Substance Abuse & Mental Health Services Administration

CMHS Consumer Affairs E-News
January 10, 2006, Vol. 06-02

2005 Year in Review

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION CENTER FOR MENTAL HEALTH SERVICES ASSOCIATE DIRECTOR FOR CONSUMER AFFAIRS

The following is a year-end review of the activities of the office of the Associate Director for Consumer Affairs (ADCA) within the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS).

For more information on any of these activities, please contact the staff listed at the end of this update.

National Consensus Conference on Mental Health Recovery and Mental Health Systems Transformation

SAMHSA is soon to release the National Consensus Statement on Mental Health Recovery that was based on this December 2004 meeting. Over 110 consumers, family members, providers, researchers, advocates, and State and local officials participated in this landmark event for which SAMHSA/CMHS/ADCA provided the lead staff. The consensus statement will help guide efforts to promote recovery for individuals and systems. Please contact Paolo del Vecchio for more information.

National Anti-Stigma Campaign (NASC)

In July 2005, SAMHSA published Transforming Mental Health Care in America: The Federal Action Agenda - First Steps. This report, led and developed by CMHS, contains 70 action steps to transform the mental health care system with the goal of recovery for individuals with mental health problems. The very first step of the action agenda calls for a national campaign to reduce stigma associated with mental health problems, promote the principles of recovery, and encourage those in need to seek help and support. SAMHSA's National Anti-Stigma Campaign is a three-year, national, public education campaign to educate the general public about mental health problems. The NASC will also target specific audiences including older adults, ethnic and racial minorities, and rural communities. The NASC will produce television, radio, and print public service announcements as well as indoor, transit, web-based, and outdoor advertising. The impact of the NASC will be measured to evaluate, reach, awareness, utilization, and shifts in public attitudes and behavior. The projected launch of the materials for the NASC will take place in June of 2006. For more information on the NASC, please contact Chris Marshall.

Elimination of Barriers Initiative (EBI)

After three years, the Elimination of Barriers Initiative demonstrated successful implementation of anti-stigma efforts. The EBI was an 8 State demonstration and evaluation project to test the effectiveness of public education models to reduce discrimination and stigma. The eight states were California, Florida, Massachusetts, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin. The EBI has laid the groundwork for the National Anti-Stigma Campaign and created TV, radio, and print informational materials including those targeted for schools and businesses. For more information, please see: http://www.allmentalhealth.samhsa.gov and/or contact Paolo del Vecchio.

SAMHSA Resource Center to Address Discrimination and Stigma (ADS Center)

The SAMHSA ADS Center helps States, local communities, providers, advocates, family members, and consumers with information and resources on effective, practical approaches to counter stigma, research findings on stigma and what works to counter it, anti-stigma campaigns and programs, and anti-stigma events and trainings. The ADS Center uses its ever expanding database of resources and information on addressing stigma and discrimination to respond to technical assistance and information requests. The database includes references to and citations of research studies, books, articles, campaigns, educational materials, fact sheets, personal stories, and other anti-stigma activities. The ADS Center Web site is at www.stopstigma.samhsa.gov, and its phone number is (800) 540-0320. You may also email the Center at promoteacceptance@samhsa.hhs.gov.

During 2005, the ADS Center provided an array of training teleconferences on reducing stigma and discrimination in secondary school settings and in African American, American Indian and Alaska Native, and Asian American/Pacific Islander communities. Also, training was provided on media strategies for reducing stigma within Spanish-speaking communities. These teleconferences are archived along with their power point presentations. Information on how to access these free archived telephone calls and their power point presentations is on the Web site: http://www.stopstigma.samhsa.gov---click on Trainings.

The ADS Center also produced and distributed quarterly electronic updates, titled Mental Health News You Can Use focusing on anti-stigma resources, research findings, campaigns, and opinion pieces. These updates can be found on the Web site at Memoranda or you can sign up for them on the Web site. Please contact Carole Schauer for more information.

Older Adults Roundtable Meetings

In December, CMHS released the publication, Mentally Healthy Aging: A Report on Overcoming Stigma for Older Americans. This report summarizes the results of two older adult roundtables held in Washington, DC and Los Angeles, California. Consumers, providers, public officials, researchers, older adults, and media representatives explored the types of stigma and discrimination older adults with mental illnesses face, determined what barriers existed to reducing stigma and discrimination, and recommended initiatives including education and media campaigns to address stigma and discrimination among older adults with mental illnesses. Copies of the publication are available at (800) 789-2647. For more information, contact Carole Schauer.

