Shaping the Future of Behavioral Health: Understanding Drivers, Challenges and Opportunities

Pamela S. Hyde, .D. SAMHSA Administrator

Mental Health America Annual Conference Washington, D.C. June 10, 2011

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udget constraints, cuts and realignments ! economic challenges li"e ne#er $efore

%o s&stem in 'lace to mo#e to scale inno#ati#e 'ractices and s&stems change efforts that 'romote reco#er& Science has e#ol#ed( language and understanding is changing

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*ntegrated care re+uires ne, thin"ing a$out reco#er&, ,ellness, role of 'eers, res'onding to ,hole health needs %e, o''ortunities for $eha#ioral health
-arit&.Health /eform 0ri$al 1a, and 2rder Act %ational Action Alliance for Suicide -re#ention

3#ol#ing role of $eha#ioral health in health care

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A*M7 *m'ro#ing the %ation8s eha#ioral Health

1 2 ) 4 -re#ention 0rauma and Justice Militar& 9amilies /eco#er& Su''ort

A*M7 0ransforming Health Care in America

5 Health /eform 6 Health *nformation 0echnolog&

A*M7 Achie#ing 3:cellence in 2'erations

; Data, 2utcomes < =ualit& > -u$lic A,areness < Su''ort

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/eco#er& from mental health 'ro$lems and addictions is a 'rocess of change ,here$& indi#iduals ,or" to im'ro#e their o,n health and ,ellness and to li#e a meaningful life in a

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1. -erson@centered 2. 2ccurs #ia man& 'ath,a&s ). Holistic 4. Su''orted $& 'eers 5. Su''orted through relationshi's

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6. Culturall& $ased and influenced ;. Su''orted $& addressing trauma >. *n#ol#es indi#idual, famil&, and communit& strengths and res'onsi$ilit& ?. ased on res'ect

10.3merges from ho'e

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/eco#er& domains

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/eco#er& 'rinci'les /eco#er& month /eco#er& outcome measures /eco#er& 0A Center A /SS 0ACSB /eco#er& curricula for.,ith 'ractitioners

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Dis'arities
3thnic minorities C HHS Strategic Action -lan to /educe /acial < 3thnic Health Dis'arities 1D 0= 'o'ulations C 1D 0 Coordinating Committee A*.A% *ssues C 0ri$al Consultations Women and girls

2ffice of eha#ioral Health 3+uit& @ Ee& Dri#ers < Acti#ities

HHS 2ffice of Minorit& Health fi#e core goal areas7 a,areness, leadershi', health s&stem and life e:'erience, cultural and linguistic com'etenc&, and data, research and e#aluation AH/=8s %ational Healthcare Dis'arities /e'ort ! identifies im'ro#ing, maintaining and ,orsening health indicators, including de'ression, illicit drug use and suicide SAMHSA8s 3ight Strategic *nitiati#es

!ational !et5or6 to #liminate Disparities in Behavioral Health 7!!#D8 555.nned.net

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Maintenance of 3ffort AM23B Wai#ers

9F10.SF0? ! 1) SA ,ai#ers( G26,2;?,454 9F10.SF0? ! 16 MH ,ai#ers( G>4?,;40,;??.50 9F11.SF10 ! 1> SA ,ai#ers( G1;?,410,?46H 9F11.SF10 ! 1? MH ,ai#ers( G51;,>?4,>>4H

H9F11.SF10 ,ai#er information reflects information a#aila$le as of June ;, 2011

State 9unds
MH ! G 2.2 $illion reduced SA ! eing Determined

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9F 2011 /eductions G42 illion SAMHSA ! G)>.5 mil A'lus CG15 mil in earmar"sB 9F 2012 -ro'osals
G4 ! 6.5 0rillion o#er 10 &ears 9undamental changes to Medicaid, Medicare < federal.state roles in health care

9F 201) udget De#elo'ment %o,

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Dollars in Millions

ACA PHS BA

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9ocusing on the Strategic *nitiati#es

9F 2011 $udget reductions < /9As 9F 2012 $udget 'ro'osal( S*s, *3*, mo#ing to 2014 9F 201) tough choices a$out 'rograms and 'riorities

