September 2006 NACBHDD Newsletter
The Newsletter of the National Association of County Behavioral Health and Developmental Disability Directors
In this Issue...
NACBHD's 2007 Membership Campaign is Underway!
Very soon NACBHD members will receive a 2007 Membership Campaign brochure and dues invoice. In the mailing, members will also notice that NACBHD has changed its dues determination methodology. As stated in the mailing, this change in methodology is not intended to increase dues. It is intended to facilitate increased membership by simplifying the process (based on census versus agency budget). Electronic mailings will follow in the next few weeks.
NACBHD staff conducted a simulation of the new process and found that dues for several members increase under the new methodology. In other cases, dues decrease. NACBHD's leadership recognizes the difficulty an increase in dues may cause some and has instituted a two year window or lag. If your membership dues increase and you are unable to make the new level, please contact Melissa Staats at mstaats@nacbhd.org or Maeghan Gilmore at mgilmore@nacbhd.org to affect the two year window.
This year, NACBHD staff almost tripled the number of brochures and invoices sent to members and potential members. This was a significant undertaking and many of our members helped by providing contact information for potential members previously unknown to the staff. Many thanks for your assistance and patience.
As you meet your colleagues, please encourage them to join NACBHD. A strong grassroots membership is critical to ensuring a local government presence in Washington DC. NACBHD staff is expecting a great response to our membership drive!
2007 LEGISLATIVE CONFERENCE-SAVE THE DATE
NACBHD will convene its annual Legislative Conference on February 28, 2007. The Conference will conclude at 12 Noon on March 2, 2007. The Conference will be held at the Jurys Washington Hotel at Dupont Circle. NACBHD will notify members when the hotel is ready to take reservations.
In Antipsychotics, Newer Isn't Better
Drug Find Shocks Researchers
NACBHD participated on a brief conference call with colleagues regarding the study described below. The community plans a response to the findings. NACBHD will share this response with members when it is available.
By Shankar Vedantam
Washington Post Staff Writer
Tuesday, October 3, 2006; A01
Schizophrenia patients do as well, or perhaps even better, on older psychiatric drugs compared with newer and far costlier medications, according to a study published yesterday that overturns conventional wisdom about antipsychotic drugs, which cost the United States $10 billion a year.
The results are causing consternation. The researchers who conducted the trial were so certain they would find exactly the opposite that they went back to make sure the research data had not been recorded backward.
The study, funded by the British government, is the first to compare treatment results from a broad range of older antipsychotic drugs against results from newer ones. The study was requested by Britain's National Health Service to determine whether the newer drugs -- which can cost 10 times as much as the older ones -- are worth the difference in price. There has been a surge in prescriptions of the newer antipsychotic drugs in recent years, including among children.
The study, published in the Archives of General Psychiatry, is likely to add to a growing debate about prescribing patterns of antipsychotic drugs. A U.S. government study last year found that one of the older drugs did as well as newer ones, but at the time, many American psychiatrists warned against concluding that all the older drugs were as good.
Yesterday, in an editorial accompanying the British study, the lead researcher in the U.S. trial asked how an entire medical field could have been misled into thinking that the expensive drugs, such as Zyprexa, Risperdal and Seroquel, were much better.
"The claims of superiority for the [newer drugs] were greatly exaggerated," wrote Columbia University psychiatrist Jeffrey Lieberman. "This may have been encouraged by an overly expectant community of clinicians and patients eager to believe in the power of new medications. At the same time, the aggressive marketing of these drugs may have contributed to this enhanced perception of their effectiveness in the absence of empirical information." Peter Jones, a psychiatrist at the University of Cambridge in England who led the study, searched yesterday for the right word to describe what had happened to his colleagues. "'Duped' is not right," he said. "We were beguiled."
One drugmaker immediately questioned the findings. Carole Puls, a spokeswoman for Eli Lilly and Co., which makes Zyprexa, said it was problematic to compare large groups of medications because there are differences between the drugs in each class. Individual patients need different medication options, she said.
Janssen Pharmaceutica, which makes Risperdal, and AstraZeneca, which makes Seroquel, did not respond to requests for comment.
Schizophrenia is a serious mental disorder that is believed to affect about one in 100 adults. It is characterized by psychotic symptoms such as hallucinations and delusions and negative symptoms such as social withdrawal.
Especially over the past decade, older antipsychotics such as Haldol have been widely criticized for triggering uncontrolled body movements, even as the new "atypical" antipsychotics were hailed for causing fewer side effects. Recently, however, concern has grown that antipsychotics in general, and some of the newer drugs in particular, may be causing metabolic side effects.
The new study randomly assigned 227 schizophrenia patients to two groups -- one received a newer antipsychotic, the other an older drug. The patients were evaluated for more than a year by experts who did not know which drug was being taken.
