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,"
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overcome "outdated science, outmoded financing systems, and unspoken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
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>.▪