Never a dull moment with our colleagues at SAMHSA. The announcement of a new round of funding opportunities for Healthy Transitions grants (HTI), which we consider excellent news, comes tinged with the apparent decision not to include a robust evaluation component. According to SAMHSA, while they are remaining committed to conducting evaluations as part of grant programs, they also want to be mindful of "grantee burden."
What about all of the outrage during the crafting of the Helping Families in Mental Health Crisis Act, which eventually became part of the Cures bill? Back then, (seems forever ago), members of Congress were raking SAMHSA officials over the coals for not being evidence-based enough. In fact, several new entities were created (Assistant Secretary position, Mental Health and Substance Use Policy Laboratory, Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC)) to ensure a more rigorous approach to evaluation.
And yet, with a new Assistant Secretary, a newly created Mental Health and Substance Use Policy Laboratory, and freshly created ISMICC, we are witnessing an agency going in reverse when it comes to supporting rigorous evaluation. Two prime examples are the cancellation of the NREPP contract and the cancellation of the evaluation contract for the current round of HTI and Project Aware grants.
To be fair, SAMHSA is indicating that the new round of HTI grants will include an evaluation component that focuses on the collection and analysis of NOMS data by SAMHSA staff. Not quite sure yet who these staff will be or if there will be sufficient person-power to complete this task. Beyond the collection of NOMS data, which is "evaluation-lite" at best, there is apparently discussion taking place with the Center for Behavioral Health Statistics and Quality (CBHSQ) to determine next steps for conducting evaluation activities.
Uh, yep, that explanation is about as clear as mud.
Let's be clear, we are excited that the President's budget includes funding for HTI, and we encourage readers to apply for this funding. But we are also concerned that the new round of funding comes with vastly reduced evaluation requirements. This trend toward lowering evaluation requirements for grantees and moving evaluation efforts in-house makes the recent decision to cancel the evaluation contract for the current round of HTI grants even more important to revisit.
I remain supremely puzzled at the apparent lack of interest in conducting a robust evaluation of programmatic efforts to learn more about "what works." For the current round of grants, the time one baseline assessment has been completed, but the more important time two assessments still need to be done. Without those time two assessments there is no way to assess meaningful change.
Why does SAMHSA seem to be so intent on weakening the evaluation component of the grants it funds? At a minimum, it would be most helpful for Assistant Secretary McCance-Katz to reconsider the decision to cancel the evaluation contract for the current round of HTI and Project Aware grants and give the opportunity for the evaluation to reach completion.
Remember, these grants were initially created after the Sandy Hook massacre when the nation was screaming for answers and SAMHSA was under the hot light of congressional scrutiny about not doing enough for those with serious mental illness.
I encourage readers who have an investment is seeing SAMHSA continue robust evaluation of the programs they (and ultimately we) fund, write Dr. McCance-Katz an email and let her know your thoughts about the importance of a healthy and independent evaluation of HTI efforts. Remember to:
Start a dialogue with the Assistant Secretary
Your message doesn't have to be fancy. In fact, short and sweet is probably best. The email address for Assistant Secretary McCance-Katz is firstname.lastname@example.org.
We need the evaluation of the current HTI and Project Aware grant programs to continue. The goal of any grant program is to identify effective strategies for meeting the needs of the identified population being served. A complete evaluation of five years worth of HTI and Project Aware activities would go a long way to help new grantees further improve upon efforts to meet the needs of youth with mental health challenges effectively. The time 1 baseline assessment has been completed, but the more important time 2 assessments still need to be done. Without those time 2 assessments, there is no way to assess meaningful change. Even if the new grants never get an evaluation component that goes beyond minimum standards, they would have the benefit of learning more about what works from the study of five years worth of HTI and Project Aware grants that are close to completion.
Remember that Dr. McCance-Katz is no different than you, and that like you, she is most likely doing the best she can with the information she has. Writing an email message to Dr. McCance-Katz provides you a valuable opportunity to help broaden her view of the importance of what a robust evaluation could and should, entail.
Okay, Network faithful, change only happens if we all get involved. If this issue is important to you, take a few moments to send the Assistant Secretary a message encouraging her to rethink the decision to end the evaluation contract for the HTI and Project Aware grants prematurely.
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President & CEO
Children's Mental Health Network