While the researchers had expected a difference of five points on a quality-of-life scale -- showing the newer drugs were better -- the study found that patients' quality of life was slightly better when they took the older drugs. Jones said a conservative interpretation of the data suggested that there is no difference, "so the notion you would pay 10 times as much would be difficult to justify."
"Why were we so convinced?" he asked, referring to the widespread opinion among psychiatrists that the new drugs were worth the great difference in cost. "I think pharmaceutical companies did a great job in selling their products. That is certainly one issue.
"It became almost a moral issue on whether you would prescribe these dirty old drugs," he added. "It became the 'my son' phenomenon. What would you prescribe for your son?"
In retrospect, Jones and others said, there were hints going back many years. In 2003, Robert Rosenheck, a psychiatrist at the Department of Veterans Affairs, found there was no difference between Haldol and Zyprexa -- after patients taking Haldol were treated to prevent the movement side effects.
Last year, the U.S. government trial found that an older drug called perphenazine did about as well as the newer medications. Still, the belief in the newer drugs was so ingrained that many psychiatrists insisted that the results could not be extrapolated to other old drugs, said Rosenheck, who helped conduct that study.
Darrel Regier, who directs research at the American Psychiatric Association, cautioned against drawing broad conclusions after the new study and said that "a thoughtful and prolonged process is needed before treatment guidelines are changed. Not all the drugs used in the British study were available in the United States," he said, and "with many of the newer medications reaching the end of their patent lives," he predicted that questions of cost would fade away.
Jones and Rosenheck said the problem with many drug company studies that seemed to show that new drugs are better is that they focused on short-term results -- a symptom or side effect -- rather than the big picture: how patients fare long-term.
"The story of these newer antipsychotic drugs is a story that reveals an institutional gap," Rosenheck said. "It should not have needed 10 years to get three government studies." Jones said the studies also illustrate the importance of trusting data, rather than judgment. He drew an analogy with his hobby of walking.
"Sometimes the compass tells you go straight in front of you, but you somehow know it is wrong and that north is behind you," he said. "I have learned to follow the compass."
SAMHSA Has New Administrator
NACBHD staff attended a meeting at the Department of Health and Human Services (HHS) on August 31 to meet the new Substance Abuse and Mental Health Services Administration (SAMHSA) Administrator, Eric Broderick, DDS, MPH. According to an information release from SAMHSA, Dr. Broderick is committed to leading the $3.4 billion agency in its "vision of 'a life in the community for everyone,' as well as its mission of 'building resilience and facilitating recovery.'"
Dr. Broderick has been at HHS for over 33 years, in the positions of Acting Deputy Administrator and Senior Advisor for Tribal Health Policy. He has experience in budget formulation, program assessment, health policy development, and in managing public health programs that focus on mental health, substance abuse, and oral health. He has undergraduate and dental degrees from Indiana University, a General Practice Residency from the United States Public Health Service Hospital in Seattle, and a Master of Public Health from the University of Oklahoma. He is an Assistant Surgeon General in the United States Public Health Service.
Medicaid Update
Concerns Continue Around Citizenship Documentation Requirements
An update from the Center for Budget and Policy Priorities
Melanie Nathanson, Director of the Federal Budget Initiative, a project designed to provide technical and analytic assistance to state organizations that work on federal budget issues, at the Center for Budget and Policy Priorities, recently sent advocates, including NACBHD, the following update on the Citizenship Documentation provision of the Deficit Reduction Act.
Ms. Nathanson began her update with, "As many of you know, states have begun to implement the Citizenship Documentation provision and many of our partner organizations are working with state affiliates to begin to get a sense of changes in state policies and their impact on beneficiaries, applicants, providers, eligibility workers, state agencies and myriad other stakeholders."
She went on to state that, "CMS received a huge number of comment letters to its interim final rule this August. Most of you, and many of your state partners, sent in thoughtful, well-structured comments. There were a variety of comments sent from Congressional Members, Governors and state agencies. We are hopeful that they are being taken into account by the Agency and will make a difference in the ultimate promulgation of the law."
Melanie Nathanson provided colleagues with a document designed to assist states with the new requirements. The document is called DOCUMENTING CITIZENSHIP AND IDENTITY USING DATA MATCHES: A Promising Strategy for State Medicaid Programs." It can be accessed at http://www.cbpp.org/9-1-06health.htm. Ms. Nathanson writes that, "This piece provides a concise overview of how states can use their option to do data cross matching to document citizenship and identity for many residents seeking insurance through the Medicaid program. It also sites some current state practices, which can be exported to other states to make the requirements less onerous."
As part of the Federal Budget Initiative Project, Ms. Nathanson also plans to start a series of technical assistance calls, geared toward state groups that are engaged in these efforts (collecting implementation data), covering a variety of issues related to effective monitoring. Ms. Nathanson will send NACBHD a schedule of these calls.
The project is developing a link on the Center of Budget and Policy priorities website www.cbpp.org, which will chronicle information that we receive from state partners and agencies on implementation of the new requirements.
