are simple:
Do we think that the values and principles of a system of care approach has stuck sufficiently to the point that we can let the CMHI come to a "natural end" and declare victory that states across America have taken the important step of embracing a system of care approach in the development of services and supports for children with emotional and behavioral challenges and their families?
Do we think that states across America will embrace a system of care approach and honor the significance of children's mental health in budget planning and block grant discussions, showing a level of support for children's mental health that is commensurate to that given to adult populations?
If the answer is yes, then we are all set - victory is ours. If the answer is no, we have much work to do. I think the answer is no. So here is some homework for all of us:
Recognize the challenge that SAMHSA is in with the current budget crisis. This is not an exercise without significant pain attached. Cuts are a reality and need to come from somewhere, and that does not nor should not exclude children's mental health.
A prime SAMHSA strategy for going forward appears to involve bringing grant activities "to scale through state-level funding streams", as evidenced by the move from the six-year cooperative agreements to the one-year expansion planning grants. We as advocates cannot just ask SAMHSA to make sure that the values and principles of a system of care approach drive the concept of "going to scale." We need to shine a very bright light on what this looks like state by state. The Children's Mental Health Network will be doing this and we are sure other children's mental health partners will be as well.
The point is, before the current fiscal crisis it was easier and probably more comfortable to rely on SAMHSA to "keep the light on." And for 20 years and multiple administrations, both Republican and Democrat, they have done that. But now, in the worst economic crisis our nation has seen in decades, they need our help. This budget proposal reflects the hard work of really smart people who have to make cuts somewhere. They are doing the best they can based on research about best practice, content experts and the voices of constituents like us. If we do not mobilize and speak up more loudly than we have been about the importance of a strong focus on children's mental health, then that's on us.
What do we do next?
So, what next? Here are three key points for you to share with SAMHSA and your elected representatives. Again, there are more, but let's start with these three:
Do not curb the progress made for children with mental health needs and their families. Do not allow the hard work and years of federal investments to be lost through faulty assumptions that the states are ready and able to just pick it up from here. The impressive track record of the CMHI speaks for itself, but the work is not done. The six-year demonstration efforts of improving children's mental health services and supports through a system of care approach needs to continue in some form and not be phased out.
Heighten attention and oversight to ensure that the values and principles of a system of care approach guide implementation efforts at the state level, whatever the outcome for the final SAMHSA budget.
On average, state funding for children's mental health services amounts to a mere 22% of a states total mental health budget (click here for a closer look at the numbers). "Going to scale" will require a commitment to funding technical assistance and administrative support to help state children's mental health efforts achieve their objectives.
Join us and get involved
SAMHSA cannot do this alone. We need to do our part to provide information, research, education and personal testimony about the importance of a system of care approach. Click here if you want to be part of our campaign to strengthen, not diminish, system of care development efforts across the country.
I urge you to express your thoughts to those who serve you at the local, state and national level about the importance of maintaining a strong focus on children's mental health as the national discussion of the federal budget moves forward.
The deadline has passed but that does not mean we can rest. Continue to share your comments and be sure to put them in the comment section below as well. Our journey as participants in the evolution of health care reform in America has just begun. Stay tuned for next steps.
In a December bulletin, the U.S. Department of Health and Human Services (HHS) proposed to give states wide discretion to set their own essential health benefits (EHB) standard for health plans sold through the new exchanges. However, there are challenges ahead for children's mental health supporters as this does not have a clear-cut, comprehensive federal standard to help guide the process. It is our belief that if left up solely to the states, we could see significant disparities in coverage.
Here are the four key points you need to make in your message to HHS. Cut and paste or create your own message:
1. Support the Inclusion of a Wide Array of Mental Health Benefits and an Expanded Work Force to Carry Them Out
We risk going backward if what is required in the mental health component only includes inpatient and outpatient mental health services. The Bulletin must stress the importance of intensive community-based mental health services for children, youth and their families. Since the early 1980's the Children's Mental Health Initiative has been showcasing the value of a systems of care approach in meeting the mental health needs of children and families.
