Three of SAMHSAs Priority Areas CoOccurring Disorders HIVAIDS Substance Abuse Ulonda Shamwell, M.S.W

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Three of SAMHSAs Priority Areas Co-Occurring
DisordersHIV/AIDSSubstance AbuseUlonda
Shamwell, M.S.W.Director, Division of Policy
CoordinationOffice of Policy, Planning and
BudgetFriday, December 12, 2003
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SAMHSAs Matrix
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Co-Occurring Disorders

• Seven to ten million individuals in the US have
  at least one mental disorder as well as an
  alcohol or drug use disorder.
• Individuals with co-occurring disorders have
  particular difficulty seeking and receiving
  diagnostic and treatment services, even though,
  separately, these disorders are as treatable as
  other chronic illnesses.

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Co-Occurring Disorders- continuation

• Report to Congress on the Prevention and
  Treatment of Co-Occurring Substance Abuse
  Disorders and Mental Disorders
• Released November 2002.
• Available at http//www.samhsa.gov/reports/congres
  s2002/index.html
• Included in this report is a Five-Year Blueprint
  for Action.

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Co-Occurring Disorders- continuation

• National Summit Policy Academy
• One of the major items of the Blueprint.
• Facilitate the development and implementation of
  State action plans to address co-occurring
  disorders.
• The national summit evolved into the co-occurring
  Policy Academy, to be held April 14-16, 2004.
  Participants will be encouraged to share ideas,
  practices, and lessons learned in areas of
  prevention, evidence-based practices, funding and
  service system change.
• Planning partners include the State Associations
  of Addiction Services, National Council for
  Community Behavioral Healthcare, NASADAD,
  NASMHPH.

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Co-Occurring Disorders- continuation

• Achieving the Promise Transforming Mental Health
  Care in America
• Released July 2003 by the Presidents New Freedom
  Commission on Mental Health.
• Available at http//www.mentalhealthcommission.gov
  /reports/reports.htm
• Goal 4 of the report ensures that early mental
  health screening, assessment, and referral to
  services are common practices. A recommendation
  to achieve this goal is to screen for
  co-occurring mental and substance abuse disorders
  and link with integrated treatment strategies.

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Co-Occurring Disorders- continuation

• The first Co-Occurring State Incentive Grants
  (COSIG) grantee meeting will occur December
  15-17, 2003. Seven states will participate.
• The contract for the National Co-Occurring
  Disorders Cross-Training Center for Excellence
  was awarded this September.

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HIV/AIDS

• Since the AIDS epidemic began, injection drug use
  (IDU) has directly and indirectly accounted for
  more than one-third of AIDS cases in the United
  States. Of the estimated 381,012 persons living
  with AIDS at the end of 2002, 98,794 (26) were
  IDU-associated.
• African Americans and Hispanic/Latinos account
  for 12 and 9 percent of the US population
  respectively, yet they currently represent almost
  50 and 20 percent of new case of HIV/AIDS
  respectively.

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HIV/AIDS- continuation

• Participation with HHS and Office of HIV/AIDS
  Policy
• HIV/AIDS Program Management Coordination Team-
  promotes interagency coordinated efforts on
  organizational and operational issues related to
  HIV/AIDS prevention, care and treatment, and
  grants management.
• Capacity Building Roundtables- training and
  technical assistance activities for HIV/AIDS.
• OHAP/The Leadership Campaign on AIDS- Forum on
  Substance Abuse and HIV/AIDS in Communities of
  Color- convened community-based minority leaders
  to discuss HIV/AIDS and substance abuse.

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HIV/AIDS- continuation

• Significant Collaboration with other HHS Agencies
• Cross-Training for Collaboration Systems of
  Prevention, Treatment and Care- CDC, HRSA,
  SAMHSA, and the Association of State and
  Territorial Health Officials (ASTHO).
• Advancing HIV Prevention Initiative- SAMHSA and
  CDC.

