Transforming the Mental Health System

COSIG States MeetingBethesda, MDDecember 16, 2004

A. Kathryn Power, M.Ed., Director Center for Mental Health Services

·U.S. Department of Health and Human ServicesSubstance Abuse and Mental Health Services AdministrationCenter for Mental Health Serviceswww.samhsa.gov

22

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

33

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.

44

The SAMHSA Matrix

55

The Goals of a Transformed SystemGoal 1 Americans understand that mental health is

essential to overall healthGoal 2 Mental health care is consumer and family

drivenGoal 3 Disparities in mental health services are

eliminatedGoal 4 Early mental health screening, assessment, and

referral to services are common practiceGoal 5 Excellent mental health care is delivered and

research is acceleratedGoal 6 Technology is used to access mental health

care and information

66

Goal 4: Early Mental Health Screening, Assessment, and Referral to Services Are Common PracticeRecommendations4.1—Promote the mental health of young children4.2—Schools should have the ability to play a larger

role in mental health care for children4.3—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

77

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 ModelThe Public Health Model

88

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

99

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-occurringdisorder

1010

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%

1111

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

1212

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