Substance Abuse & Mental Health Services (SAMHSA) Reauthorization
The efforts to reauthorize of the Substance Abuse and Mental Health Services Administration (SAMHSA) during the 110th Congress have stalled in the Senate. The Senate took the initiative on this reauthorization and its committee staff worked for nine months to draft a bipartisan bill that could be sent to the House. The issue of "charitable choice," that is, allowing religious entities that receive SAMHSA funding to deny employment and services to those of another faith, was a deal breaker.
The APA submitted a comprehensive association-wide set of recommendations intended to improve SAMHSA. These recommendations are available on the Education GRO website. Within this set of recommendations, APA's Education GRO promoted initiatives that will strengthen workforce training opportunities for mental and behavioral health professionals.
The Senate Health, Education, Labor and Pensions (HELP) Committee released a draft version of their SAMHSA reauthorization. APA secured some important language in this draft related to prevention and early intervention services, programs and services for older Americans and a general authority for training of "interns and fellows". Critically important recommendations made by APA were not included as part of the SAMHSA draft.
Mental Health Workforce Development
Investing in a highly qualified mental and behavioral workforce is an area of critical national need. A ground breaking report by the Institute of Medicine in 2001, Crossing the Quality Chasm: A New Health System for the 21st Century, identified the pervasive problems of health care today. This study lead to a 2006 report entitled, Improving the Quality of Health Care for Mental and Substance Use Conditions, which identified the inadequacy of mental health and substance abuse care and recommended building, maintaining and ensuring a competent and qualified workforce. In an effort to meet the workforce needs identified by the Institute of Medicine, the APA recommended providing an authorization for the Minority Fellowship program as well as significantly expanding Center for Mental Health Services workforce efforts.
Minority Fellowship Program
The minority fellowship program is a proven effective SAMHSA program that supports pre- and post- doctoral fellowships for minority psychologists. APA has a grant to train psychologists. While this program has received funding from SAMHSA for over a decade, it does not have a specific authority in the current statute. APA continues to seek full authorization for the MFP during the review of SAMHSA programs.
Training Mental Health Professionals
Also requested was a loan repayment program as well as an institutional grant program to train mental health professionals with underserved populations and place them in underserved communities. The training would be interdisciplinary and focused on multi-cultural and evidence-based practice. Senate staff immediately found these recommendations unacceptable and what was left on the table was federal support for "interns and fellows". Education GRO staff will continue to promote these important training programs.
Youth Suicide Prevention Program (Garrett Lee Smith Memorial Act)
During the reauthorization process, Education GRO has pushed to include a new use of funds that would allow for college counseling centers to strengthen and expand residency, internship or fellowship programs. While these changes were not included in the Senate HELP Committee's SAMHSA reauthorization draft, Education GRO will continue to educate House and Senate staff about the mental and behavioral health needs that exist on college campuses around the country in an effort to ensure that the federal legislation is better designed to address these problems.
APA member Jeffery Pollard, Ph.D. ABPP, Director of Counseling and Psychological Services at George Mason University came to Capitol Hill and briefed a group of Senate HELP Committee staff about issues facing college counseling centers, which included: increased student awareness about signs of depression/suicide without an increase in trained professionals able to see these patients seeking assistance; a new presence of returning Iraqi war veterans, whose mental and behavioral needs may or may not have been met, pursuing their university degrees; and new fears and concerns associated with the tragic events of Virginia Tech last school year.
SAMHSA Suicide Prevention Programs
The Garrett Lee Smith Memorial Act authorized a number of important federal programs that focus on suicide prevention. These programs, the Statewide Youth Suicide Early Intervention and Prevention Program, a Suicide Technical Assistance Center and the Campus Suicide Prevention program, are administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). The Campus Suicide Prevention program is an outgrowth of the Campus Care and Counseling Act (108th Congress); legislation championed by Sen. Jack Reed (D-RI), former Sen. Mike DeWine (R-OH), Rep. Danny Davis (D-IL), and former Rep. Tom Osborne (R-NE), and developed by members of the APA working in college counseling centers. The GLSMA programs have received full funding each year since their creation thanks to the significant work of Sen. Gordon Smith (R-OR)
To date, the Campus Suicide Prevention program has made grants to 56 institutions of higher education to assist colleges and universities in their efforts to prevent suicide and enhance services for students with mental and behavioral health problems that place them at risk for suicide. These grantees are working on campus to raise awareness and provide education to the campus community about the risks and warning signs of suicide. Further, they are communicating with each other and sharing best practices nation-wide with their colleagues in other colleges and universities. This program is meeting a critical need on college campuses around the country.
In early November 2007, SAMHSA announced that approximately $1.5 million would be made available for 15 new Campus Suicide Prevention grants with an average award of $100,000 for 3 years based on FY'08 funds.
FY 2008 SAMHSA Suicide Prevention Programs Funding
The Senate provided $30 million FY 2008 funding for the Youth Suicide Prevention grants - an increase of $12.2 million over the FY 2007 level. The Campus Suicide Prevention program received $5 million - the same amount as last fiscal year's level. Finally, the Suicide Prevention Technical Assistance and Resource Center received $5 million (i.e., level funding from FY 2007). The FY 2008 omnibus appropriations bill provided the Senate levels of funding for the GLSMA programs under SAMHSA.