Finally, Ms. Nathanson reminded NACBHD and others about the Technical Corrections bill still pending in Congress. Ms. Nathanson continues to believe that the corrections will wind up in the law. She points out "that as we learn more about the actual impact of the law on patients (consumers), providers and states it is important that we share this information with key lawmakers and our affiliates' Congressional delegations."
The final regulations defining the citizenship requirements are still pending.
And, Andrea Fiero of the National Association of State Mental Health Program Directors forwarded this article to advocates, including Melissa Staats. (Published in BNA, Volume 11, Number 182, Wednesday, September 20, 2006, ISSN 1091-4021, Lead Report).
Federal Judge Declines to Invalidate New Law Requiring Proof of Citizenship
CHICAGO--A federal judge in Chicago declined to invalidate a new law requiring Medicaid recipients to provide proof of citizenship as a prerequisite for gaining or maintaining benefits under the federal-state health care program (Bell v. Leavitt, N.D. Ill., No. 06 CV 3520, 9/14/06).
In an interim ruling dated Sept. 14, Judge Ronald Guzman of the U.S. District Court for the District of Northern Illinois avoided a legal determination on the validity of a portion of the 2005 Deficit Reduction Act pertaining to citizenship documentation procedures for individuals involved in the Medicaid program. Rather than confront the constitutional questions head on, Guzman issued a procedural ruling finding that the plaintiffs in the case did not have standing to attack the rule at this time.
Plaintiffs in the case, who received copies of the ruling Sept. 19, reacted with disappointment and vowed to reconfigure their complaint to force Guzman to address their concerns with respect to the validity of the law.
"We are really disappointed with the latter aspect of the ruling because it means United States citizens are going to have to continue to prove, and reprove and re-reprove their citizenship using this confusing and time-consuming and, by all accounts, unnecessary process set forth in the regulations and the statute,'' John Bouman, lead attorney for the plaintiffs and director of the Sargent Shriver National Center of Poverty Law in Chicago, told reporters during a teleconference.
The Sargent Shriver center, together with the health care advocacy organization Families USA and several other advocacy groups, filed the class action on June 29 seeking to bar the Department of Health and Human Services from implementing rules pertaining to the new documentation statute. Under Section 6036 of the 2005 Deficit Reduction Act, individuals are required to provide a passport, birth certificate, or other satisfactory documentary evidence of citizenship or nationality when initially applying for Medicaid or upon a recipient's first Medicaid redetermination. Previously, individuals simply were required to declare their U.S. citizenship under penalty of perjury and did not have to provide any additional supporting documents.
The lawsuit alleged that the new law violates the plaintiffs' Fifth Amendment rights because it deprives them of their Medicaid benefits without due process of law. The groups contended that the law would cause an estimated 3 million to 5 million Medicaid beneficiaries to lose their coverage. The lawsuit asserts that the individuals most at risk of losing their Medicaid coverage include seniors in nursing homes, individuals with mental or physical disabilities, and people not born in hospitals who never had birth certificates.
Carveout Possible for Children in Foster Care
While Guzman declined to roll back the new statute, Bouman said the judge signaled his willingness to carve out a large group of Medicaid recipients from its requirements. In this regard, Guzman agreed to certify a nationwide class of 500,000 children in foster care or adoption assistance programs. Bouman said Guzman likely would issue an injunction Oct. 5 relieving such children from the new documentation rules.
Ron Pollack, executive director of Families USA, said that while he was pleased with Guzman's ruling with respect to children in foster care, the fate of millions of other Americans that rely on Medicaid remains in jeopardy. He said the plaintiffs in the case would continue to challenge the validity of a law crafted essentially for political purposes.
"This new law, if not ultimately overruled, will produce a tragic irony," Pollack said during the teleconference. "In its zeal to politically pander and appear tough on illegal immigrants, Congress enacted this law that will cause millions of low-income American children and families to lose Medicaid coverage. This law is as unnecessary as it is harmful."
Medicare Update: Problems with 2007 Drug Plan Options Anticipated
On September 28, the Centers for Medicare and Medicaid Services (CMS) released information on the 2007 drug plan options that begin with open enrollment November 15. The memo containing this information, which CMS has asked that advocates share with their local partners, is reprinted below for members' information.
Karen Sanders, Associate Director for Publicly Funded Services at the American Psychiatric Association, has provided perspective and insight into the impact of the Medicare Modernization Act for NACBHD before, and has provided a forecast of what some concerns with the 2007 drug plan options may be:
September 29 memo from CMS on 2007 Drug Plan Options
HHS Secretary Mike Leavitt announced today that seniors and people with disabilities who are satisfied with their current Medicare prescription drug coverage will not have to take any action when the Medicare Open Enrollment period begins November 15th, but those who wish to make a change will find new options with lower costs and more comprehensive coverage available for 2007. They will also find new tools from Medicare to help them make a choice. Surveys consistently show over 80 percent of Medicare beneficiaries are satisfied with their current coverage and drug plans. As a result of the Medicare prescription drug benefit, more than 38 million seniors and people with disabilities now have some form of drug coverage.
