164,000 people with serious mental illness are homeless. 365,000 seriously mentally ill are in jails and prisons. 770,000 are on probation or parole. 95,000 who need to be hospitalized can’t get a bed. 5,000 kill themselves every year. They are more likely to be murdered and almost three times more likely to be victims of violent crime than the mentally healthy. They die up to 25 years earlier than others.
To address these issues, Congress established CMHS and SAMHSA. It was directed to serve “adults with a serious mental illness [SMI] and children with a serious emotional disturbance (SED).” SAMHSA was instructed “to target … mental health services to the people most in need” like those just described above.
SAMHSA refuses to focus on the most seriously ill or those most in need.
SAMHSA’s strategic plan claims SAMHSA’s goal is to create “a high-quality, self-directed, satisfying life integrated in a community for all Americans.” A top SAMHSA official told Time magazine: “The behavioral health of the entire population is a priority for SAMSHA.” Of SAMHSA’s eight “strategic initiatives,” only one involves getting treatment to adults with serious mental illness. Schizophrenia was not mentioned in the strategic plan. SAMHSA has not helped reduce homelessness, incarceration, violence, the lack of hospital beds and the lack of treatment for people with serious mental illness. Instead, it has encouraged states to focus exclusively on the higher functioning.
SAMHSA encourages states to use $459 million in Mental Health Block Grants for people without mental illness.
The instructions state “SAMHSA strongly recommends that Block Grant funds be directed...to fund primary prevention: universal, selective, and indicated prevention activities and services for persons not identified as needing treatment” and “The focus is about everyone, not just those with an illness or disease, but the whole population.”
SAMHSA refuses to certify programs that help the seriously mentally ill and certifies programs that don’t
SAMHSA maintains a collection of privately developed workshops, training sessions, and courses they label a “National Registry of Evidence-based Practices and Programs” (NREPP) and encourage the spending of funds on. Less than ten of the 300 programs are for people with serious mental illness. SAMHSA certifies programs as “effective” that don’t serve people with serious mental illness and don’t improve meaningful outcomes, such as reducing violence, arrest, incarceration, suicide, homelessness, and hospitalization. Many purport to improve soft measures like ‘sense of empowerment.’ The only ‘evidence’ for the listed programs comes from those who sell and profit from them. SAMHSA refuses to evaluate non-commercial programs that deliver treatment and prevent people with serious mental illness from becoming homeless, arrested and incarcerated. Programs that help people with serious mental illness that SAMHSA has not included in NREPP include medication management, case management, mental health courts, police training, crisis intervention teams, clubhouses (Fountain House) and assisted outpatient treatment.
SAMHSA replaced the “medical model” with a SAMHSA-invented “recovery model”
SAMHSA created an 1100-word definition of a “Recovery Model” to replace the medical model and funds it. SAMHSA summarized recovery as “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” Using this definition SAMHSA encourages states to divert mental health funds to anything anyone believes will help them “reach their full potential”. Because "self-determination and self-direction are the foundations for recovery" the model makes no allowance for the fact that there are individuals with severe mental illness who cannot self-direct their care.
SAMHSA invented a new mental illness: Trauma
Trauma is not a mental illness. PTSD is and it can run from mild to severe. But rather than relying on science, SAMHSA let stakeholders vote to make ”Trauma” itself an illness and funds it. Everyone experiences trauma sometime in life (ex. loses a loved one). It is normal. But eliminating trauma is now one of SAMHSA’s eight most important strategic initiatives. SAMHSA didn’t exactly define trauma, but declared “trauma can occur from a variety of causes, including maltreatment, separation, abuse, criminal victimization, physical and sexual abuse, natural and manmade disasters, war, and sickness” and “individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's functioning and physical, social, emotional, or spiritual well-being.” These definitions can include anyone who got divorced, found their spouse was cheating, knows someone who died, was in a storm, or had any event they ”experienced as...emotionally harmful” if it affected their “spiritual well-being.” SAMHSA is diverting millions that should helping people with serious mental illness into preventing trauma.
SAMHSA funds antipsychiatry and antipsychiatrists
SAMHSA gives funds and support to antipsychiatry and organizations that oppose treatment. SAMHSA’s Mental Illness Awareness Week Guide suggests that schools invite the MindFreedom, the Icarus Project, and the National Coalition for Mental Health Recovery (NCMHR) into classrooms to teach children about mental illness. MindFreedom believes “mental illnesses are not brain diseases”. The Icarus Project believes “these experiences—commonly diagnosed and labeled as psychiatric conditions—are mad gifts needing cultivation and care, rather than diseases or disorders.” NCMHR believes “psychiatric labeling is a pseudoscientific practice of limited value in helping people recover.” Is that who we want teaching our children? Some of the organizations funded by SAMHSA do not believe mental illness exists.
SAMHSA provided $329,000 to the Mental Health Association of Oregon, whose former board president lent her support to a group that wanted to have involuntary mental health treatment classified as “torture.” SAMHSA gave $70,000 to the Pennsylvania Mental Health Consumers Association. It wants to close all state psychiatric hospitals, thereby preventing the most seriously ill from receiving treatment. SAMHSA gave Advocates for Human Potential over $8 million in contracts. A senior research associate at AHP claimed “All the diagnoses in the DSM are ‘made up disorders’ in that they are social constructs based on absolutely no valid scientific evidence.” SAMHSA invited someone to its advisory board who runs a website featuring articles on “How to escape a mental hospital” and “Stopping Psychiatric Drugs,” and claimed credit for having “deprogrammed them [consumers] from the brainwashing cult of psychiatry.” SAMHSA gives $300,000 a year to fund an “Alternatives” conference where alternative (unproven) treatments are espoused. Conferences have included workshops to teach that hearing voices is normal and how to go off medications.
SAMHSA wastes money intended to help people with serious mental illness
SAMHSA wastes money. It publishes and distributes children’s books, such as Play Day in the Park; Look What I Can Do!; Wally Bear and Friends; and our favorite, The Lion and the Mouse sing-along. SAMHSA has publications covering “What a Difference a Friend Makes”, “oil spill response”; hurricane recovery; American Indian and Alaska native culture; peer pressure; social marketing; employment services; and health promotion. SAMHSA has only a single publication on schizophrenia, and it is out of stock. SAMHSA recently created a “National Wellness Week” to encourage “visiting a farmers’ market, reading poetry, making a collage, taking a walk, joining a song circle, taking a class on how to make sacred drums,…and join[ing] the Line Dance for wellness.” SAMHSA commissioned a $22,500 painting, "to help raise awareness about the roles of families and the community." It sits in SAMHSA’s headquarters. SAMHSA spent $200,000 to put on a party at Paramount Studies in Hollywood.
Solution: SAMHSA has its eye off the prize. It encourages mission-creep thereby causing people with mental illness and the communities they live in to needlessly suffer. Congress should eliminate SAMHSA and transfer the savings to other agencies willing to serve the seriously ill. Alternatively, fire the current SAMHSA πadministrator and CMHS Director and replace with a medical doctors who understand serious mental illness and want to help those who suffer from it.
DRAFT 2/10/15 Sources and more info on SAMHSA at http://mentalillnesspolicy.org/samhsa.html
This fact sheet is on the adult mental health programs at SAMHSA/CMHS, not the substance abuse programs or the mental health programs focused on children with serious emotional disturbance (SED).