CMHS National Advisory Council Subcommittee on Consumer/Survivor Issues

The Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) maintains a congressionally mandated National Advisory Council (NAC) that advises the CMHS Director on Center activities. In 2000, a subcommittee to the NAC was formed, the Subcommittee on Consumer/Survivor Issues, to serve as a fact-finding body and advise and make recommendations to the NAC on issues from the consumer/survivor perspective. To accomplish this task, members of the NAC serve on the Subcommittee as well as expert consumer/survivor consultants. A current list of members appears at the end of this section. All meetings are open to the public.

The Subcommittee on Consumer/Survivor Issues met two times in 2005 and addressed the following issues: the development of a recovery orientation for evidence-based practices; SAMHSA trauma initiatives; the community mental health services block grant program; workforce development and the Annapolis Coalition; and the SAMHSA Mental Health Transformation State Incentive Grants. In addition, the Subcommittee has also begun a process of developing a definition for consumer-driven care. A draft version of the statement can be found at http://www.mentalhealth.samhsa.gov/cmhs/AdvisoryCouncil/consumerdrivenDraft.asp

The Subcommittee makes recommendations to the full CMHS National Advisory Council, which are then voted on for adoption. All recommendations made by the Subcommittee in 2005 were adopted by the full Council. To view the recommendations, please go to http://www.mentalhealth.samhsa.gov/cmhs/AdvisoryCouncil/matrix.asp

Individuals interested in serving as expert consultants on the CMHS National Advisory Council's Subcommittee on Consumer/Survivor Issues should submit a resume and a letter of interest to Chris Marshall using the contact information at the end of this email. Please contact Chris Marshall for more information.

Current Subcommittee Members

D.J. Ida, Ph.D. (term expires Nov. 30, 2007)
J. Rock Johnson, J.D. (term expires Nov. 30, 2007) Maria Maceira-Lessley (term expires Nov. 30, 2005) Carlette Randall, M.S.W. (term expires Nov. 30, 2006) Pat Risser (term expires Nov. 30, 2007) Paula Stockdale (term expires Nov. 30, 2007) Michael J. Vergare, M.D. (term expires Nov. 30, 2007) Ellen Awai, HCPS, CPRP (term expires Nov. 30, 2008) Randall Bosin (term expires Nov. 30, 2008) Frances Priester, J.D. (term expires Nov. 30, 2008)

Consumer/Survivor Regional Meetings

In this past year, CMHS/ADCA held two consumer/survivor regional meetings to identify critical needs and receive recommendations from mental health consumers on how to improve mental health services and to address consumers' concerns. Regional meetings create a forum for networking between states and provide useful information on the successful implementation of state and local initiatives. The information from regional meetings is utilized on the state and federal level. This year a particular focus was placed on addressing the transformation goals of the President's New Freedom Commission on Mental Health. The regional meetings took place in Seattle, Washington and Kansas City, Missouri.

The Seattle regional meeting included participants from Alaska, Idaho, Oregon and Washington. The following themes were identified as regional needs.

 Rural issues
 Access to services
 Disproportionately lower impact of advocacy
 Greater access to alternative treatments
 Marginalization of consumers
 Increased peer support and self-help services
 Access to medications and other supports, including clubhouses
 Self-advocacy (e.g., rights issues, need for consumers to speak
on own behalf)
 Self-determination (e.g., brokerage work and self-help choice
issues)
 Greater enforcement of laws and regulations (for example, the
Americans with Disabilities Act and the U.S. Supreme Court's
Olmstead decision)
 Housing and employment
 Increased advocacy for recovery paradigm
 Poverty

The Kansas City regional meeting included participants from Iowa, Kansas, Missouri, and Nebraska. The following major themes emerged from the discussion of needs and issues of States in the region:

