Cynthia Hansen, PhD, says she saw the mental health-care system break down one too many times during her 18 years as a private practitioner in Portland, Ore.

Too often bureaucratic obstructions--such as overcrowded mental institutions and inadequate funding and delivery systems in the public and private sectors--prevented her from helping her clients then and in her 10 years as a school psychologist, intern and psychological examiner in group homes, rural and urban community mental health centers, psychiatric hospitals and schools, she says.

Today, however, she's working to help remove those barriers as an APA Practice Organization Health Policy Fellow in the Center for Mental Health Services' organization and financing team at the Substance Abuse and Mental Health Services Administration (SAMHSA). The position is teaching her the nuts and bolts of crafting and revising national mental health policy.

The learning curve, Hansen says, has been steep.

"When I walked in on my first day I didn't understand the details of how public policy is made," she says. "I had pounds of reading materials to dig through and endless acronyms to learn. But I've quickly learned that it takes careful discussion and analysis to change the way the system works."

Hansen works with SAMHSA staff to rework national mental health policy. In a typical week, she might participate in or review reports written by expert advisory panels and her colleagues at SAMHSA, represent SAMHSA at various conferences that involve substance abuse- or mental health service-related issues and attend meetings with multiple federal agencies to discuss the provision of psychological services and assessment.

After her yearlong fellowship ends in December, Hansen hopes to remain involved in either state or federal policy.

"As a psychologist, I'm intrigued by changing the system," she says. "It takes a lot of people and a lot of effort to move the mental health delivery system to a better place."

--Z. STAMBOR