"With next year's drug coverage, we want to build on the high level of beneficiary satisfaction in 2006 by strengthening the drug benefit in key ways," said CMS Administrator Mark B. McClellan. M.D., Ph.D. "As a result of robust competition and smart choices by seniors, plans are adding drugs, removing options that were not popular, and providing more options with enhanced coverage."
Across the country, nearly all beneficiaries enrolled in Medicare prescription drug plans will be able to remain in the plan in which they enrolled for 2006 since almost all Part D sponsors are either continuing their current plans in 2007 or streamlining and consolidating their 2006 plans. They will be able to choose from plans that offer enhanced benefits or services, such as coverage in the gap and little or no deductible. Beneficiaries will have a wide range of plans that have zero deductibles, some of which also offer other enhanced benefits. There are also options that cover generics and preferred brand name drugs through the coverage gap for as low as $38.70, and generally for under $50.
Beneficiaries with limited incomes who qualify for the extra help will have a range of options available for comprehensive coverage. Beneficiaries who qualify for the full Medicare subsidy will pay no premiums or deductibles in these plans. Nationally, over 95 percent of low income beneficiaries will not need to change plans to continue to receive this coverage for a zero premium.
There are eight new national organizations offering drug plans to beneficiaries, in addition to the nine national organizations that were available in 2006. The list of national plans, as well as links to the state-level prescription drug plan lists (PDP landscapes) can be found at www.medicare.gov/medicarereform/local-plans-2007.asp.
For state-specific press releases, which provide further plan information at the state level, please visit the following link: http://www.cms.hhs.gov/apps/media/?media=pressr.
Attached please find the national press release announcing the release of the 2007 drug plan options. National Press Release (PDF).
Update on the Campaign for Mental Health Reform
The Campaign for Mental Health Reform continues to actively work with national advocacy partners, including NACBHD, on critical issues. An update on the Campaign's most recent activities follows. Bill Emmet, Interim Director, spoke with NACBHD about the Campaign's recent and upcoming activities.
Policy retreat planned for the Fall. A two-part policy and communications retreat is planned for the Fall. The Campaign will work on an agenda for 2007 on October 12, and meet again on December 5, after the election, to determine the next course of action.
September 20 Senate Mental Health Caucus Briefing. The briefing, which focused on mental health as a part of overall health, was the caucus' first event since it was formed in March with the advocacy and assistance of the Campaign. (The Caucus is led by Senators Pete Domenici, Edward Kennedy, Tom Harkin and Gordon Smith.) Dr. David Satcher, former U.S. Surgeon General, and Dr. Howard Goldman, Professor of Psychiatry at the University of Maryland School of Medicine spoke, and Emmet says Dr. Satcher was "brilliant," and that Dr. Goldman "was remarkably versatile in weaving in various themes." And while the two Senate staffers who had planned to speak at the event were unable to do so due to pressing Senate business, about 15 Senate staffers were in the audience. Emmet reports that the briefing went very well, and is "the first, we hope, of many Senate Mental Health Caucus briefings."
To view an invitation from the Caucus, click here.
To view a press advisory about the Caucus, click here.
SAMHSA's New National Registry of Evidence-Based Practices (NREPP)
Reformulated NREPP is more accessible and useful as a decision support tool NACBHD recently spoke with Kevin Hennessy, Ph.D., Science to Service Coordinator, Office of Policy, Program and Budget, SAMHSA, about SAMHSA's new National Registry of Evidence Based Practices, which has been reconceptualized as a decision support tool for end users, such as counties, to identify evidence-based interventions that best meet their needs. Hennessy says that the registry was ready to launch in Spring 2005, but various stakeholders still wanted to provide input, so SAMHSA asked for comments through announcements in the Federal Register. Over 100 comments were received from federal, state, and local officials and from individuals. Based on these comments, the system was revised, and the revised system was posted in the March 2006 Federal Register. To view a one page fact sheet on NREPP, including information on the review process for interventions, click here.
Given the limited resources, Hennessy says it is uncertain how many interventions will be reviewed. Each center at SAMHSA prioritizes the types of interventions they would like included in NREPP annually, and factors this into their annual budget planning process. Hennessy describes the registry, "as by no means an exhaustive list," and says he expects that the expansion may take three to five years.
Window of submission begins October 1
NREPP will have an annual submission period, and the four month window of submission during which interventionists may submit materials for the upcoming fiscal year starts October 1. For information on how SAMHSA will prioritize interventions submitted for review during fiscal year 2007, see www.samhsa.gov and click on "National Registry of Evidence-Based Practices." The information listed in the June 30 issue of the Federal Register, which can be accessed at this site, may be useful for those applying to have an intervention reviewed and listed in the registry.