 Housing
 Transportation
 Education and employment, including the problem of loss of
benefits when employed, which serves as a disincentive for work
 Stigma and discrimination, including internalized stigma and
stigma among older adults
 Recovery education for providers and consumers, including
awareness of the New Freedom Commission report
 Limited timely access to quality services, supports, and
medications, including restrictive formularies and fail-first policies
for medications
 Cutbacks in funding from Medicaid and lack of parity in insurance
coverage
 Lack of providers in rural areas
 Lack of choice in services and supports
 Lack of holistic care for people with co-occurring disorders
 Criminalization of people with mental illnesses, inappropriate
treatment in correctional settings, and difficulty in emerging from
the criminal justice system
 Lack of programs to cover persons in transition from childhood to
adult programs
 Child custody issues
 Funding for consumer-operated services
 Evidence-based practices that are not consumer driven
 Cultural competence
 Disparities in power between consumers and others in decision
making

Summaries of these meetings are available upon request. CMHS/ADCA will be holding regional consumer/survivor meetings in 2006 in San Francisco and New York City. The San Francisco regional meeting includes representatives from the states of California, Hawaii, Nevada and New Mexico, and the New York City regional meeting includes representatives from the states of New Jersey, New York, Puerto Rica, and the U.S. Virgin Islands. These meetings are open to the public and will be announced on this E-News service. Contact Carlton Speight for more information.

Participatory Dialogue Meetings

Mental Health on Campus Dialogue

In December 2005, CMHS/ADCA held a participatory dialogue meeting entitled Mental Health On Campus that brought together university and college student leaders with mental health problems and college administrators, counselors, faculty and representatives from different sectors of the college mental health system including legal experts, researchers, and clinicians. The dialogue meeting examined recent research and media reports that have been reporting a steady increase in the incidence of serious mental health problems among students on college campuses, suicides and suicide attempts, and substance abuse. The meeting participants identified attitudinal, cultural, and systemic barriers to mental health and developed recommendations that promote the recovery of students and create an effective services and supports delivery system. The participants developed a series of recommendations for the field that focus on campus culture, student control and choice, stigma and discrimination, suicide prevention, access to information and supports, meaningful collaboration between students and providers/administrators, administrative college mental health system challenges, and accommodations and rights policies. A meeting report is currently being developed and will be available later in 2006. Please contact Chris Marshall for more information.

Mental Health Consumers and Primary Health Care Representatives in Dialogue

In March 2005, CMHS convened a dialogue between consumers of mental health services and representatives of various sectors of the primary health system. The purpose of the meeting was to identify issues that both hinder and help recovery and develop recommendations regarding attitudinal shifts and systems transformation that can lead to improved mental and physical health care responses by primary care and mental health providers to people with mental illnesses. It is apparent the consumers of mental health services experience unnecessary suffering, functional impairment, mortality, economic losses, and health care costs as a result of ineffective care due to fragmentation of the nation's multiple health care systems. Recommendations were proposed that address communication and engagement of mental health and primary care providers in integrating care, stakeholder education and accountability, research, and finance. A summary of the meeting is being developed and will be available in 2006. Contact Carole Schauer for more information.

Seclusion and Restraint

ADCA staff has led the development of a consumer-based staff training manual on alternatives to the use of seclusion and restraint (S&R) that will be published shortly by SAMHSA. A new contract was awarded to develop a training video focused on prevention of and alternatives to S&R. ADCA provides staffing to the SAMHSA seclusion and restraint matrix work group that has a national action plan to reduce and eliminate the use of such practices. See the following for more info: http://www.samhsa.gov/matrix2/seclusion_matrix.aspx. Please contact Paolo del Vecchio for more information.

Self Care Project

CMHS/ADCA completed the first phase of a project to develop and produce a training protocol to be used by State, county and local mental health delivery systems that will identify self-help skills and strategies to aid people with mental illnesses to achieve levels of wellness, stability and recovery. The manual is based on a train-the-trainer model intended for trainees who are people in mental health recovery, parents, and mental health workers. It is expected that those trained will be able to lead consumers through self-care and recovery planning training. The manual and protocol detail both the content of the training as well as the process that a public mental health system may use in implementing the training. Pilot testing of the manual was initiated in late 2005 and is currently taking place in three states, Connecticut, West Virginia, and Texas. Once the evaluation has been competed, the recovery self care curriculum will be published and distributed nationally.

For more information, please contact Chris Marshall.

Peer Specialist Project

CMHS/ADCA is near completion of the Peer Specialist Certification Resource Kit to be used by State mental health delivery systems. The Resource Kit includes a manual for States with detailed information on the steps needed to design, plan, implement, and manage a Certified Peer Specialist Program; a guide for consumers and advocates to understand the program; and one-page fact sheets on the program. The toolkit uses the Georgia Peer Specialist Certification Project as a model and reports on peer support initiatives taking place in other states. The program trains former or current mental health consumers to become Certified Peer Specialists (CPS) who provide peer support services. A pilot demonstration of the resource kit is taking place in 2006. For more information, please contact Chris Marshall.

