Moving Forward on SAMHSA’s Plan for Leading Change
By Pamela S. Hyde, J.D.
Thank you to everyone who provided SAMHSA with thoughtful and much-appreciated feedback on SAMHSA’s draft of Leading Change: A Plan for SAMHSA’s Roles and Actions: 2011–2014, posted on the SAMHSA.gov home page. Comments were received from many interested individuals, members of Congress, behavioral health stakeholder and advocacy groups, as well as from SAMHSA staff, Federal partners, and National Advisory Council members. Work is underway to extract common themes, incorporate suggestions, and produce a final version of the paper as soon as possible.
So far, comments cover a wide range of topics. Those include specific policy suggestions, such as working with the Centers for Medicare & Medicaid Services about Medicaid provisions affecting payment for behavioral health services. They also include broad concerns, such as addressing the connection between mental and substance use disorders and criminal justice involvement.
SAMHSA Administrator Pamela S. Hyde, J.D.
The comment period closed at the end of October 2010.
As reported in SAMHSA’s October 29 blog entry, nearly 3,000 people participated in the Agency’s web-based Strategic Initiatives Forum, submitting almost 2,500 ideas and comments and casting more than 23,000 votes. A number of these comments addressed the importance of recovery and the imperative of involving people with behavioral health issues in SAMHSA’s efforts. Based on these comments, we listened, and we have revised the Housing and Homelessness Strategic Initiative to include the broader topic of Recovery Support. The Recovery Support Strategic Initiative will advance recovery and resiliency-oriented systems to help individuals and families achieve the four universal goals of Health, Home, Purpose, and Community.
Through the voting process, participants in the online forum expressed their support for ideas ranging from self-directed care for consumers and people in recovery to the use of assisted outpatient treatment. In areas where there are opposing opinions, SAMHSA is exploring ways to convene a dialogue meeting to understand the implications of different approaches and chart a path forward.
Of the many ideas and comments submitted online, the following issues were cited most frequently as areas needing greater emphasis in the paper:
- Include consumers, survivors, and people in recovery in decision making at all levels.
- Improve employment outcomes for people with mental and substance use disorders.
- Address fetal alcohol spectrum disorders.
- Explore alternatives to psychiatric medication.
- Strengthen the behavioral health workforce.
- Meet the needs of a variety of groups including people with disabilities; underserved racial and ethnic groups; American Indians and Alaska Natives; lesbian, gay, bisexual, and transgender people; children, teens, and young adults; and older Americans.
Unfortunately, SAMHSA does not have the resources to address every issue that was raised. This means making hard choices about competing priorities.
Some of the feedback addresses existing commitments at SAMHSA that did not come through in the current draft version of the paper. Those will be better reflected in the final version of the plan.
In other cases, SAMHSA amended the initiatives to address topics suggested through the comment process. SAMHSA may also engage other Federal partners who have primary responsibility for some of the suggested areas of focus.
Overall, the level of participation and comments is gratifying and underscores the importance of SAMHSA’s mission. Even if specific ideas are not reflected in the final version of the paper, those ideas may contribute to the development of SAMHSA’s initiatives and other work in the future.
Thank you for your continued interest and support. Together we will accomplish SAMHSA’s mission—to reduce the impact of substance abuse and mental illness on America’s communities. While systems, services, and programs are the means, people’s lives matter most.