/e#ised A''roach to Drant@Ma"ing

raided funding ,ithin SAMHSA < ,ith 'artners 3ngaging ,ith States, 0erritories < 0ri$es ! 9le:i$ilit&

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*m'lementing a 0heor& of Change

0a"ing 'ro#en things to scale AS-9, S2C, 0raumaB /esearching.testing things ,here ne, "no,ledge is needed

3fficient < 3ffecti#e Ise of 1imited Dollars

Consolidating contracts < 0A Centers Consolidating 'u$lic information < data collection acti#ities and functions

/egional -resence < Wor" ,ith States

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-romotes consistent 'lanning, a''lication, assurance and re'orting dates 0a"e $roader a''roach ! reach $e&ond those historicall& ser#ed 9le:i$ilit& ! one e#er& t,o &ears # t,o e#er& &ear -re'aration for 2014 D dollars for 're#ention, treatment, reco#er& su''orts and other ser#ices that su''lement ser#ices co#ered $& Medicaid, Medicare and 'ri#ate insurance 9orm strategic 'artnershi's for $etter access to good and modern $eha#ioral health ser#ices *m'ro#ing accounta$ilit& for +ualit& < 'erformance Descri'tion of tri$al consultation acti#ities

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4-6 mil

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+ndividuals Served <y .H%s

+ndividuals Served <y SS%s
Uninsured ;?> +nsured =(>

+nsured ;?>

Uninsured =(>

?0@?5 'ercent ,ill ha#e o''ortunit& to $e co#ered $& Medicaid or through *nsurance 3:changes

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Comments /ecei#ed
-ositi#e Direction Clarif&ing /e+uirements 0imelines /e'orting urden Concerns

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-lans due Se'tem$er 1 for 20 months -hased in 'lanning a''roach Mo#ing to,ard A'ril 1, 201) for ne:t t,o@&ear a''lication Annual re'orting

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%ational eha#ioral Health =ualit& 9rame,or" ! similar to %ational =ualit& 9rame,or" for Health
SAMHSA funded 'rograms measures -ractitioner.s&stem@$ased measures -o'ulation@$ased measures

We$cast.1istening Session
Draft document on ,e$ ,,,.samhsa.go# June 157 )700 ! 5700 '.m. 3astern

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Ise of SAMHSA tools to im'ro#e 'ractices

Models AS-9, coalitions, S */0, S2Cs, suicide 're#entionB 3merging science Aoral fluids testingB 0echnical Assistance A0AB ca'acit& AtraumaB -artnershi's Ameaningful use( Medicaid < Medicare +ualit& measuresB Ser#ices research as a''ro'riate

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*nternal7 Communications Do#ernance Council

Consolidation of We$site.>00 Js ! sa#ing mone& and increasing customer use and satisfaction Social Media /e#ie, of 'u$lications < materials

3:ternal7 -u$lic cam'aigns in 'artnershi' ,ith others ! common messages, common a''roaches
S02- Act( What a Difference a 9riend Ma"es

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0ucson, 9ort Hood, Kirginia 0ech, /ed 1a"e, Colum$ine Kiolence in school $oard and cit& council meetings, in courtrooms and go#ernment $uildings, on high school and college cam'uses, at sho''ing centers, in the ,or"'lace and 'laces of ,orshi' C60 'ercent of 'eo'le ,ho e:'erience MH 'ro$lems and ?0 'ercent of 'eo'le ,ho e:'erience SA 'ro$lems 'ercei#e need for treatment $ut do not recei#e care

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Suicides are almost dou$le the num$er of homicides As man& 'eo'le need SA treatment as dia$etes, $ut onl& 1.6L # >4L recei#e care SA and MH often misunderstood
Discrimination

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Americans ha#e general "no,ledge of $asic first aid $ut not ho, to recogniNe M* or SA, or ho, or ,hen to get hel' for self or others
Most "no, uni#ersal sign for cho"ing( facial e:'ressions of 'h&sical 'ain( and $asic terminolog& to recogniNe $lood and other 'h&sical s&m'toms of illness and inMur& Most "no, $asic 9irst Aid and C-/ for 'h&sical health crisis Most do not "no, signs of suicide , addiction or mental illness or ,hat to do

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