SAMHSA announces opioid crisis, serious mental illness as ‘strategic priorities’

The Substance Abuse and Mental Health Services Administration has announced several “strategic priorities” to address substance use and mental disorders in the United States, according to a presenter at the American Psychiatric Association Spring Highlights Meeting.

“It’s really important for federal agencies to have strategic plans that are quite focused in what they will require of an agency,” Elinore McCance-Katz, MD, PhD, assistant secretary for mental health and substance use at the Substance Abuse and Mental Health Services Administration (SAMHSA), said during the presentation. “Our first strategic priority is combating the opioid crisis, and we do that through a variety of grant programs to states and communities.”

Among the administration’s largest initiatives are its State Opioid Response (SOR) grants, which fund prevention, treatment and recovery services for opioid use disorder. According to McCance-Katz, funds of this nature were first dedicated to the opioid crisis in 2017 through $500 million included in the 21st Century Cures Act; for fiscal year 2020, this number has increased to $1.5 billion. McCance-Katz noted that SAMHSA successfully advocated for the expansion of these funds to allow states to address stimulant use disorders, as well as opioid use disorders, depending on the severity of the problem in a particular state. Programs that apply for an SOR grant must be using evidence-based practices, such as FDA-approved pharmacotherapies, McCance-Katz said.

“We calculate the severity of [a state’s opioid problem] by looking at overdose mortality rates and treatment gap,” McCance-Katz said. “Based on that, we allot funding to the states and U.S. territories. ... The main role of SAMHSA in all of this is to oversee the use of those funds and to work with states directly on effective use of those funds.”

SAMHSA’s other initiatives related to the opioid crisis include continued funding of the Drug Abuse Warning Network and helping to expand the Drug Addiction Treatment Act of 2000 waiver so more specialties can prescribe or dispense buprenorphine. SAMHSA’s budget increases for fiscal year 2020 include continued funding for the Sober Truth on Preventing Underage Drinking Act grants, as well as funding for new programs and research areas, such as comprehensive opioid recovery centers, ED alternatives to opioids and recovery workforce support, according to McCance-Katz.

The administration has also prioritized addressing serious mental illness and serious emotional disturbance.

“The mental health services budget was that part of our budget that received the greatest increase in funding for 2020, [including] our mental health block grants and our children's mental health initiatives,” McCance-Katz said. “We saw increases in our infant and early childhood consultation programs, [as well as in] our program called Project [Advancing Wellness and Resiliency in Education], which is a school-based program that funds training of teachers and other school professionals on how to recognize children who may be experiencing mental health issues.”

SAMHSA’s mental health services budget also includes funding for the National Child Traumatic Stress Initiative, suicide prevention efforts, and mental health awareness and crisis intervention trainings. SAMHSA’s key issues for serious mental illness include addressing its role among individuals who are incarcerated and distributing a block grant that requires funds be used to deliver services addressing serious mental illness by community-based providers.

Other overall strategic priorities for the administration include:

• advancing prevention, treatment and recovery support services for substance use;

• improving data collection, analysis, dissemination, and program and policy evaluation; and

• strengthening health care practitioner training and education.

Regarding the ongoing COVID-19 pandemic, McCance-Katz noted that SAMHSA took steps to address the related mental health impact, such as advocating for the use of telemedicine and creating a new funding program during the crisis for substance use disorder resources that will go to local providers, as well as new suicide prevention funding.

“[We] have much more confidence in our agency and our ability to get things done for the American people by our increases in budget, and since 2017, we've had a 56% increase in our budget,” McCance-Katz said. – by Joe Gramigna

Reference:

McCance-Katz E. Federal initiatives to address substance use and mental disorders: An update from SAMHSA. Presented at: American Psychiatric Association Spring Highlights Meeting; April 25-26, 2020 (virtual meeting).

Disclosures: Healio Psychiatry could not confirm relevant financial disclosures at time of reporting.