For more information
For more information on NREPP, see www.samhsa.gov, and click on "National Registry of Evidence-Based Practices." (Previous notices in the Federal Register detailing the changes can be accessed here.) Information will be available to the public on a new NREPP web site at www.nrepp.samhsa.gov by March 2007.
CMS Administrator Resigns
The Center for Medicare and Medicaid Services (CMS) Administrator Mark McClellan announced on September 5 that he will leave his position in about five weeks. McClellan is a physician and economist, who has said he wants to spend more time with family and will probably join an academic think tank. (Kaiser Daily Health Policy Report, September 6, 2006, www.kaisernetwork.org). According to the report (which summarizes reports in various major newspapers), the new CMS administrator will face challenges in: how to pay for Medicare and Medicaid as baby boomers age, how to decrease the number of people without health insurance, the scheduled cut in Medicare reimbursement to physicians, the Congressional debate next year on reauthorization of the SCHIP program, the soon-to-be released Medicaid commission report that is likely to include big program cuts, and various issues related to the Medicare prescription drug benefit. The Kaiser article contained a quote from Ron Pollack, Executive Director of Families USA (an advocacy organization with which NACBHD sometimes works and consults) "In the context of an administration that doesn't make health care a high priority and that has made a series of harmful proposals that will exacerbate the health care crisis, Mark McClellan served in an admirable way to try to implement the administration's policies in the best way possible" (Washington Post, September 6).
ANCOR-a NACBHD developmental disability advocacy partner provided the following information on leadership changes at CMS:
NACo Accepting Applications for Regional Health Leadership Institute
NACo recently forwarded the following information to Melissa Staats for distribution:
NACo is now accepting applications for the first Regional Health Care Leadership Institute, to be held November 13-14 in Chandler, AZ in conjunction with the Arizona Association of Counties annual meeting.
The Institute, supported by the W.K. Kellogg Foundation, is a two-day training workshop targeting elected county officials and their community partners from states in southwest region. The goal of the Institute is to educate participants on issues related to access to care; to strengthen their leadership skills in building community support for programs that will strengthen the quality of health care for underserved populations; and to cultivate partnerships between county officials and local organizations working to improve access to care.
NACo will offer partial travel reimbursement awards on a competitive basis to 15-20 county teams. Priority will be given to applications from counties in our target states, but we will reserve a limited amount of space for counties from other regions. The application and more information are available on NACo's website, www.naco.org/techassistance in the Health section. The deadline for applications is October 13. Please contact Christina Rowland at crowland@naco.org or 202-942-4267 for more information.
Resources Related to Youth with Mental Illness in the Juvenile Justice System Now Available Online
The National Center for Mental Health and Juvenile Justice (NCMHJJ) recently announced the availability of a series of research and program briefs on issues critical to youth with mental health issues who are involved in the juvenile justice system. The four brief can be downloaded from the publications page of the NCMHJJ website at www.ncmhjj.com. The title and descriptions of the brief, from information distributed by NCMHJJ, are as follows:
A Blueprint for Change: Improving the System Response to Youth with Mental Health Needs Involved with the Juvenile Justice System, written by Kathleen Skowyra and Joseph J. Cocozza, Ph.D. This brief provides an overview of the National Center for Mental Health and Juvenile Justice's report "Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth with Mental Health Needs in Contact with the Juvenile Justice System", summarizing the key features of the Blueprint, including the Underlying Principles, Cornerstones, and Critical Intervention Points. The brief also highlights some of the Program Examples featured in the Blueprint.
Youth with Mental Health Disorders in the Juvenile Justice System: Results from a Multi-State Prevalence Study, written by Jennie L. Shufelt, M.S. and Joseph J. Cocozza, Ph.D. This brief discusses the key findings from a multi-state study of the prevalence of mental health disorders among youth in the juvenile justice system.
Juvenile Mental Health Courts: An Emerging Strategy, written by Joseph J. Cocozza, Ph.D. and Jennie L. Shufelt, M.S. This brief summarizes the results of a recent National Center for Mental Health and Juvenile Justice survey of juvenile mental health courts, and discusses some of the key issues surrounding the growing use of these courts.
Juvenile Diversion: Programs for Justice-Involved Youth with Mental Health Disorders, written by Kathleen Skowyra and Susan Davidson Powell, M.A. This brief provides an overview of the current state of juvenile diversion for youth with mental health disorders, reviewing the key findings from a National Center for Mental Health and Juvenile Justice survey of diversion programs, and providing an overview of promising program models for diverting youth with mental disorders.
SAMHSA Announcements
Among the many SAMHSA announcements this month are three on methamphetamine, which NACBHD has identified as a critical issue facing counties.
