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Mental health.

The article, A Healthy Mind for a Healthy Population (Issues, Summer 2006), asserts that health care for mental problems and substance use conditions "requires fundamental redesign." I could not agree more. As the newly confirmed Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), within the Department of Health and Human Services, I share the author's concerns regarding quality, access, and outcomes of behavioral health services in the United States (U.S.).

I am pleased to report that SAMHSA has already taken steps to "transform" mental health care in America and implemented a new, innovative financing approach for substance abuse treatment and recovery support services. The President's New Freedom Initiative and Access to Recovery program have cemented recovery as the new framework for public policy development in mental health and substance abuse services in this country. However, in lieu of providing a litany of SAMHSA's many important activities already under way to achieve improved access and higher quality services, we must remain focused on how much is yet to be accomplished.

New data point to the alarming and unacceptable rates of early mortality and morbidity for people with serious mental illnesses, a loss of 25 years. Sadly, these years lost to early death and disability are primarily attributable to a lack of attention to consumers' physical healthcare needs. And after years of debate, we have established that individuals with co-occurring mental and substance use disorders should be the expectation, not the exception in our treatment systems. While we have made notable strides in this area over the past decade, there is yet much to be achieved when it comes to ensuring that access to services exist, evidence-based practices are applied, and financing structures promote, not hinder, integrated care. Our own 2005 data tells us that among the 5.2 million adults with both serious mental and substance use problems fewer than half (47%) received mental health treatment or substance use treatment at a specialty facility. Only 8.5% received treatment for both mental health problems and substance use treatment.

To continue our quest for quality improvement, we must continue efforts to reduce the significant lag time between the generation of new scientific knowledge and its application at the community level by prevention and treatment programs and providers. These issues demand our attention and our action. Through SAMHSA's partnership with the states to adopt a few carefully chosen national and state-level outcome measures, we are building accountability and effectiveness measures into every grant dollar and agency program, rewarding performance with proven results at the levels of the individual, family, community, and service system as well as measuring our own effectiveness as an agency

SAMHSA welcomes the support provided in the article for the work we are doing. We hope this will help open further doors when collaborating with consumers, family members, clinicians, academicians, policymakers, and administrators in behavioral health. Together, through concerted efforts, we can effectively make recovery the outcome for those persons with mental and substance abuse disorders.



Substance Abuse and Mental Health Services Administration

Rockville, MD
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Title Annotation:FORUM
Author:Cline, Terry L.
Publication:Issues in Science and Technology
Article Type:Letter to the editor
Date:Mar 22, 2007
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