SAMHSA is under attack – and the rank and file are paying the price
March 29, 2015
March 29, 2015
It was joyous and sobering for me, standing on stage looking out at the audience filled with bright, passionate and dedicated researchers, policymakers and providers. Everyone attending the 28th Annual Research and Policy Conference for Child, Adolescent, and Young Adult Behavioral Health this past week, has in some way been touched by involvement in a SAMHSA-funded grant or initiative.
If my close to 30 years being involved in this work has shown me anything, it is that innovation and creativity always find a way to rise to the top. And this room was full of creative innovators.
How ironic that of the close to 700 people in attendance at the conference, easily two-thirds of them have had direct involvement with a SAMHSA-funded initiative. In that capacity, these bright researchers have been able to extend our knowledge about the science of prevention and treatment strategies that make a difference for youth with mental health challenges and their families. I can only hope that the small slice of SAMHSA that I am most familiar with, the Child Mental Health Initiative, is representative of the other initiatives that SAMHSA funds. If this is the case, then I am inspired and hopeful for the continued development of innovative treatment strategies based on the realities of today, not 30 and 40 years ago.
However, it seems that for each innovative step forward, we tend to cycle through regressive periods when we take three steps back. You know we are in a regressive cycle when you realize that we seem to have forgotten the lessons learned from the evolving science of effective prevention, treatment and support for individuals with mental health challenges. That forgetfulness is evidenced by a tendency to embrace the safety and comfort of antiquated and simplistic notions of effective treatment. We are in such a cycle right now.
SAMHSA is under attack – rank and file are paying the price
SAMHSA, and specifically Administrator Pam Hyde, is under scrutiny by the House Energy and Commerce Committee Oversight and Investigations Subcommittee as part of their ongoing discussion of mental health reform. In the last two years we have seen pronouncements of simple, quick fix answers to some our most complex mental health challenges; the proliferation of six-word sound bytes denigrating SAMHSA (e.g., SAMSHA doesn’t care about mental illness), smug commentaries in leading newspapers across the nation that reward and encourage the constant attack on SAMHSA, and a barrage of questions and probes which focus on individual examples from agency-funded grants that show complete disregard for the overall context in which they exist. I fear that the tug of war between the Oversight and Investigations Subcommittee and Administrator Hyde is a harmful distraction to the overall functioning of the agency.
And yet, the rank and file who work within SAMHSA continue to do the work that needs doing, following orders from above and remaining loyal to the mission of the agency.
I cannot come close to imagining what that must be like or how it must feel.
SAMHSA employees don’t need to imagine. They live it day in and day out.
The strain on SAMHSA employees is obvious to me and my fellow colleagues. It is also painfully clear in polling data. In a recent poll by the Partnership for Public Service on the best places to work in federal government, SAMHSA ranks 298th out of 315. SAMHSA ranks lowest in morale in all of HHS. There are only 17 agencies in federal government who rank lower.
The deterioration of knowledge within SAMHSA is further evidenced by the increasing number of seasoned professionals leaving SAMHSA for other endeavors. This institutional knowledge cannot be replaced. There has got to be a solid effort to stem the tide of knowledgeable innovators leaving the agency for other pursuits.
Recommendation to Congress
It is no secret that the House Energy and Commerce Committee Oversight and Investigations Subcommittee has had SAMHSA squarely in its sites for some time now. I have written about the childish behavior exhibited by some members of Congress in hearings with SAMHSA Administrator Pamela Hyde, as well as the contentious responses from Administrator Hyde to subcommittee questions. While that behavior on both sides may continue, the staff of SAMHSA do not deserve to be drawn into the fray.
Here is my respectfully submitted recommendation to members of Congress:
Whenever a member of Congress decides to lay into Administrator Hyde, it would be a good start if he or she would preface the shellacking with acknowledgment of the foot soldiers working within the walls of SAMHSA. If members of Congress don’t begin doing this, then they are part and parcel in contributing to the low morale of agency staff and the alarming brain drain that is taking place.
Recommendation to Administrator Hyde
Yes, some of the barbs thrown your way have, for the most part, been out of context. But the field needs you to rise above and broaden your leadership approach. Viewing your leadership approach from afar feels a bit like “my way or the highway.” That may not be your intent or what you are doing in practice, but that is how it looks and feels to many in the field. I fear that if you stay on this course, SAMHSA ultimately loses. And the loss most significantly will be in the brain trust that is the staff that make up the organization.
Here are my respectfully submitted recommendations to Administrator Hyde:
Folks, SAMHSA is in crisis, and we cannot sit by and watch it both self-destruct and be torn down by political forces outside. There is too much good being done by too many good people to let this happen. Show your support for the dedicated employees who work for SAMHSA and send a clear message to Congress and Administrator Hyde that they have got to figure out how to work together.
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President & CEO
Children’s Mental Health Network