From a September 29 press release:
Methamphetamine Use Varies Widely Across States and Remains Highest Among Young Adults
A new study from SAMHSA continues to show that individuals in the 18-25 age group are the most likely to be using methamphetamine. The NSDUH Report: State Estimates of Past Year Methamphetamine Use is based on data combined from the last four years of the National Survey on Drug Use and Health. The combined data from more than 250,000 people who were surveyed for this report give a more detailed picture of who is using the drug than in previous SAMHSA reports and marks the first time that SAMHSA has provided data by age groups within states for methamphetamine use. "This information is important for policy makers, prevention and treatment specialists and for anyone concerned with the spread of methamphetamine use throughout the country," said Assistant Surgeon General Eric Broderick, D.D.S., M.P.H., SAMHSA Acting Deputy Administrator. "The more information we have about the users of this drug and their location, the better we are able to place resources in the areas where they are needed most."
While methamphetamine has garnered significant attention in the media and in Congress, the actual numbers of users are quite small compared to other drugs such as marijuana (1.3 million vs. 25.4 million users in 2005). This new report and the expanded data set are not only able to draw finer distinctions of methamphetamine use among states, dividing the prevalence rates into five levels from the very highest in Nevada, Montana, and Wyoming to the very lowest in Connecticut, Maryland, Massachusetts, New Jersey, and New York, but also to illuminate the differences in usage among various age groups. The report is available on the web at www.oas.samhsa.gov.
From a September 29 press release:
$10 Million Awarded to Fight Methamphetamine in Rural America
SAMHSA has announced the award of seven grants, totaling nearly $10 million over three years, to provide treatment for methamphetamine abuse and other emerging drugs for adults residing in rural communities. These new grants, and 17 previously awarded through this program in 2004 and 2005, support substance abuse treatment in areas among the hardest hit by methamphetamine abuse over the past decade, enabling rural communities to provide more comprehensive, integrated care for adults using methamphetamines or other emerging drugs of abuse. While the number of past year users of methamphetamine aged 12 or older has significantly declined in the past year (0.7 percent in 2002 to 0.5 percent in 2005), the number of persons seeking treatment for methamphetamine abuse has increased dramatically according to SAMHSA surveys. Non-urban and rural areas, in particular, have difficulty meeting treatment needs. "Methamphetamine abuse has leveled off or declined recently, but its effects continue to be seen primarily in smaller communities and rural areas across the country," said Assistant Surgeon General Eric Broderick, DDS, MPH, Acting Deputy Administrator of SAMHSA. "As with other illicit drug use, methamphetamine abuse can be treated. People can, and do, recover. These grants can help individuals abusing methamphetamines get the help they need where they need it."
The new targeted capacity grants awarded today are part of SAMHSA's overall effort to help states and local communities identify and address through both treatment and prevention new and emerging trends in substance abuse. The seven awards are for up to $500,000 in the first year and are renewable for up to three years. The total funding for 2006 is $3.365 million. Continuation of these awards is subject to both availability of funds and progress achieved by awardees. Grants were made to:
California: Yolo County, Woodland -- $500,000 in first year funding will support a county-wide program, designed to engage all providers of residential and outpatient alcohol and drug treatment services to meet the treatment needs of adult methamphetamine abusers. The program will use the Assertive Community Treatment (ACT) model that emphasizes aggressive case management and treatment services.
Georgia: Administrative Office of the Courts, Atlanta, -- $369,782 in the first year to better enable communities to provide a more comprehensive, integrated, treatment and recovery service-oriented response to the increasing problem of methamphetamine use by adults in underserved rural northwest Georgia.
Illinois: Illinois Department of Children and Family Services, Springfield -- $500,000 in the first funding year will enable the Southern Illinois Methamphetamine Project to expand outpatient treatment for adult methamphetamine users in rural Southern Illinois. This project will serve adults in four contiguous rural counties that have had difficulty matching treatment capacity to service need.
Iowa: City of Cedar Rapids Development Department - $499,969 in the first year to expand and enhance methamphetamine treatment services provided by the Cedar Rapids Methamphetamine Clinic, including the provision of outpatient, residential and wrap-around supportive services to indigent individuals who are abusing methamphetamine.
Kentucky: Kentucky Justice and Public Safety Cabinet- $500,000 in the first year to provide integrated, community-based mental health services, substance abuse treatment and recovery support through assertive community efforts under the Assertive Community Living for Appalachian Dual-Diagnosed Adults program for adults with co-occurring substance abuse and severe mental disorders.
Oregon: Yamhill County Chemical Dependency, McMinnville -- $495,674 in the first year to expand capacity to provide treatment to adult individuals diagnosed with methamphetamine dependency. The program will maintain an aggressive posture toward ongoing client engagement in treatment and recovery, including those individuals referred to treatment through the criminal justice system.
Virginia: Department of Mental Health, Mental Retardation and Substance Abuse, Richmond -- $500,000 in first year funding will support Project REMOTE that will expand capacity and access to treatment for methamphetamine abuse by adults in rural southwest Virginia. The project will implement an enhanced service model, developed with community input, which integrates pharmacologic therapies with behavioral interventions, linkages to treatment following detoxification, and recovery support to sustain positive treatment effects.
