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SAMHSA to establish new mental health care approaches

The Substance Abuse and Mental Health Services Administration plans to take a new approach to serious mental illness, which includes providing evidence-based psychiatric treatment and supporting a collaborative care model with community resource providers, according to a viewpoint published in Psychiatric Services.

These efforts will also include prioritizing the training of health care professionals, creating a national system of technical assistance and training, and continuing to fund important programs.

“These are important times for addressing behavioral health issues — specifically, the mental and substance use disorders that affect over 64 million Americans every year,” Elinore F. McCance-Katz, MD, PhD, assistant secretary for mental health and substance use, U.S. Department of Health and Human Services, wrote. “We are in the grip of an opioids crisis characterized by addiction and death such as we have never seen.”

McCance-Katz, who oversees that SAMHSA’s work, and the collaborative work of other agencies, addresses mental and substance use disorders using best evidence-based practices, wrote that her overall approach to her position is to prioritize the training of health care practitioners that provide evidence-based treatment and technical assistance to provider organizations. To emphasize training, SAMHSA’s approach to evidence-based programs and practices must be transformed. McCance-Katz explained that most SAMHSA evidence-based programs do not include enough strong evidence and are supported by too few controlled studies.

“We are now in the process of establishing a national system of practical training on topics in behavioral health that can be requested by any organization or provider with a focus on establishing local trainers familiar with the specific needs of a region,” she wrote.

In addition, SAMHSA plans to build a national system of technical assistance and training, allowing resources to be available at low or no cost to any individual or program. SAMHSA grantees will have funding built into their grants that allows them to identify the training or technical assistance necessary and purchase that training via its national network. Also, funds not used for training can be used for other services described in the grant proposal, McCance explained.

The biggest change in technical assistance, she wrote, will be creating new technology transfer centers for the prevention of substance use disorders and serious mental illness. SAMHSA has issued funding announcements to encourage applications for these centers, which will provide national coverage, and for centers focused on the needs of minorities.

“These newly established centers will work collaboratively in their regions, with each other, and with the existing addiction technology transfer centers to ensure that training needs of health care providers are being met,” she wrote. “With these centers, all health care providers and organizations can participate in educational programs that will improve their abilities to serve the mental health and substance use disorder needs of Americans, and in doing so, we will serve the nation rather than only select grantees.”

SAMHSA will also continue to fund innovative programs that address major issues like the opioid epidemic and suicide prevention. McCance-Katz wrote that a major success of SAMHSA was the appropriation of extra funding for Certified Community Behavioral Health Clinics, which offer integrated care for mental and substance use disorders. These programs will be expanded to community organizations to provide integrated services and crisis services; peer and family supports; and psychiatric evaluation, diagnosis, treatment and rehabilitation.

“These are important times for establishing new models that will use evidence-based care to manage the needs of Americans experiencing serious mental illness and substance use disorders,” McCance-Katz wrote. “SAMHSA will play a key role in establishing these new care approaches and in preparing the behavioral health workforce.” – by Savannah Demko

Disclosure: McCance-Katz is assistant secretary for mental health and substance use at HHS.