The Future of Prevention: Our Challenges and Opportunities Frances M. Harding, Director SAMHSA’s Center for Substance Abuse Prevention2011 NCADD Conference of Affiliates Arlington, VA • September 7, 2011
SAMHSA’s Key Messages Behavioral health is essential for health Prevention works Treatment is effective People recover from mental and substance use disorders
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 20 percent say believe they would 30 percent say 20 percent feeltreatment and Two thirds 75 percent think less of a they would persons with support can believe believe recovery friend/relative if think less of a mental illness help people addiction can from addiction they discovered person with a are dangerous with mental be prevented is possible that person is in current to others illness lead recovery from addiction normal lives an addiction
Drivers of Change EMERGING Federal SCIENCE Domestic Spending StateBudgetDeclines Health Reform
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
Challenges—State Leadership Individuals Served by SSAs Individuals Served by MHAsInsured Uninsured 39% 39% Uninsured Insured 61% 61% • 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).
SAMHSA’S Strategic Initiatives 6. Health 7. 8. Public 2. Trauma and 3. Military 4. Recovery 5. Health1. Prevention Information Data, Outcomes Awareness & Justice Families Support Reform Technology & Quality Support
Strategic Initiative 1: Prevention of Substance Abuse and Mental IllnessGoal 1.1With primary prevention as the focus, build emotional health, prevent ordelay onset of, and mitigate symptoms and complications fromsubstance abuse and mental illness.Goal 1.2Prevent or reduce consequences of underage drinking and adult problemdrinking.Goal 1.3Prevent suicides and attempted suicides among populations at high risk,especially military families, LGBTQ youth, and American Indians andAlaska Natives.Goal 1.4Reduce 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 • Office of Minority Health Families • Office of National Drug Control• Administration on Aging Policy• Centers for Disease Control and • Office of the Surgeon General Prevention • Department of Education• Centers for Medicare and • Department of Defense Medicaid Services • Department of the Interior• Food and Drug Administration • Department of Justice• Health Resources and Services Administration• Indian Health Service• National Institutes of Health
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 BeforeRisk 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 PEOPLE PERFORMANCE PARTNERSHIPStay focused on the Make a measurable goal Cannot do it alone difference www.samhsa.gov