Consumer Direction Meeting

The publication Free To Choose: Transforming Behavioral Health Care to Self-Direction was released in 2005. Self-directed care, an approach used for more than a decade with people with developmental and physical disabilities and older adults, offers opportunities to transform behavioral health services by fostering consumer- and family-driven services. The publication summarizes the outcomes of the Consumer Direction Initiative Summit, a meeting of 80 recipients of mental health and addiction services and family members, policymakers, providers, and State and Federal representatives. Values and principles as well as critical operational elements central to self-directed care in behavioral health are discussed. Examples of several self-directed care programs are offered.
The publication discusses potential barriers to self-directed care within behavioral health care. Also, recommendations are offered for developing self-directed initiatives, and a listing of numerous resources is provided. The publication is available from the SAMHSA National Mental Health Information Center at (800) 789-2647 or at web site www.mentalhealth.samhsa.gov/publications/publications_browse.asp?ID=4&Sort=Format. For more information, please contract Carole Schauer.

Self-Direction Education Project

SAMHSA/CMHS/ADCA initiated a contract to conduct a mental health self-direction education project. This effort included a series of videoconferences and fact sheets on mental health self-direction approaches. To view archived versions of the webcasts, please see: www.connectlive.com/events/samhsa For more information, please contact Paolo del Vecchio.

New Publications

In addition to the EBI materials mentioned above, four new publications were released in 2004. These included summaries of two dialogues focused on the faith community and co-occurring disorders. Building Bridges: Mental Health Consumers and Members of Faith-Based and Community Organizations in Dialogue highlights recommendations to achieve better mutual understanding and to create partnerships that promote recovery for persons with mental illnesses within faith and community organizations. The publication is available at (800) 789-2647 or http://store.samhsa.gov/shin/content/SMA04-3868/SMA04-3868.pdf. Building Bridges: Co-Occurring Mental Illness and Addiction----Consumers and Services Providers, Policymakers, and Researchers in Dialogue identifies themes and recommendations related to improving services delivery. It is available at (800) 789-2647.

A third publication, Moving from Coercion to Collaboration in Mental Health Services, discusses reduction of coercion, seclusion, and restraint within inpatient psychiatric treatment settings for adults and the criminal justice system. It also discusses pharmacological treatments and interventions for children.

Lastly in response to the lack of transportation that limits access to treatment, employment and socialization for mental health consumers, Getting There: Helping People With Mental Illnesses Access Transportation was published. It describes specific transportation barriers and discusses ways to address or resolve them. It is available at (800) 789-2647.

Consumer Scholarships

More than 200 mental health consumers were provided travel, lodging, meals, and registration support to attend 20 national and other mental health meetings during the past year. This effort promotes mental health transformation via the communication of consumer perspectives to mental health professionals, policy makers, and State officials at these meetings. Summaries generated from these meetings, based on consumer reports, provide CMHS staff and others valuable information on cutting-edge services and emerging trends and issues related to mental health service delivery. Scholarship announcements for upcoming meetings are announced on this e-news service. For more information, please contact Carole Schauer.

Fine Line: Mental Health/Mental Illness" Photo Exhibit Opens at SAMHSA

CMHS/ADCA is collaborating with acclaimed photographer Michael Nye and has brought his interactive, instructive photo exhibit, "Fine Line: Mental Health/Mental Illness" to SAMHSA's office building in Rockville, Maryland. A reception and opening event was held at SAMHSA on January 3, 2006.

The Fine Line exhibit features 55 black-and-white- portraits and voices of persons impacted by mental health problems and address various aspects of mental health such as family, trauma, treatment, recovery and healing. The exhibit uses an artistic interpersonal approach that helps reduce the stigma associated with individuals with mental health problems and highlights their humanity in a respectful and dignified manner.

The exhibit was completed in the fall of 2003 and had its debut opening at the Witte Museum in San Antonio, Texas. The exhibit is open to the public from 8:30am - 5:00pm daily until February 15th. To make an appointment to see the exhibit, please contact Carlton Speight.

