Joint Do DVA Conference on PostDeployment Mental Health

Joint Do. D/VA Conference on Post-Deployment Mental Health Transforming Mental Health Care in America Alexandria, VA March 8, 2005

SAMHSA’s Vision: A Life in the Community for Everyone U. S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services 2 Center for Substance Abuse Prevention Center for Substance Abuse Treatment

Photo courtesy of U. S. Air Force 3 …the soldier above all other people prays for peace, for he must suffer and bear the deepest wounds and scars of war. But always in our ears ring the ominous words of Plato, that wisest of philosophers: “Only the dead have seen the end of war. General Douglas Mac. Arthur West Point, May 12, 1962

The time has long passed for yet another piecemeal approach to mental health reform. Instead, the Commission recommends a fundamental transformation of the Nation’s approach to mental health care. 4

Transformation must facilitate a culture of change and innovation…. That culture must foster leadership, education, processes, organizations, values, and attitudes that reward innovation. 5

Defining Transformation Ø Transformation is, foremost, a continuous process, without end. It is meant to create or anticipate the future. Ø Transformation is not accomplished through change on the margin but, instead, through profound changes in kind and in degree. These changes result in new behaviors and new competencies. Thus, in transformation, we look at what we can do now that we were unable to do before. Ø Transformation is meant to identify, leverage, and even create new underlying principles for the way things are done. Ø Transformation is meant to identify and leverage new sources of power. Ø Once the process of transformation begins, a profoundly different organization emerges, including changes in structure, culture, policy, and programs. 6 Retired Vice Admiral Arthur Cebrowski Former Director, Office of Force Transformation, Office of the Secretary of Defense

In a Transformed Mental Health 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 7

Goal 1 Americans Understand That Mental Health Is Essential to Overall Health Recommendations 1. 1 — Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention Photo courtesy of U. S. Army 8 1. 2 — Address mental health with the same urgency as physical health

Goal 2 Mental Health Care is Consumer and Family Driven Recommendations 2. 1 — Develop an individualized plan of care for every adult with a serious mental illness and child with a serious emotional disturbance Photo courtesy of U. S. Army 2. 2 — Involve consumers and families fully in orienting the mental health system toward recovery 2. 5 — Protect and enhance consumers’ rights 9

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Defining Recovery is a process, sometimes lifelong, through which a person achieves independence, self-esteem, and a meaningful life in the community. For some individuals, recovery implies the reduction or complete remission of symptoms. For others, recovery is the ability to live a fulfilling and productive life despite a disability. 11

Goal 3 Disparities in Mental Health Services Are Eliminated Recommendations 3. 1 — Improve access to quality care that is culturally competent 3. 2 — Improve access to quality care in rural and geographically remote areas Photo courtesy of U. S. Navy 12

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 13

Available from www. health. org 14

Goal 5 Excellent Mental Health Care Is Delivered and Research Is Accelerated Recommendations 5. 1 — Accelerate research to promote recovery and resilience and, ultimately, to cure and prevent mental illnesses 5. 2 — Advance evidence-based practices (EBPs) using dissemination and demonstration projects and create a public-private partnership to guide their implementation 5. 3 — Improve and expand the workforce providing evidencebased mental health services and supports 5. 4 — Develop the knowledge base for… • Eliminating mental health disparities • Assessing long-term effects of medications • Reducing the impact of trauma 15 • Improving acute care

Goal 6 Technology Is Used To Access Mental Health Care and Information Recommendations Photo courtesy of the U. S. Navy 16 6. 1 — Use health technology and telehealth to improve access and coordination of mental health care, especially for Americans in remote areas or in underserved populations 6. 2 — Develop and implement integrated electronic health record and personal health information systems

Federal Partners Workgroup Department of Health and Human Services 17 Other Federal Partners Ao. A ACF NIH/NIDA NIH/NIMH Department of Education Department of Housing and Urban Development AHRQ CDC CMS OS/ASPE OS/OCR OS/OD OS/OPHS Department of Justice Department of Labor SAMHSA Department of Veterans Affairs HRSA IHS Social Security Administration

The Promise of Transformation We envision a future when everyone with a mental illness will recover, a future when mental illnesses can be prevented or cured, a future when mental illnesses are detected early, and a future when everyone with a mental illness at any stage of life has access to effective treatment and supports— essentials for living, working, learning, and participating fully in the community. 18 Vision statement from Achieving the Promise: Transforming Mental Health Care in America