Center for Mental Health Services: Overview

A. Kathryn Power, M.Ed., Director
5600 Fishers Lane Room 17-99, Rockville, MD 20857

Purpose Background Work Impact Activities

Divisions and Supporting Offices:: Division of Prevention, Traumatic Stress, and Special Programs; Division of Service and Systems Improvement; Division of State and Community Systems Development; Associate Director for Organization and Financing; Associate Director for Medical Affairs; Associate Director for Consumer Affairs.

Issues:: Adults With Severe Mental Illnesses; Services for Children and Adolescents; Services for Adults With Serious Mental Illnesses Who are Homeless; Emergency Mental Health and Traumatic Stress Services; Jail and Prison Populations; Managed Care; Data Collection and Reporting; Protection and Advocacy; HIV/AIDS Mental Health Care; Public Education

What does CMHS do?

CMHS leads Federal efforts to treat mental illnesses by promoting mental health and by preventing the development or worsening of mental illness when possible. Congress created CMHS to bring new hope to adults who have serious mental illnesses and to children with serious emotional disorders.

When and why was CMHS established?

CMHS was established under the 1992 ADAMHA Reorganization Act, Public Law 102-321, which mandates CMHS' leadership role in delivering mental health services, generating and applying new knowledge, and establishing national mental health policy. CMHS is a component of the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services.

How does CMHS help the population?

CMHS pursues its mission by helping States improve and increase the quality and range of their treatment, rehabilitation, and support services for people with mental illness, their families, and communities. Further, it encourages a range of programs—such as systems of care—to respond to the increasing number of mental, emotional, and behavioral problems among America's children. CMHS supports outreach and case management programs for the thousands of Americans with severe mental illness who are homeless and supports the development and adoption of "models" for improving services.

What other activities is CMHS involved in?

CMHS promotes consumer participation in the design, financing, and delivery of mental health and related support services.
As the Nation moves toward managed care delivery systems in the public sector, CMHS collects new data, critically evaluates CMHS initiatives to determine what works, and disseminates the latest information to the field.
CMHS works with other Federal agencies and private sector organizations whose programs and policies enhance mental health services delivery and advance policy development.

Divisions Offices:

The Division of Prevention, Traumatic Stress, and Special Programs identifies gaps in prevention and service delivery and designs, develops, and implements programs for underserved and at-risk populations. Among its constituencies are people involved with the criminal justice system, minorities, women, older people, rural Americans, and those affected by disasters and terrorism.
The Division of Service and Systems Improvement plans, implements, and evaluates knowledge development and application programs to determine which models will work best for what groups under what conditions. Target groups are adults with severe mental illnesses, children and adolescents with serious emotional disturbances and their families, the elderly, and homeless people who have severe mental illnesses.
The Division of State and Community Systems Development administers the Performance Partnership Grant Program (formerly known as the Community Mental Health Services Block Grant Program), manages CMHS' data collection and analysis effort, and helps translate knowledge into practice. The Division monitors State implementation of planning requirements and provides technical assistance to States.
The Associate Director for Organization and Financing serves as the CMHS lead for activities involving managed care and the financing and organization of mental health services. The Associate Director handles projects and activities assigned to CMHS under the SAMHSA managed care initiative and coordinates managed care activities within CMHS.
The Associate Director for Medical Affairs maintains a liaison with the medical/ psychiatry communities; provides leadership in the development of appropriate programs; promotes prevention of HIV infection in people at risk, the delivery of effective mental health services for people with HIV infection, and the education of health care providers to address the neuropsychiatric and the psychosocial aspects of HIV infection and AIDS; provides leadership to assure the delivery of mental health services needs to people affected by, and living with, HIV/AIDS, their families, partners, significant others, volunteer and professional health care providers and other affected individuals.
The Associate Director for Consumer Affairs plays a lead role in developing and implementing consumer information activities, supporting consumer-operated networks, and coordinating CMHS anti-stigma efforts. The Associate Director works in partnership with other Federal agencies, as well as with public and private health and human service agencies, to develop standards and guidelines for mental health services, ensure that consumer mental health needs receive adequate attention, and promote consumer participation in services.

