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Government News
Grants Will Foster Reform Of MH Systems
Psychiatric News
Volume 40 Number 21 page 9-9

A new federal grant program supported by APA aims to spur a nationwide reorganization of state mental health services, beginning with seven states that will serve as reform models for other states.

In October the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded $92.5 million to seven states over five years as part of its Mental Health Transformation State Incentive Grants program. The grants will fund planning to reorganize and integrate "systems dictated by outmoded bureaucratic and financial incentives to systems driven by consumer and family needs that focus on building resilience and facilitating recovery," according to SAMHSA.

The states receiving the grants are Connecticut, Ohio, Oklahoma, Washington, Maryland, New Mexico, and Texas. Organizers expect Congress to consider funding planning grants for several more states next year.

The total amount of funding being distributed for the first year of the program is $18.5 million; grants over the next four years are expected to be of similar amounts, assuming Congress approves the funds.

"Right now the states are spending all of their money on services and rarely fund integration or planning," said Lizbet Boroughs, deputy director of APA's Department of Government Relations. "When forced to choose, they are choosing to treat, and you can't blame them for that decision, but you end up with the same uncoordinated services."

Boroughs added that APA had advocated strongly for the program on Capitol Hill with federal budget appropriators. "Given the tight federal fiscal situation, APA is very gratified that the program was robustly funded," she said.

The funds are intended to help implement recommendations from the 2003 report of the President's New Freedom Commission on Mental Health and to overcome "outdated science, outmoded financing systems, and unspoken discrimination," said SAMHSA Administrator Charles Curie, M.A. (Psychiatric News, August 15, 2003).

The grants, administered by SAMHSA's Center for Mental Health Services, will be used to test strategies that better coordinate the activities of mental health programs fragmented across many levels of government and to serve as models for the most-effective approaches to reorganization when the program is expanded to all state, U.S. territorial, and Native-American governments.

The grants require states to include consumers and family members in all planning activities and take a "lifespan approach" to service delivery that includes promotion, prevention, treatment, and recovery.

Ron Honberg, J.D., legal director of the National Alliance on Mental Illness (NAMI), said the program is a good first step in implementing the recommendations of the New Freedom Commission. However, the ultimate value of the grants will stem from whether the programs they fund generate meaningful reforms in state mental health systems, he said.

Among the largest recipients, Connecticut will have $2.73 million for the first year to fund development of a "recovery-oriented system of mental health care" to better coordinate state and local systems that aim to prevent mental illness and promote recovery across residents' lifetimes.

As one of the measures to implement recommendations in the report of the President's New Freedom Commission on Mental Health, President Bush initially proposed $44 million for the grants, including administration, but Congress approved only $20 million for the program in Fiscal 2005.

More information on SAMHSA's Mental Health Transformation State Incentive Grants is posted at<www.samhsa.gov/news/newsreleases/050928_StateIncentiveGrants.htm>.

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