Thursday, December 14, 2017

Federal Agencies Must Provide Better Care for People With SMI, Says SAMHSA Report

Too many individuals with serious mental illness (SMI) are not getting the treatment and support they need because of fragmented federal systems that are providing inadequate services, according to the first report by a federal committee tasked with improving care for this population. The report was delivered to Congress and issued to the public today.

The Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) was created as part of the 21st Century Cures Act. It aims to enhance coordination across federal agencies that impact the care of adults and youth with SMI. Serious mental illness is defined as a mental illness that seriously impacts the ability to work, live, or form relationships with others.

The report noted that there were 10 million American adults living with a serious mental illness in 2016, and 35% received no treatment. More than 7 million youth experienced a serious emotional disturbance (SED). Both populations face a greater risk of suicide and a life expectancy 10 years shorter than that of the general population. Because of inadequate mental health resources, 2 million people with SMI are incarcerated each year. 

The committee brings together representatives from eight federal government departments that support programs for individuals with SMI or SED, including the departments of Health and Human Services (HHS); Justice; Labor; and Housing and Urban Development, along with nonfederal members including researchers, advocates, and health care professionals. 

“Too often, people with SMI or SED lack access to evidence-based treatments, so they experience high rates of homelessness, joblessness, disability, involvement with the criminal justice system, premature death, and other negative outcomes,” said Elinore F. McCance-Katz, M.D., Ph.D., assistant secretary for mental health and substance use at HHS, head of the Substance Abuse and Mental Health Services Administration, and chair of ISMICC. “Our health care system can do better, and the federal government can marshal its resources to help make that happen.”

The committee offered five basic recommendations on how the federal government could improve the care it provides and the outcomes for this population: strengthen federal coordination between departments to allow for better care, improve access and engagement to make it easier to get high-quality care, close the gap between effective treatments that are known to work and what is actually offered, boost diversion from and treatment for people with SMI in the criminal and juvenile justice systems, and develop finance strategies to make care more available and affordable. 

APA welcomed the report and is looking forward to seeing the responses of federal agencies. “Our members are ready to work with the administration and Congress to implement the recommendations made today,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., in a press statement. “Our patients deserve the best care possible, and today’s report is a step in the right direction.”

ISMICC is required to issue a second report to Congress in four years. 

(Image: David Hathcox)


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