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)

Biden Announces $100 Million in New Mental Health Funding

Vice President Joseph Biden yesterday announced the federal government will make $100 million available to increase access to mental health services and improve mental health facilities.

“The fact that less than half of children and adults with diagnosable mental health problems receive the treatment they need is unacceptable,” Biden said. “The President and I have made it a priority to do everything we can to make it easier to access mental health services, and today’s announcements by the U.S. Departments of Health and Human Services and Agriculture build on that commitment.” The announcement was made just a few days short of the one year anniversary of the shootings at Sandy Hook Elementary School that took 26 lives.

Biden said the $100 million in new funds will include $50 million for community health centers to establish or expand services for people with mental illness or addiction.  The centers can use these funds, made available through the Affordable Care Act, for efforts such as hiring new mental health care professionals and adding mental health and substance abuse services.

Another $50 million will help finance construction, expansion, or improvement of mental health facilities in rural areas over the next three years. These funds, made available through the Department’s Community Facilities direct loan program, can be used to improve or construct mental health service facilities or put in place innovative tools such as telemedicine to expand access to mental health services at rural schools, community centers, hospitals, and other community-based settings.

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