connotes some process and intent surrounding a profound, deep, intense, and penetrating alteration i

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connotes some process and intent surrounding
a profound, deep, intense, and penetrating
alteration in the status quo. It implies a
formation of and an effort to realize a vision
that is palpably different from what existed
beforea conscious decision to substantively
alter and make a difference in a
given reality. from Concepts of
Transformation

Noel A. Mazade, Ph.D.
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Mental Health System Transformation
Phase 1
SAMHSA/CMHS will

• Advance the work of an internal Matrix Workgroup
• Develop strong partnerships and collaborative
  activities with other Federal partners
• Release the first Federal Action Agenda
• Increase Federal support to States for their
  formal transformation efforts
• Capture and evaluate transformation strategies
  that work
• Focus on emerging issues, practices, and trends. 
  

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Federal Action Agenda Partners
Department of Health and Human Services
AoA HRSA HHS/OS ACF IHS - ASPE
AHRQ NIH/NIDA - OCR CDC
NIH/NIMH - OD CMS SAMHSA - OPHS

Other Partners Department of Education Department
of Housing and Urban Development Department of
Justice Department of Labor Department of
Veterans Affairs Social Security Administration
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Mental Health System Transformation
State Incentive Grants

• Provide 18.8 million to support States efforts
  to focus on systemic changes
• Help States develop and implement Comprehensive
  State Mental Health Plans
• Are limited to the immediate office of the Chief
  Executive Officer for States, Territories, the
  District of Columbia, native tribes, and tribal
  organizations
• Applications are due by June 1, 2005.  

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The CMHS Budget
Overview
FY 2006/- FY 2004 FY 2005 FY
2006 FY 2005 Actual Appropriation
Estimate Appropriation Programs of
Regional and National
Significance 240,796,000 274,297,000 210,213,00
0 -64,084,000 Childrens Mental Health
102,353,000 105,112,000 105,129,000
17,000 Protection Advocacy
34,620,000 34,343,000 34,343,000
--- PATH 49,760,000
54,809,000 54,809,000 ---
MH Block Grant 434,690,000
432,756,000 432,756,000 ---
Total 862,219,000 901,317,
000 837,250,000 -64,067,000
(Dollars in thousands)
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Proposed National Outcome Measures for Mental
Health

• Decreased mental illness symptomatology/improved
  functioning
• Increased or retained employment for adults and a
  return to or retention in school for children
• Decreased criminal justice involvement
• Increased stability in family and living
  conditions
• Increased access to services
• Reduced utilization of psychiatric inpatient beds
• Increased social supports/social connectedness
• Client perception of care outcome
• Use of evidence-based practices. 

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Transformation Action Center (TAC)
Vision
The TAC will provide a cohesive, coordinated, and
strategic structure for the provision of
technical assistance within the Mental Health
Transformation SIG program and for CMHS programs
focused on assisting individuals in achieving
recovery and promoting resilience. Technical
assistance for the TAC will be realigned with
mental health transformation priorities,
including

• Leadership/Consumer Leadership
• Comprehensive Mental Health Plans
• Individualized Plans of Care (person-directed
  planning approaches)
• Disparities Reduction/Elimination
• Evidence-based Practices and National Registry of
  Effective Programs and Practices
• Workforce Development (including consumers as
  staff)

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Strategic Transformational Leadership
Vision
Effective behavioral health care leadership will
be developed at the State and local levels. CMHS
will build and sustain this leadership by
developing a support model that moves away from
the train and hope approach.
FY 2005 Proposed Activities

• Educate individuals and groups in leadership
  theory and techniques
• Maintain the network of leaders to ensure
  continuity of support for sustaining systems
  change
• Provide access to a wide range of current
  leadership curricula from programs such as
  Harvard, the Center for Creative Leadership, and
  the Office of Personnel Management
• Develop consumer leadership at all levels

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Disparities Reduction/Elimination
Vision
Providers will become more effective in working
with communities of color so that they will no
longer be underserved.
FY 2005 Proposed Activities

• National Strategic Plan on the elimination of
  disparities
• Workforce training curricula evaluation
• Workforce development task force
• Cultural competence standards and guidelines
• Behavioral health care training program
  assessment
• Public education program description
• Evidence-based practice adaptation and
  implementation

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Science to Service
Vision
Evidence-based treatments will be widely applied
to support recovery. Consumers will have
meaningful involvement in the development of
these treatments.
FY 2005 Proposed Activities

• Develop four new toolkits related to
• Supportive housing
• Aging
• Consumer-operated services
• Children
• Publish an implementation guide on supported
  education
• Offer technical assistance for implementation of
  evidence-based practices and individual care plans

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Individualized Plans of Care (IPC)
Vision
Every adult with a serious mental illness and
every child with a serious emotional disturbance
will have a consumer- and family-directed IPC
that promotes resilience and recovery.
FY 2005 Proposed Activities

• Development of prototypes of IPCs for adults and
  children
• Contractor review of existing models and best
  practices
• Strategy and consensus meetings with stakeholders
• Dissemination and technical support for prototype
  care plans

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Model Comprehensive State Mental
Health Plans
Vision
State plans will create an extensive and
coordinated system of services and supports that
enable each person to attain an optimal level of
self-care, interpersonal relationships,
employment, and community participation.
FY 2005 Proposed Activities

• Develop a model plan template through
  collaboration with NASMHPD, consumers, and other
  stakeholders
• Make model plan available for States when the
  Mental Health Transformation SIG awards are made

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Workforce Development
Vision
An ethnically and racially diverse workforce,
including consumers as staff, will be trained and
supported in evidence-based practices. This
workforce will respond to and help shape a mental
health policy and practice environment that
supports recovery.
FY 2005 Proposed Activities

• Develop a draft national strategic plan with
  consumers and key constituents
• Provide technical assistance to the field
• Develop toolkits for field use and to monitor
  progress and evaluate success

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What You Can Do To Advance Transformation
Help policymakers understand and believe that

• Recovery is a real possibility
• We must use our fiscal resources to support
  proven, evidence-based treatments and services
• Cutting-edge information technology and
  communications infrastructure is critical
• SAMHSA has a comprehensive plan for advancing
  transformation!

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...set out to change the way things are done in
the clinic, the laboratory, and the government
by causing a revolution in all three. 
Christopher Reeve,
Actor and Activist