From a September 29 SAMHSA press release:
SAMHSA Awards $10.1 Million in Grants to Prevent Methamphetamine Abuse
SAMHSA has announced the award of 10 grants, totaling over $10.1 million over three years, to help local communities expand evidence-based substance abuse prevention programs and systems to stop abuse of methamphetamine. SAMHSA data have found that admissions to treatment for methamphetamine abuse have increased nationally, moving across the country from West to East. States in the Midwest and South that had few admissions due to methamphetamine/amphetamine abuse in 1993 are now experiencing high rates of admissions. Methamphetamine/amphetamine admissions have increased nationally in the decade from 1993-2003, from 13 to 56 admissions per 100,000 population ages 12 and older. "Methamphetamine is a uniquely destructive drug, both for those using it and for those living near its production sites, said Assistant Surgeon General Eric Broderick, D.D.S., M.P.H., Acting Deputy Administrator of SAMHSA. "While the rates of methamphetamine use and numbers of new users have declined recently, experience reminds us that complacency is not an option. Prevention remains our first line of defense. These grants can help local communities continue to drive down the use of methamphetamine and prevent it from ever being used in the first place."
Grant recipients are using these awards in a number of ways, such as implementing evidence-based community prevention programs that target populations at greatest risk for methamphetamine abuse; training and education of professionals, educators, law enforcement personnel, families and others about the signs of methamphetamine abuse and prevention options; and testing and evaluating pilot programs focused on drug-endangered children.
The 10 awards are for up to $350,000 in the first year and are renewable for up to three years in all. Total funding for 2006 is just over $3.4 million. Continuation of these awards is subject to both availability of funds and progress achieved by awardees. Grants were made to:
Colorado: State Judicial Branch/State Court Administration, Denver -- $348,354 in first-year funding to engage justice-involved youth of methamphetamine-abusing parents and their families in a comprehensive substance abuse prevention program designed to prevent methamphetamine abuse and addiction. The program will help build a coordinated community methamphetamine prevention strategy in Denver.
Illinois: Cra-Wal-La Volunteers in Probation, Inc., Lawrenceville -- $326,063 in first-year funding to develop a methamphetamine prevention program targeting youth in rural Southeastern Illinois who are at risk for methamphetamine abuse or living in areas of high methamphetamine production or trafficking.
Massachusetts: Fenway Community Health Center, Boston -- $349,941 in the first year to implement the New Champions Project in Boston, an evidence-based methamphetamine prevention intervention focused on adult men who have sex with other men.
Oklahoma: Cherokee Nation, Tahlequah -- $350,000 in first-year funding to forge a comprehensive, community-base, integrated system to prevent methamphetamine abuse for American Indian children and adolescents. The preventive intervention will be culturally appropriate, use known-effective program elements, and engage the active participation of community members in development and implementation.
Department of Mental Health and Substance Abuse Services, Oklahoma City -$350,000 in the first year to enable the state to help communities expand existing, known-effective substance abuse prevention interventions, emphasizing methamphetamine abuse. The program will increase both state and local capacity through infrastructure development.
Oregon: Native American Rehabilitation Association of NW, Inc., Portland -- $350,000 in the first year to implement Raising Our Seventh Generation, a pilot program to identify innovative methodologies to prevent, reduce or delay methamphetamine abuse among young Native American children whose parents are in treatment for methamphetamine abuse, including culturally relevant program components to develop or strengthen known protective factors for young children at risk of drug use.
Tennessee: Centerstone Community Mental Health Centers, Inc., Nashville -- $350,000 in the first year to provide a culturally sensitive, community-based prevention program of outreach and education to adults and youth at risk for methamphetamine abuse in a rural Appalachian area in which methamphetamine production, trafficking and abuse has been outpacing law enforcement capacity and endangering the health of area inhabitants.
Ridgeview Psychiatric Hospital and Center, Inc., Oak Ridge -- $319,977 in first-year funding for the Meth P.I. Program to implement alternative school-based prevention programs focused on adolescents at high risk for methamphetamine use, employing Project SUCCESS, a school-based model from SAMHSA's National Registry of Evidence-based Programs and Practices, modified for particular emphasis on prevention of methamphetamine use.
Texas: San Antonio Fighting Back, Inc., San Antonio - $348,000 in the first year to support methamphetamine use prevention through a school-based program for youth and their families built on the evidence-based Project Success, a model project in SAMHSA's National Registry of Evidence-based Programs and Practices. In addition, both juveniles and adults in drug courts, and their families, will be served by accessing recovery support service vouchers from the Texas Access to Recovery program.
Washington: University of Washington, Seattle -- $308,655 in first year funding to pilot test and evaluate an innovative intervention for prenatal methamphetamine exposure, using an evidence-based parent-child model, that works with both the mother who has either used or been exposed to methamphetamine and her infant who has been exposed prenatally to the drug.