The VOICE Awards

ADCA staff organized the first-ever Federal awards event that recognized positive, accurate, and dignified portrayals of people with mental illness in TV, film and radio entitled The Voice Awards. The event took place July 20, 2005 in Los Angeles, California.

The writers and producers of "The Aviator," "ER," "Monk" and "Scrubs" were honored for their positive portrayals of people with mental health problems. In addition, actors Brooke Shields and Maurice Benard and Spanish language television network Univision were honored by the federal government for their activities on behalf of mental health awareness, and writer/producer Neal Baer received a special Career Achievement Award at the gala awards ceremony hosted by Mariette Hartley and Kathleen Sullivan.

Writers and producers from more than 50 productions were nominated for Voice Awards. From this group, writers and producers of the following productions were named as Voice Award winners: "The Aviator," "ER," "Huff," "Larry King Live," "Monk," "People Say I'm Crazy," "Scrubs," "Stateside," "Strong Medicine," and "There's No Such Thing As Crazy."

Neal Baer, executive producer of "Law & Order: SVU" and former executive producer of "ER," was presented with a special award for his work in bringing mental health issues into the mainstream. Baer co-created the character of Maggie Lockhart (Sally Field), a woman who faces and ultimately recovers from schizophrenia, on NBC's "ER", and as executive producer of "Law and Order: Special Victims Unit" has created several characters with mental health problems.

Shields recently wrote a book about her experiences with postpartum depression. Emmy Award winner Benard, who has bipolar disorder, is best known for his portrayal of Sonny Corinthos on "General Hospital". Univision devoted extensive coverage to mental health awareness through its "Salud es Vida.¡Entérate!" (Health Is Life.Inform Yourself!) initiative.

In addition to the entertainment awards, the Voice Awards recognized mental health advocates across the country for their efforts to expand public understanding that mental health problems exist in every community and affect almost every family in the United States. The following consumers and advocates received Voice Awards for their work: Stephanie Welch, California; Jeffrey Ryan, Florida; Jessel Paul Smith, Massachusetts; BethaAnn Russell, North Carolina; Tracee Black, Ohio; Frank Scassellati, Pennsylvania; Bruce Black, Texas; and Cara Hansen, Wisconsin.

Efforts are underway to replicate the program this year. For more information, contact Paolo del Vecchio or Chris Marshall. For more information about the Voice Awards or the EBI visit http://www.whatadifference.samhsa.gov/voiceawards/.

Self-Disclosure Paper

An analysis is being prepared examining the factors that impact a person's willingness to self-disclose their mental health problems. This will include ramifications for addressing discrimination and stigma. For more information, contact Paolo del Vecchio.

Evaluation of Consumer Direction

ADCA facilitated the expansion of SAMHSA's partnership with the Department of Education's National Institute on Disability Rehabilitation and Research to study the impact of models of consumer direction in mental health. For more information, please contact Paolo del Vecchio.

National Consensus Meeting on Person/Family-Centered Planning In December, ADCA provided leadership in convening a national consensus conference on person/family-centered planning. The focus of this activity was to identify models of conducting such planning. The results of this meeting will be published in 2006 and training guides will be developed based on these findings. For more information, see http://www.psych.uic.edu/uicnrtc/cmhs/pfcphome.htm or contact Paolo del Vecchio.

CMHS ADCA Staff

Paolo del Vecchio
Associate Director for Consumer Affairs
SAMHSA
1 Choke Cherry Road
Room 6-1069
Rockville, MD 20857
T: 240-276-1946
Paolo.delvecchio@samhsa.hhs.gov

Carole Schauer
Senior Consumer Affairs Specialist
SAMHSA
1 Choke Cherry Road
Room 6-1067
Rockville, MD 20857
T: 240-276-1948
Carole.schauer@samhsa.hhs.gov

Chris Marshall
Consumer Affairs Specialist
SAMHSA
1 Choke Cherry Road
Room 6-1071
Rockville, MD 20857
T: 240-276-2947
Chris.marshall@samhsa.hhs.gov

Carlton Speight
Consumer Affairs Specialist
SAMHSA
1 Choke Cherry Road
Room 6-1080
Rockville, MD 20857
T: 240-276-1949
Carlton.speight@samhsa.hhs.gov
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The Center for Mental Health Services is a component of the Substance Abuse and Mental Health Services Administration, United States Department of Health and Human Services.