Essential benefits must include services such as respite care, parent support providers, behavioral aides and therapeutic mentoring. The Essential Health Benefits standard should include broad coverage of home supports and related services. Ultimately, a relatively inexpensive set of home support services, along with robust coverage of rehabilitative and habilitative services, is necessary to be in compliance with both Affordable Care Act (ACA) and Americans with Disabilities (ADA) law. Robust coverage would also prevent countless unnecessary hospitalizations and maximize the functional status, independence, and quality of life of enrollees.
The estimate is that with the Affordable Care Act an additional 37 million people will receive coverage - and that is a good thing! Expanding coverage to intensive community-based services and supports will require an expanded work force, including respite providers and parent support providers.
2. HHS Should not Allow a "Minimum Standard"
The Bulletin should not allow state or insurer flexibility to go below a national Essential Health Benefits floor or allow flexibility that will discriminate against individuals with disabilities, functional limitations, or mental health, behavioral health and substance abuse conditions or otherwise undermine efforts to achieve true parity in benefits.
3. Support the "Plus" in the "Plus Ten" Approach
The Affordable Care Act in its simplest form says that the Secretary must design an Essential Health Benefits package equivalent to a typical employer plan plus ten additional categories. Here is the "plus" part - A fundamental principle in the Affordable Care Act is that by investing in critical services, we will transform health care coverage and reduce long term spending. It would make no sense for the Affordable Care Act to, with regard to the Essential Health Benefits standard, list the critical services and then suggest they be covered only to the minimal extent already covered. It is no coincidence that the "plus ten" categories include critical gap services like preventive and wellness services and it is the Affordable Care Act's intent to invest in these services beyond current minimum norms. It is important to emphasize that the Affordable Care Act calls for a typical employer package "plus ten." Mental health and substance abuse services are included in the ten categories, however the rehabilitative and habilitative services necessary for intensive community-based services do not seem to be in place as they are in State Medicaid plans. For example, mental health rehabilitative and habilitative services are virtually non-existent in typical employer coverage. It would make no sense for the Affordable Care Act to create a requirement to cover a specific service "in the same scope as a typical employer" when that coverage is nearly nonexistent. For the inclusion of a service like intensive home-based servcices, wraparound, respite care or parent support provider to make any sense, each of the categories must be defined "beyond current minimum norms" and not satisfied by alignment with current employer coverage (or lack of coverage).
4. Require a Uniform Set of National Benefits
The Bulletin suggests that HHS will allow states to benchmark to a "reference plan" that is based on a currently available health plan in the state, modified as needed to meet the Essential Health Benefits requirements found in the Affordable Care Act. Allowing states to create their own variations of the Essential Health Benefits package will undermine the intent of the Affordable Care Act to create a comprehensive and national standard for health insurance coverage. We must make sure there are clear federal minimum Essential Health Benefits requirements and standards to ensure that vulnerable populations can access comprehensive care that consistently meets their needs across states.
Please send comments toEssentialHealthBenefits@cms.hhs.gov through today - so take 10 minutes (the time it takes to stand in line for a coffee or sitting in the drive-through lane picking up lunch). If you can do that today you surely can do this!
Want more details on our full set of considerations for the HHS Bulletin?Read more here.
After emailing your comments to EssentialHealthBenefits@cms.hhs.gov let us know what you said by sharing your thoughts in the comment section below.
Good article in USA Today Money section focusing on an innovative approach to reducing health care costs that involves a collaboration between a major corporation (Intel) two local health care systems and a health insurer.
From the article... Collaborating reduces costs of health care Peter Cady, who works 12-hour shifts on his feet at Intel's plant here, occasionally suffers severe lower back spasms. But he nearly gave up seeking medical help because in the weeks it took to get a doctor's appointment and a referral to physical therapy, the pain usually subsided.
These days, he's much happier with his care. Rather than waiting to see a doctor, Cady and other patients with routine back pain now see a physical therapist within 48 hours of calling, compared with about 19 days previously, Intel says. They complete their treatment in 21 days, compared with 52 days in the past. The cost per patient has dropped 10% to 30% due to fewer unnecessary doctor visits and diagnostic imaging tests. And patients are more satisfied and return to work faster.