CMHS Issues

Adults With Severe Mental Illnesses—Each year, almost 44 million Americans experience a mental disorder (U.S. Department of Health and Human Services, 2002). Among these, 5.4 percent have a severe mental illness, such as schizophrenia, bipolar disorder, and severe depressive disorders, which can be as debilitating as chronic heart disease or diabetes (Mental Health, United States, 1999).
Services for Children and Adolescents—One in 10 American children and adolescents experience a mental illness severe enough to impair them to some degree. Less than 20 percent of these children will receive care for their condition (National Institute of Mental Health, 1999). In addition, not all children receiving care are receiving appropriate treatment. As noted by the General Accounting Office in 1999 and the Centers for Medicare and Medicaid Services in 2001, many children treated in hospitals and residential treatment facilities would be better served in less restrictive facilities (U.S. Department of Health and Human Services, 2001).
Services for Adults With Serious Mental Illnesses Who are Homeless—By current estimates, as many as 700,000 people are homeless on any given night (National Law Center on Homelessness and Poverty, 1999). Twenty to 25 percent of homeless persons are adults who have serious mental illnesses; approximately 50 percent also have a co-occurring alcohol or drug problem (National Resource Center on Homelessness and Mental Illness, 2001).
Emergency Mental Health and Traumatic Stress Services—Virtually all individuals who live and work in a disaster area, including those engaged in emergency relief operations, may be candidates for direct crisis counseling services. CMHS works with the Federal Emergency Management Agency to provide counseling and education to "normal people responding normally to abnormal situations."
Jail and Prison Populations—CMHS is particularly interested in identifying more effective ways to provide mental health services to individuals who come into contact with the criminal justice system. According to recent Department of Justice statistics, nearly 283,800 inmates and 547,800 probationers have reported a mental illness.
Managed Care—As a result of a major movement of mental health and substance abuse populations in managed behavioral health care, CMHS, in collaboration with the Center for Substance Abuse Prevention (CSAP) and the Center for Substance Abuse Treatment (CSAT), has initiated a major grant program to investigate the impact of managed care on vulnerable populations.
Data Collection and Reporting—CMHS collects and reports national statistical information on mental health services and consumers for use by other Federal agencies, legislators, State mental health agencies, national mental health organizations, researchers, academic leaders, and national media.
Protection and Advocacy—The U.S. Congress established the Protection and Advocacy (P&A;) program to protect the rights of people with mental illnesses residing in, or recently discharged from, residential facilities. PAIMI conducts education and training for mental health administrators, legislators, P&A; staff, mental health consumers, their families, and mental health organizations.
HIV/AIDS Mental Health Care—At the end of June 2001, 793,026 cases of AIDS had been reported to the Centers for Disease Control and Prevention (CDC). It is estimated that 40,000 new HIV infections occur each year (National Institute of Allergy and Infectious Diseases, 2002). CMHS identifies models of effective mental health services for people with HIV/AIDS. CMHS also trains mental health providers to identify and treat people with mental illnesses who may be at increased risk for HIV/AIDS, as well as people with emotional trauma, depression, anxiety, severe mental disorders, and dementia associated with HIV/AIDS.
Public Education—Although some progress has been made to counteract the myths, misperceptions, and stereotypes surrounding mental illness, stigma still prevents many people from seeking treatment and causes countless others to keep their conditions secret for fear of losing their jobs, health insurance, or homes. CMHS informs and motivates the public through its National Mental Health Information Center, health communication materials, special events, and presentations. CMHS-supported consumer advocacy programs and technical assistance centers encourage self-help efforts nationwide.

KEN95-0000
08/03

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