transforming mental health care in america: the first steps chris marshall consumer affairs...
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Transforming Mental Health Care in America: The First Steps
Chris MarshallConsumer Affairs Specialist
Center for Mental Health ServicesHHS/SAMHSA
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human
Services
NIH SAMHSA CMS
Center for Mental Health Services (CMHS)► Leads Federal efforts to provide community-based services for adults
with serious mental illnesses and children with serious emotional disturbances.
Center for Substance Abuse Prevention (CSAP)► Works to improve the quality of substance abuse prevention practices
in every community, nationwide, through its discretionary grant programs.
Center for Substance Abuse Treatment (CSAT)► Promotes the quality and availability of community-based substance
abuse treatment services for individuals and families who need them.
Who is SAMHSA?SAMHSA consists of three Centers and supporting Offices that administer and fund grant programs to support States’ efforts to address substance abuse and mental health issues.
The Matrix
SAMHSA’s budget, programs, and policies have been aligned to match a series of core priority issues and cross-cutting principles. These priorities are represented on the SAMHSA matrix—an evolving tool that keeps the Agency’s work focused on the most critical issues in behavioral health.
Mental Health System Transformation
Bridging the Quality Chasm
TransformationTransformationTransformationTransformation
Health IT
Evidence-basedpractices
Focus on recoveryConsumer-driven
The behavioralhealth care that Americans receive
The behavioral health care thatwe know to be effective
Addressing Stigma & Discrimination as Central for Recovery
► In this transformed system, stigma and discrimination against people with mental illnesses will not have an impact on securing health care, productive employment, or safe housing.
► Our society will not tolerate employment discrimination against people with serious mental illnesses – in either the public or private sector.
Recommendations & Federal Action Steps
Recommendation 1.1
Undertake a national campaign to reduce stigma.
“Americans must understand and send this message: mental disability is not a scandal –it is an illness. And like physical illness, it is treatable.”
President George W. BushApril 29, 2002
Stigma: a cluster of negative attitudes and beliefs that motivate the general public to fear, reject, avoid, and discriminate against people with mental illnesses.
Source: Achieving the Promise: Transforming Mental Health Care in America
Public Attitudes
► Surveys since the 1950s► Mental illness as stigmatized
condition► No scientific understanding► Unable to identify persons with MI► Could not distinguish between MI
and worry► Fear of unpredictable violence
MacArthur Mental Health Module, General Social Survey, 1996
► Greater scientific understanding► Able to distinguish between MI and
worry► Mix of biological and psychological
stress► Social stigma unchanged► Belief that violence associated with
mental illnesses nearly doubled
Internalizing Stigma
► Embarrassment, Shame, Isolation► Nearly two-thirds of all people with
diagnosable mental health problems do not seek treatment (Regier et al., 1993; Kessler et al., 1996).
Reducing Stigma
► Public Education Campaigns► Reward / Protest► Contact Approach
History of National Efforts
► Spring to Action 2001► EBI and ADS Center► Older Adults Stigma Roundtables► President’s New Freedom
Commission on Mental Health / Federal Action Agenda
► SAMHSA National Anti-Stigma Campaign
SAMHSA Programs to Address Stigma
► ADS Center (Resource Center to Address Discrimination and Stigma)
► EBI (Elimination of Barrier Initiative)
► NASC (National Anti-Stigma Campaign)
► Help States, organizations, individuals design and implement anti-stigma initiatives
► Gather and maintain best information, policies, research, practices, and programs to counter stigma and discrimination
► Actively disseminate anti-stigma and discrimination information and practices
► Technical Assistance
► Training Teleconferences
► Informational Updates
► Web site
► Database
► Collaboration with EBI and NASC
Elimination of Barriers Initiative (EBI)
► Eight State Demonstration
► Test Public Education Messages
► Reduce stigma and discrimination associated with mental illnesses using tools such as public education and contact
► Provide Evidence-base for National Campaign
EBI Pilot States
► Ohio
► Pennsylvania
► Texas
► Wisconsin
► California
► Florida
► Massachusetts
► North Carolina
EBI Results
► More than 273 million audience impressions
• TV – 207 million• Radio – 67 million
► Equivalent airtime/advertising value: nearly $3 million
EBI Lessons Learned
1. Use a multifaceted approach
2. Use a participatory process
3. Involve consumers
4. Work closely with a smaller subgroup of key partners
5. Involve stakeholders early and often throughout the creative process
6. Identify your audience(s) and speak to them in their own language
Lessons Learned
7. Focus on positive, strength-based messages that demonstrate that recovery is both real and possible
8. Localize and personalize educational strategies
9. Choose a campaign theme that can be tailored to specific audiences
Lessons Learned
10. Develop and implement a comprehensive evaluation
11. Use existing commemorative events
12. Generate and maintain enthusiasm
13. Provide basic training and tools on media outreach
14. Utilize train-the-trainer opportunities
Lessons Learned
15. Provide forums for peer-to-peerinformation sharing
16. Additional training may be required in the development
and ongoing operation of speakers’ bureaus
17. Recognize that messages directedat media gatekeepers may
vary from those directed at thegeneral public
NASC Toolkit
► Section 1: Introduction► Section 2: Mounting a Statewide
Anti Stigma Campaign► Section 3: Outreach Materials► Section 4: Best Practices► Section 5: Resources
► Film, TV, and radio writers and producers who have created respectful, accurate, and dignified portrayals of people with mental illnesses
► Mental health advocates whose efforts have expanded public understanding of mental illnesses
► Others whose activities promote mental health awareness
The First SAMHSA- Sponsored Voice Awards
SAMHSA’s National Mental Health Information Center
www.mentalhealth.samhsa. gov
1-800-789-2647
Chris MarshallConsumer Affairs SpecialistSAMHSA1 Choke Cherry Road, Room 6-1071Rockville, MD 20857Phone: 240-276-1947Email: [email protected]