SAMHSA Joint Advisory Councils, May 2001
breakout: faith-based initiatives:
Carole Schauer and I were the only m h people in the room; none on the panel. I noted that religiosity is often diagnosed so that people with psychiatric diagnoses dont reveal their transformative experiences and that faith, not just pharma, can be part of our recovery. But Wesley Clark, director of one of the Centers, spoke of substance abuse treatment and recovery and mental health treatment. One of the panelists was disturbed that the military must recognize Wicca and allow Wiccan practices on bases, noting that in choosing from faith-based organizations (FBOs), they will have to let in a pretty wide spectrum.
SAMHSA:NIH collaborations combine practice, policy and science.
Leshner, NIDA, applauds grandiosity; humility is good; "I take credit for everything."www.clubdrugs.org ; www.steroidabuse.org ; blending of public health and public safety in dealing with non-violent offenders - NIDA will reach out to inform these initiatives, including supporting drug courts. National Drug Abuse Prevention Research System.
Gordis: NIAAA, Project Match: attempt to match patient characteristics with verbal treatment modalities (three kinds) found no strong results;
Hyman, NIMH, symptom reduction is not always what consumers and families care out. People want functional outcomes - jobs, school, ...; effectiveness. \
This wasnt a day for perfume allergies - the taxi had *six* dangling "pine trees;" the hotel sprayed the plenary carpet with "freshener;" and the chairs cologne permeated the breakout room.
breakout: integration across the lifespan
lessons from childrens system of care is that it must be driven by consumers and their families, and as soon as old enough, consumers themselves must have voice. Early intervention and prevention for kids with depression; will be recommended to be included in health plans. (Not stated whether intervention is medication or what.) Look at systems; beyond the individual (public health model?). Kids who do the best have become their own case managers, have learned how to navigate the system. Telephone network for seniors - preset dialers for health, transportation, support group, ... (in Southern Florida).
Im staying down the road from the conference in a Springfield Suites hotel, less expensive and with a refrigerator and microwave. I made myself an instant cup-of-soup, watched the thunderstorms, and within the course of one hour, felt blissful, anger, and depressed. <gulp>
Joint Councils - Day Two
2002 budget was done quickly by new administration to meet time lines; 100 million more in drug treatment, 16 million CMHS reduction (mostly because of one year earmarks), and data collection dollars - otherwise straight-line
Dollars will go to "priority investments" from "turnover" dollars.
Hearings: interest in substance demand reduction; general interest in mental health: PATH, ptsd, community services/Olmstead; and in substance prevention and youth.
Provision authorizing 20% transfer of State grants among programs.
2003 budget will have a more careful process, with more attention to accountability, and Thomson will be more directly involved, performance will be scrutinized
Councils web page will include briefing materials.
www.samhsa.gov/council - feedback welcomed firstname.lastname@example.org (modeled on lead CMHS took) At CMHS link is all the briefing material for the advisory council, the members, ... . Some material is password protected, for council members only.
January council meeting might be pushed to February to facilitate the grant review process.
Reports from breakouts:
1. Collaboration with NIAAA, NIDA, NIMH, HRSA, IHS, and HCFA. A Good Thing. Also include CDC, ... Any federal agency. Move research into program, for instance assertive community treatment.
2. Co-occurring disorders and trauma. Early intervention; treatment is prevention with children. People-first language.
3. Faith-based initiative. Considerable discussion and interest about how to do this well, inclusively, responsibly. Add spiritual development as part of the constellation of care.
4. Reauthorization: special authorities and performance partnerships
5. Integration across the lifespan: emphasis on primary care and public health model; multiple entry points. Disease model is problematic.
6. Reducing health disparities. Develop interventions in collaboration with members of the affected community. Public policies should treat mental health and substance use disorders as a public health concern.
Center Reports: CMHS, CSAT, CSAP Q&A
erosion of infrastructure (translation - hard to get kids and adults admitted for forced treatment) Mental health planning council reports are used to determine and assess block grants. There is not a standard format so they are not coordinated to produce a national report. August - national meeting of Planning Councils.
Council discussion: legislative proposal advanced to allow for-profits to answer calls for grant applications.