"It's a real bureaucracy buster that gets you right straight to someone who can take care of the problem," says Cady, 47. "Before, the doctor wasn't helping me or explaining anything. But the physical therapist educated me, gave me stretches and exercises to do, and cleared it up."
The change came about through a collaboration between Intel, two local health care systems and a health insurer. Based on that success, the partners developed similar improvements for hip, knee, shoulder and headache treatment. Intel and its partners say the result has been $2 million in administrative savings this year, from reduced costs for patient scheduling and registration, for example.
Okay, quick quiz - Why in the world would we be posting an article about hip replacements? Because the approach they took to reduce costs with this particular physical ailment is straight out of the system of care playbook. We as a movement need to be documenting successful collaborations that involve non-traditional and traditional partners that improve functioning and save dollars. States are moving quickly to define what gets paid for and what does not. Send us your examples to help us create a national bank of successful examples of the value of a systems of care approach.
Use the example in this article as a guide but replace the phrase "hip, knee, shoulder and headache treatment" with children's mental health treatment. Have fun and think alongside the box!
Great article in the New York Times on the Essential Benefits component of the health care reform law. Check back frequently for updates on what will ultimately be included in the Essential Benefits package, especially as it relates to children's mental health.
From the article... The Obama administration surprised supporters and critics when it decided to let states define the “essential health benefits” that must be provided to their citizens under health care reform. The move could lessen opposition in Republican-led states and increase the chances that they will move ahead on building new health insurance exchanges to comply with the reform law.
The impact on most consumers may be minimal. Even the most fiercely antiregulation states will not be free to approve extremely miserly policies, because they will have to be comparable to popular and fairly comprehensive “benchmark” private plans. There are concerns that insurance company lobbyists — who are even more powerful in many states than in Washington — will find ways to shape requirements to favor their bottom lines rather than consumers. In the longer run, it would be better to set a national standard. That would also be easier for federal regulators to monitor...
Network members. Please encourage your state leaders to review this important opportunity to be a part of improving the use of psychotropic medications among children and adolescents in foster care. For some background information on the severity of the problem, read Judith Warner's article in the New York Times.
Intent to apply needs to be submitted by January 13, 2011 so you need to act quickly!
From the Application description:
The Center for Health Care Strategies, Inc. (CHCS), with funding from the Annie E. Casey Foundation (AECF), seeks state applicants to participate in a three-year quality improvement initiative to improve the practice of psychotropic medication prescribing and management for children and youth in foster care. A panel of independent experts representing clinical behavioral health practice, child welfare, Medicaid, and families and youth with experience in the child welfare system will review the applications and help CHCS select up to five state teams to participate in this three-year initiative. This initiative is intended as a state Medicaid, child welfare, and behavioral health authority partnership.
Each of the selected state teams will be part of a national multi-stakeholder quality improvement collaborative focused on improving the behavioral health care provided to children in foster care. Throughout the project, CHCS will help states to systematically track process and impact indicators using a continuous quality improvement learning community model. Findings will be broadly disseminated by CHCS and AECF, culminating with the publication of a toolkit that will serve as a how-to guide for other states to pilot the strategies tested in the collaborative.
In partnership with the National Action Alliance for Suicide Prevention and SAMHSA, Facebook is announcing a new service that harnesses the power of social networking and crisis support to help prevent suicides across the Nation and Canada. The new service enables Facebook users to report a suicidal comment they see posted by a friend to Facebook using either the Report Suicidal Content link or the report links found throughout the site. The person who posted the suicidal comment will then immediately receive an email from Facebook encouraging them to call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or to click on a link to begin a confidential chat session with a crisis worker.
This is a great example of harnessing the power of social media. Nice job SAMHSA for helping to initiate this.
About the National Action Alliance for Suicide Prevention
The National Action Alliance for Suicide Prevention (Action Alliance) is the public-private partnership advancing the National Strategy for Suicide Prevention. The Action Alliance envisions a Nation free from the tragic experience of suicide. Learn More.
