Sunday, August 10, 2014

SAMHSA FAILS SERIOUSLY MENTALLY ILL

A bill in Congress (HR3717, the Helping Families in Mental Health Crisis Act) would change SAMHSA and some wonder why change is needed. SAMHSA (Substance Abuse and Mental Health Services Administration) was created by Congress to “reduce the impact of…mental illness on America’s communities” and “target … mental health services to the people most in need”. SAMHSA has failed to do either. SAMHSA refuses to require its funds reach the most seriously ill and enacts policies to see they don't.

SAMHSA largely ignores the most significant impacts of mental illness on the communities, specifically violence, incarceration, hospitalization, homlessness and suicide. Instead, SAMHSA focuses on improving metrics like 'feeling of empowerment' 'hopefullness' and other softer outcomes.


SAMHSA also ignores the "people most in need", i.e, the 4-9% NIMH defines as having serious mental illness. Instead, SAMHSA focuses on "improving mental wellness" for all Americans. This leaves the seriously ill underserved.

Some Examples of SAMHSA Mismanagement (See documentation at http://mentalillnesspolicy.org/samhsa.html)

  • SAMHSA supports and funds groups that don’t believe mental illness exists.
  • SAMHSA’s Guide to Mental Illness Awareness Week suggests schools invites groups that don't believe mental illness exists, believe mental illness is a 'gift', and that getting the right diagnoses is of limited value.
  • SAMHSA is working to replace the scientifically-validated medical model that helps the most seriously ill with a non-scientific 'recovery model'.
  • SAMHSA certifies programs as being evidence based even when they do not help seriously mentally ill and/or lack evidence.
  • SAMHSA funds groups lobbying to prevent mentally ill from being treated until after they become ‘danger to self or others’ which causes an increase in violence.
  • SAMHSA's 600 person staff does not include a a medical doctor specializing in mental illness and only one on substance abuse making it incapable of directing mental illness policy.
  • SAMHSA encourages states to spend a portion of their $2 billion in block grants on preventing mental illness when we do not know how to prevent mental illness.
  • SAMHSA wastes massive money on make-work projects and useless publications.
  • SAMHSA refuses to adequately monitor the Protection and Advocacy for Individuals with Mental Illness program (PAIMI/P&A) with the result that rather than helping people who need treatment get it, it lobbies to get mentally ill who need hospital care out of hospitals and out of treatment
  • SAMHSA refuses to support evidence based programs that do reduce violence, incarceration, hospitalization and homlessness like Assisted Outpatient Treatment
SAMHSA's Response:

Numerous attempts over multiple years to engage SAMHSA in addressing these issues through the media, letter writing, congressional hearings, and meetings with Administrator Pamela Hyde have failed. At a recent meeting held for that purpose, Administrator Hyde told participants that while she recognizes the reality of violence by people with untreated serious mental illness, addressing violence by people with serious mental illness is stigmatizing to those without mental illness and therefore would not be addressed. She claimed more money was needed from Congress in order for SAMHSA to focus on serious mental illness instead of mental wellness; and generally failed to see any problem with the status quo. Hence we are making our SAMHSA documentation public.

Solutions to problems at SAMHSA:

HR3717 The Helping Families in Mental Health Act sponsored by Rep. Tim Murphy, has numerous provisions to address the problems at SAMHSA. It has 96 cosponsors from both parties, but needs more to pass.  Please go here to call your representative and ask him or her to cosponsor that critical legislation. Other solutions include:

Replace the current administrator, Pamela Hyde with someone who has passion for improving the lives of people with serious mental illness and knows how to do it. Perhaps an M.D. We note that NIMH had similar mission-creep problems prior to the arrival of Dr. Thomas Insel, but he was able to refocus the agency back to serious mental illness.

Summary

Hundreds of thousands of Americans with very serious mental illnesses are homeless or incarcerated. SAMHSA remains oblivious. President Obama has called on SAMHSA to lead a national dialogue on reducing violence by persons with mental illness, and they are not up to the task. As a result, there are now three times as many persons with mental illness incarcerated as hospitalized. We must ends SAMHSA's activities that divert resources andmake it more difficult to provide treatment for people with serious mental illness.

Documentation of the claims made above can be found at http://mentalillnesspolicy.org/samhsa.html

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