fran harding
TRANSCRIPT
The Future of Prevention: Our Challenges and
Opportunities
Frances M. Harding, DirectorSAMHSA’s Center for Substance Abuse Prevention
2011 NCADD Conference of AffiliatesArlington, VA • September 7, 2011
Behavioral health is essential for health Prevention works Treatment is effective People recover from mental and substance use
disorders
SAMHSA’s Key Messages
Role of Prevention in Substance Use and Mental Health Disorders
Behavioral health is essential for health Addiction as a complex and chronic disease Recovery as a process rather than an event Ongoing contact and support to complement treatment Natural supports such as friends, peers, and family Evidence-based, multi-component prevention programs
Assessing Public Knowledge and Attitudes: What Americans Believe
66 percent believe
treatment and support can help people with mental illness lead
normal lives
20 percent feel persons with mental illness are dangerous
to others
Two thirds believe
addiction can be prevented
75 percent believe recovery from addiction
is possible
20 percent say they would
think less of a friend/relative if they discovered that person is in recovery from an addiction
30 percent say they would
think less of a person with a
current addiction
Health Reform
State Budget
Declines
Federal Domestic Spending
EMERGING SCIENCE
Drivers of Change
Health Reform
More people will have insurance coverage. Theme: prevent diseases, promote wellness Integrated care: new thinking—recovery, wellness, role of
peers, response to whole health needs New opportunities for behavioral health:
• Parity: Mental Health Parity and Addiction Equality Act and within Affordable Care Act
• Tribal Law and Order Act• National Action Alliance for Suicide Prevention
Medicare and Medicaid changes
Beginning in 2014: 32 Million More Americans Eligible to be Covered
4-6 mil
Commercial Insurance
Medicaid
6–10 Million With M/SUDs
Challenges—State Leadership
Individuals Served by SSAs
Uninsured61%
Insured39%
Individuals Served by MHAs
Insured61%
Uninsured39%
• 90–95 percent will have the opportunity to be covered by Medicaid or through insurance exchanges.
Federal Domestic Spending
Focusing on the Strategic Initiatives Revised Approach to Grant-Making Prevention Funding for 2012:
• Substance Abuse-State Prevention Grant ($395 million).• Mental Health-State Prevention Grant ($90 million).• Behavioral Health-Tribal Prevention Grant ($50 million).
Staying Focused During Change
SAMHSA’S Strategic Initiatives
AIM: Improving the Nation’s Behavioral Health (1–4)
AIM: Transforming Health Care in America (5–6)AIM: Achieving Excellence in Operations (7–8)
1. Prevention
2. Trauma
and Justice
3. Military Families
4. Recover
y Support
5. Health Reform
6. Health Informati
on Technolo
gy
7. Data, Outcom
es & Quality
8. Public Awaren
ess & Support
Strategic Initiative 1: Prevention of Substance Abuse and Mental Illness
Goal 1.1
With primary prevention as the focus, build emotional health, prevent or delay onset of, and mitigate symptoms and complications from substance abuse and mental illness.
Goal 1.2
Prevent or reduce consequences of underage drinking and adult problem drinking.
Goal 1.3
Prevent suicides and attempted suicides among populations at high risk, especially military families, LGBTQ youth, and American Indians and Alaska Natives.
Goal 1.4
Reduce prescription drug misuse and abuse.
Work Ahead—SAMHSA
Revised Block Grant application and reporting Implementation of Tribal Law and Order Act—Office of
Indian Alcohol and Substance Abuse Decisions and implementation of prevention funds Evidence of good and modern services:
• Benefit decisions, practice protocols, research agenda
Current Federal Partners
• Administration for Children and Families
• Administration on Aging• Centers for Disease Control and
Prevention• Centers for Medicare and
Medicaid Services• Food and Drug Administration• Health Resources and Services
Administration• Indian Health Service• National Institutes of Health
• Office of Minority Health• Office of National Drug Control
Policy• Office of the Surgeon General• Department of Education• Department of Defense• Department of the Interior• Department of Justice
New Roles—State SA and MH Leadership
Take key role in design and execution of health reform. Develop or enhance strategic partnerships for prevention. Think beyond traditional Block Grant populations. Focus on recovery support—help people get and stay
well.
We’ve Been Here Before
Risk and protective factors—Commonalities between mental health and substance abuse.
Chronic disease indicators—Substance use represents a spectrum of conditions and risk factors as well as social context.
Links with physical health care providers—Prevent problems related to mental illnesses and substance abuse.
SAMHSA’s PRINCIPLES
www.samhsa.gov