Hey folks, this is significant. The U.S. Preventive Services Task Force (USPSTF) has come out with eleven high-priority clinical preventive services that USPSTF believes deserve further examination. (So researchers and funders of research need to listen up!)
In the Affordable Care Act, Congress also requested that the USPSTF identify evidence gaps that prevent it from making recommendations that target specific populations or age groups. On the list of four specific topics that the USPSTF has prioritized as having critical evidence gaps for targeted populations and age groups that may be addressed through research and that if filled are likely to result in important new recommendations, number two is Screening for Depression in Children.
From the report:
High-Priority Evidence Gaps in Clinical Preventive Services Targeting Specific Populations and Age Groups Screening for Depression in Children Major depressive disorder (MDD) among youth is a disabling condition that is associated with serious long-term morbidity and risk of suicide. However, the majority of depressed youth are undiagnosed and untreated. In 2009, the USPSTF found inadequate evidence that screening tests accurately identify MDD in school-aged children, and that antidepressants (i.e., selective serotonin reuptake inhibitors [SSRIs] such as fluoxetine) reduce MDD symptoms in children. There are limited data on the benefits of psychotherapy and the benefits of psychotherapy plus SSRIs in children. Studies are also needed that examine collaborative care management approaches compared with usual clinical care, as well as epidemiologic studies that describe the prevalence of MDD in children in primary health care settings according to age, sex, and race/ethnicity. Observational studies of risks for longer-term outcomes associated with the use of antidepressants would also contribute to addressing current evidence gaps.
Okay, the message is clear - USPSTF is telling Congress that this is an important area of focus and that more research could result in important new recommendations. Time to get busy.
Read the press release:
In its “First Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services,” the USPSTF highlights eleven high-priority clinical preventive services that the USPSTF believes deserve further examination with the hope that it will assist public and private researchers and research funders in targeting their efforts. Additionally the Report includes an overview of the USPSTF, its methods, and processes.
Concurrent with the release of the USPSTF’s report, the Community Preventive Services Task Force (CPSTF) issued its first Report to Congress. The work of the USPSTF complements that of the CPSTF, which makes recommendations to identify programs, services, and policies proven effective in communities, worksites, schools, and local governments. The CPSTF report provides background on the CPSTF, its methods, findings, and recommendations, and describes both gaps in existing research on community preventive services and priorities for future Task Force efforts.
Taken together, the recommendations of the two Task Forces provide our nation with the knowledge of how health is improved by prevention in both clinical and community settings. The two reports were submitted to Congress together on October 27, 2011 to demonstrate the close collaboration of the two Task Forces, and to provide a full picture of our nation’s prevention research needs.
The Association of Maternal & Child Health Programs, the National WIC Association, and the National Family Planning and Reproductive Health Association invite you to join them in an unprecedented National Mobilization for Women, Children and Families on October 26. The goal is to flood Capitol Hill with a unified message opposing MCH and women’s health program cuts.
In the next few weeks, Congress will be considering additional cuts to critical discretionary health programs for women, children and families that could exceed $1 billion in 2012 alone. Elected officials need to hear a clear message that these cuts are unacceptable.
Share this simple message: you oppose any efforts cut core programs for women, children and families, including Title V, WIC and Title X.
Other key points to share include:
Women and children should not be at the forefront of any discussion to reduce the federal deficit. We urge you oppose any efforts to cut core programs for women, children and families, including Title V, WIC and Title X and instead take a balanced approach that does not start with cuts to programs for women and children.
These programs provide the foundation for efforts to improve the health of women and children in our state. Further cuts will devastate state and local programs serving pregnant women, babies, children and children with special health care needs.
Ask if the the senator/congressman/congresswoman will support our cause!
Use our Congressional Search Engine to find members of your Congressional delegation. Then, send a follow-up e-mail or fax using the messages above.
Register for Pre-Event Webinar on October 25 at 3:30 p.m. EST
Join the Health Leaders above for a review of their main messages and share tips and best practices about communicating key messages. Registerherefor a pre-mobilization webinar on Tuesday, October 25 at 3:30 p.m. EST.
