GAO Wants Better Coordination, Evaluation of MH Programs

Members of the U.S. House Energy and Commerce Subcommittee on Oversight and Investigations today took representatives of the Department of Health and Human Services (HHS) to task for the GAO’s finding of poor coordination and evaluation of programs focusing on people with mental illness.

The department was in denial, said Subcommittee Chair Tim Murphy (R-Pa.). “Meanwhile the lives of individuals with severe mental illness, and their families, remain in the balance.”

Murphy, a clinical psychologist, is preparing comprehensive mental health legislation that would include a high-ranking coordinator within HHS.

The hearing was sparked by a report from the Government Accountability Office (GAO) that noted significant problems in how federal agencies managed 112 programs supporting people with serious mental illness.

For one thing, the agencies had difficulty simply identifying all programs. (For instance, a program aimed at reducing homelessness might serve people with mental illness but might not be specifically targeted at them.) Also, only nine of the 30 nondefense programs had completed evaluations, leaving the agencies (and the GAO) in the dark about program effectiveness.

More critically, there was no formal interagency coordination of the programs, in part because the Federal Executive Steering Committee for Mental Health has not met since 2009, said Linda Kohn, Ph.D., the GAO’s director of health care.

“We are concerned that the lack of coordination inhibits an understanding of the federal footprint in this area,” said Kohn. “Coordination helps identify overlaps and gaps to maximize existing resources.”

“HHS recognizes the need to coordinate at the agency, program, provider, and individual levels, but people with mental illness don’t live their lives at program boundaries,” replied Richard Frank, Ph.D., assistant secretary for planning and Evaluation at HHS.

"The problem is the lack of services and the lack of support," said Pamela Hyde, J.D., administrator of the Substance Abuse and Mental Health Services Administration.

The GAO recommended that the secretary of Health and Human Services “establish a mechanism to facilitate intra- and interagency coordination” and that all the agencies set up plans to prioritize when and how to evaluate their programs.

For more in Psychiatric News about Murphy's mental health bill, cosponsored by Rep. Eddie Bernice Johnson (D-Texas), see "Author of House Mental Health Bill Addresses APA Assembly."

 (Image: Aaron Levin/PN)