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HIV/AIDS- continuation

• Policy Studies on Coordination of HIV, Substance
  Abuse and Mental Health Services
• HIV/AIDS Treatment Adherence, Health Outcomes and
  Cost Study.
• Jointly funded by HRSA, NIH and SAMHSA.
• Focuses on the effects of integrated treatment
  interventions on person living with HIV and
  co-occurring mental health and substance abuse
  disorders.
• Coordination to Address the Co-Occurrence of HIV,
  Chemical Dependency, and Mental Illness- examines
  state interagency coordination activities on HIV,
  substance abuse and mental health services.

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HIV/AIDS- continuation

• Minority AIDS Initiative (MAI)- funding to
  enhance and expand integrated substance abuse
  prevention, treatment, and mental health services
  in conjunction with HIV/AIDS to African American,
  Latino/Hispanic, and/or other racial or ethnic
  communities.
• Block Grant Early Intervention Services (EIS or
  HIV set-aside).
• SAMHSA- wide Workgroup on HIV/AIDS and Hepatitis.
• Coordination with NASTAD, NASADAD, NASMHPH, and
  ASTHO- external stakeholders provide input to
  SAMHSA policy discussion.

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Substance Abuse

• SAMHSA's 2002 National Survey on Drug Use
  Health estimates that among the general
  population age 12 and older, 120 million
  Americans were current alcohol users, 75.1
  million Americans were current tobacco users, and
  19.5 million Americans were current illicit drug
  users. An estimated 22 million Americans were
  classified with abuse or dependence on either
  alcohol, illicit drugs or both.

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Substance Abuse- continuation

• Presidents Access to Recovery Initiative
• Ensure that voucher recipients have a genuine,
  free, and independent choice of clinical
  treatment and recovery support service options.
• Increase capacity over the period of the voucher
  program.
• Enable providers previously not able to compete
  for Federal funds to participate in the Access to
  Recovery program (such as some faith- and
  community- based providers).

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Substance Abuse- continuation

• The President proposed 200 million a year for
  three years for this program. Based on the
  recent conference report, we expect that this
  program will be funded at the 100 million level.
  
• The conference report directed that will
  providers participating in the Access to Recovery
  program should be held accountable to the same
  standards of care, performance, licensure and
  certification as other licensed or certified drug
  and alcohol programs in their respective States.

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Substance Abuse- continuation

• Strategic Prevention Framework
• Grounded in SAMHSAs mission to promote
  resilience and facilitate recovery by reducing
  risk factors that lead to substance abuse, and by
  promoting protective factors.
• Emphasizes the use of evidence-based practices,
  and the idea that systems of prevention work
  better than silos.
• Operationally, it means that all levels of
  government, and communities, should (1) profile
  their needs, including readiness for change, (2)
  mobilize and build capacity, (3) select and
  implement programs that are know to be effective,
  and (4) evaluate programs for effectiveness.

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Substance Abuse- continuation

• Screening, Brief Intervention and Referral
  Program (SBIRT)
• Instituted in recognition of the strong evidence
  base for the effectiveness of brief
  interventions- particularly for those who abuse
  alcohol- and the fact that this cost effective
  strategy is underutilized in most States.
• Designed to expand the continuum of care to
  include screening, brief intervention, referrals
  and brief treatment.
• In FY 2003, SBIRT awards totaling 20 million
  were made to seven States.

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Substance Abuse- continuation

• Addiction Technology Transfer Center (ATTC)
  Network
• Improves addiction treatment by strengthening the
  knowledge, skills, and attitudes of substance
  abuse treatment practitioners by creating and
  expanding continuing education and university
  coursework, developing academic programs,
  increasing clinical placements, and setting
  educational standards.
• Advocates for and carries out initiatives that
  are designed to enhance the addiction treatment
  profession and make it attractive to todays best
  and brightest professionals.
• Operates as 14 individual Regional Centers and a
  National Office.
• Additional information can be found at
  http//www.nattc.org/

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Questions?