Elected officials need to hear a clear message that these cuts are unacceptable. That is why the Association of Maternal & Child Health Programs, the National WIC Association, and the National Family Planning and Reproductive Health Association are inviting us to join them in an unprecedented National Mobilization for Women, Children and Families on October 26. Register today!
WHY THIS IS IMPORTANT In the next few weeks, Congress will be making budget decisions that will affect funding for critical public health efforts for years to come. These decisions could threaten the very existence of some public health programs, and those serving women, children and families are highly vulnerable. The U.S. House of Representatives is currently considering proposals to cut over $1.3 billion for maternal and child health efforts in FY 2012 alone – $700 million cut from WIC; $299 million and elimination of Title X family planning grants; $350 million and elimination of Title V home visiting program funds; as well as elimination of $1 billion in the Prevention and Public Health Fund and $1.2 billion for community health centers. A Senate Committee also recently passed an appropriations bill including a $50 million cut to the Title V MCH Block Grant.
Followers of the Children's Mental Health Network know full well that we have been less than enamored with the level of prominence of children's mental health in the broader scope of SAMHSA planning efforts, specifically relating to one of the flagship programs - the Children's Mental Health Initiative - but that is for another discussion. What's important right at this moment is that SAMHSA could benefit from our support and we need to rally.
Here's what's up:
Although the House Appropriations Committee has yet to approve FY 2012 legislation funding, Committee Chairman Hal Rogers (R-W) relased a draft bill on September 29, proposing an 8% cut to SAMHSA. These cuts would cripple the availability and expansion of community-based programs that translate research into best practices for children and adults with mental disorders. Go to one of our favorite sources - the Bazelon Center website - for an in-depth analysis.
What You Can Do
Please urge your Senators and Representative to:
Reject deep funding cuts to the mental health budget for the Substance Abuse and Mental Health Services Administration (SAHMSA), as proposed by the House Appropriations Committee.
Sign on to the Dear Colleague Letter that Rep. Grace Napolitano (D-CA), co-chair of the House Mental Health Caucus, is circulating, urging other Representatives to reject these deep cuts.
Okay, got it? Go to our "Find your representatives in Congress page", enter your zip code and send your Representative a strong message of support for keeping SAMHSA funding levels where they are. It's bad enough as it is!
Thanks to all of the Children's Mental Health Network members who listened in on the August 16th SAMHSA Advisory Committees meeting. (Note: We will post transcripts of the meeting as soon as we receive them). As always, your support is much appreciated. Since that meeting, we’ve had some interesting dialogues that resulted in creating a list of short-term priorities. Some are about us and some are about how to help SAMHSA move forward. Read about our priority focus areas and see how you might get involved and support the effort…
Children's Mental Health Network – Priority Areas of Focus
Keep it Up
Your Voice Counts -Our recent campaign to get system of care language inserted into the Unified Application was recognized at the opening of the SAMHSA Advisory Committees meeting. SAMHSA seems to be genuinely interested in stakeholder input, especially from consumers, family members and ordinary citizens who care - hey, that's us! Make sure you sign up for our Twitter and RSS feeds so you can be ready for action. We anticipate we’ll be calling on you soon.
Getting Our House in Order
Push for Special Focus on Children and Adolescents at the Next SAMHSA Advisory Committee Meeting - At the recent Advisory meeting, the SAMHSA Administrator indicated that perhaps there should be a special focus on children and youth at the next Advisory meeting. We need to do everything in our power to help this thought become reality. We have set up a SAMHSA Advisory Committee Focus area on the website where you can share your thoughts about children's mental health issues you would like to see addressed at the next meeting. We will use this feedback to formulate a list of key topics that should drive the next SAMHSA Advisory meeting discussion. SAMHSA is clearly moving forward. We can choose to be in front of the train, hanging on to the caboose for dear life, or helping to drive the train. Let’s help drive the train!
