On July 22, the Substance Abuse and Mental Health Services Administration (SAMHSA) released "Transforming Mental Health Care in America. The Federal Action Agenda: First Steps," the federal government's official recommendations to begin transforming the nation's mental health-care system.

The steps include focusing on community-based care that coordinates public and private health payers; expanding criminal justice and mental health collaborations; and integrating mental health and primary-care services for racial and ethnic minorities. Other steps include encouraging innovation, flexibility and accountability in all mental health services at all levels of government by awarding a number of competitive grants and advancing the use of evidence-based practices.

Unlike the Campaign for Mental Health Reform's guide, SAMHSA's agenda primarily focuses on intergovernmental coordination. Seven cabinet-level departments--Education, Health and Human Services (HHS), Housing and Urban Development, Justice, Labor, Veterans Affairs and the Social Security Administration--collaborated to develop the 70 steps outlined in the SAMHSA agenda.

"The action agenda details the initial steps the federal government is taking to transform the form and function of the mental health-delivery system in America," according to Mike Leavitt, HHS secretary. "HHS and its partners across the federal government are committed to a shared goal of collaborating to fundamentally change the way the nation's mental care system currently functions."

However, A. Kathryn Power, director of SAMHSA's Center for Mental Health Services, and Charles G. Curie, administrator of SAMHSA, noted at a press conference announcing the agenda that the process will take time.

"The action agenda is not a 'quick fix' for the problems that have ailed the mental health-care system for decades," Curie said. "It is a living document that begins to chart the course for the long term."

At the press conference, SAMHSA also announced the creation of a Federal Executive Steering Committee, housed within SAMHSA, to oversee the work of mental health system reorganization.

--Z. STAMBOR

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