Using this forum and others in the future, let's help SAMHSA define what is next for the Children’s Mental Health Initiative cooperative agreement program based on our collective wisdom and experience. We are an alliance of citizens from across the United States, the territories of Guam and Puerto Rico with a growing number of international supporters. Let’s pool our individual voices and make a collective statement about the importance of system of care values and principles and service delivery approaches that we know work.
Clarify Our Message - It is increasingly clear that we need to do a better job promoting our message that "children and adolescents with emotional and behavioral challenges and their families need support." Our emphasis is on promoting the values and principles of a system of care approach. Unfortunately, some continue to interpret this to mean a thing or specific project, which of course, it is not…it’s a way of being. We will be calling on our social marketing friends for guidance on this one!
Let's Not Forget History - Remember the days when we spoke about transformation? Remember the President's New Freedom Commission Report (Complete Report / Executive Summary)? We don't hear too much about those things these days. We get it that when Administrations change they bring in new ideas. The Obama Administration came in with a clear charge to not do business as usual. We support this, and Health and Human Services has done some amazing things in the past few years. However, let's not forget the solid work of the past. It is incumbent upon us to keep the President's New Freedom Commission and lessons learned from efforts to transform mental health care in America alive as we move forward.
Supporting Others to Get Their House in Order
Support and Promote Innovation and Change - Innovation and change are popular descriptors among SAMHSA leadership. What could be more innovative and change-oriented than the system of care approach? As we encourage SAMHSA to maintain a focus on children and adolescents with emotional and behavioral challenges and their families, we need to showcase how this movement has served as a laboratory of innovation and change for over 25 years. We need to highlight how systems of care exemplify innovation and change with proven results and that efforts that fully embrace these values and principles can provide the foundation for future innovative initiatives emanating from federal government.
Reinstate a "Senior Advisor for Children" at SAMHSA - One of the beneficial actions of a previous SAMHSA Administrator was the establishment of a Senior Advisor for Children to the Administrator of the SAMHSA. The value this position brought to SAMHSA with respect to collaboration, communication and continuity of effort in policy and planning was a welcome development. It appears that a position solely dedicated to this purpose no longer exists. While we are not interested in dictating the SAMHSA organizational structure, we do feel strongly that this role and function should be defined and reinstated.
Help SAMHSA Know What Helps Children, Adolescents and Families - Under the leadership of Kathleen Sebelius, Secretary of Health and Human Services, HHS has prioritized public access to information and citizen input. Let's capitalize on this spirit of openness by helping SAMHSA better understand what works. They need to better understand the impacts of the CMHI that don't necessarily get measured. Four specific examples (of a much larger list) include:
Statewide Family Networks - The Statewide Family Network Program, which has been in existence since the mid-1980's, beginning under the direction of the National Federation of Families for Children's Mental Health, is a great example of how families can mobilize with little funding to ensure a family-driven approach to improving mental health services for children, adolescents and their families. The grant program began with grants around $25,000 per year and, over the course of twenty-five years, has risen to a paltry $60,000 per year plus an additional $10,000 per year for youth involvement. Despite a growth in funding that works out to approximately a "raise" of about $1,400 per year, Statewide Family Networks continue to be the glue that ensures family voice in system of care development efforts. (Click here for a good read on Family and Youth Voice in Systems of Care by Friesen, Koroloff, Walker and Briggs)
Youth M.O.V.E National - This youth-led national movement is devoted to improving services and systems that support positive growth and development by uniting the voices of individuals who have lived experience in various systems including mental health, juvenile justice, education, and child welfare. I have had the wonderful opportunity to visit communities across the nation that are working to improve services and supports for children and families. More and more, I am hearing youth talk about organizing and becoming a part of Youth M.O.V.E. National. There are big things ahead for this movement.
Building Bridges - A direct result of the CMHI, Building Bridges was designed to address the historical tensions between residential and community-based service providers and systems, and to find ways to better integrate and link residential (out-of-home) and community-based services and supports. This effort has grown to over 80 partners from across the country who have endorsed the Joint Resolution and are actively working to advance system of care and Building Bridges principles in residential and community-based settings. Click here for a powerpoint overview of the Building Bridges initiative.