From a September 6 SAMHSA press release:
SAMHSA Awards $9.8 million for Peer to Peer Recovery Support Services
SAMHSA announced the award of seven Recovery Support Services grants totaling $9.8 million over four years. These grants to community-based organizations are designed to deliver and evaluate peer-to-peer recovery support services that help prevent relapse and promote sustained recovery from alcohol and drug use disorders.
"Peer recovery support services are expected to extend and enhance the treatment continuum," said Assistant Surgeon General Eric Broderick, D.D.S., M.P.H., SAMHSA's Acting Deputy Administrator. "These grants will help prevent relapse and maximize the opportunities to create a lifetime of recovery and wellness for self, family, and community. And, when individuals do experience relapse, recovery support services can help minimize the negative effects and if needed make sure there is an appropriate referral to treatment."
The seven awards in five states are funded up to $350,000 per year in total costs. Continuation of these awards is subject to the availability of funds as well as the progress achieved by the grantees. Total funding for year one is $2.4 million.
The Recovery Community Services Program grantees are as follows:
Arizona: Pima Prevention Partnership, Tucson -- $350,000 to recruit and train a 10-member core group of peer leaders in recovery, who will develop and implement the service infrastructure in four months. Recovery Services will be offered at the partnership's Learning Center and offer peer-led emotional, informational, instrumental and affiliation support services five afternoons/evenings per week, including Saturdays.
Tohono O'odham Nation, Sells -- $350,000 to implement a comprehensive peer-to-peer system to support individuals in recovery with a full range of recovery support services provided locally in the 11 districts that make up the federally recognized tribe, which has $350,000 per year to provide peer-led support services that help sustain Atlanta's inner city addiction recovery community. The one of the highest rates of substance abuse among all populations in the United States.
Georgia: Recovery Consultants of Atlanta, Inc. -- program will provide a recovery center offering more than 40 weekly 12-step, faith-based, health-specific (HIV and Hepatitis C, a liver disease), gender-specific and family-specific support groups.
New York: National Alliance of Methadone Advocates, Inc., New York City -- $349,998 per year to provide peer-to-peer recovery support services to patients of the Albert Einstein College of Medicine's Methadone Maintenance Treatment Programs. The overall goal is to create a climate for recovery among a population usually neglected by the larger recovery community. Center for Community Alternatives, Inc., Syracuse -- $350,000 per year to develop a network of peer-lead community services for individuals in recovery and who also have past criminal justice involvement. The project will extend services into two additional cities, Rochester and Albany.
Oklahoma: Oklahoma CART System, Oklahoma City-- $350,000 per year to implement Sister to Sister, the states first model of peer-driven substance abuse recovery support services for women in Oklahoma County. This project expects to serve over 580 women in all stages of recovery and their children.
Texas: El Paso Alliance, Inc., El Paso-- $350,000 per year to enable the Recovery Alliance to improve existing services and support the development of new ones through a peer recruiting and retention system.
From a September 7 SAMHSA press release:
Youth Drug Use Continues Downward Slide Older Adult Rates of Use Increase
SAMHSA has announced that current illicit drug use among youth ages 12-17 continues to decline. The rate has been moving downward from 11.6 percent using drugs in the past month in 2002 to 11.2 percent in 2003, 10.6 percent in 2004 and 9.9 percent in 2005. This initial report from the 2005 National Survey on Drug Use and Health (NSDUH), released at the annual observance of National Alcohol and Drug Addiction Recovery Month Observance, focuses on significant trends in substance abuse and mental health problems since 2002. Similarly, the rate of current marijuana use among youth ages 12 to 17 declined significantly from 8.2 percent in 2002 to 6.8 percent in 2005, and the average age of first use of marijuana increased from under age 17 in 2003 to 17.4 years in 2005. Furthermore, drinking among teens declined, with 16.5 percent of youth ages 12-17 reporting current alcohol use and 9.9 percent reporting binge drinking. This compares with 17.6 percent of this age group reporting drinking in 2004 and 11.1 percent reporting binge drinking in the past month in 2004. These declines in alcohol use by youth, ages 12-17, follow years of relatively unchanged rates.
The baby boomer generation presents a different story. Among adults aged 50 to 59, the rate of current illicit drug use increased from 2.7 percent to 4.4 percent between 2002 and 2005, reflecting the aging into this age group - the baby boom cohort.
"The trends among young people are encouraging," said Health and Human Services Secretary Mike Leavitt. We know prevention activities must start with our children. There is more to be done and we must build on our work to ensure that children and their parents understand that they must live free of drugs and alcohol to be healthy. "Something important is happening with American teens," said John P. Walters, Director of National Drug Control Policy. "They are getting the message that using drugs limits their futures, and they are turning away from the destructive patterns and cruelly-misinformed perceptions about substance abuse that have so damaged previous generations." "The news today is there is a fundamental shift in drug use among young people in America," said Assistant Surgeon General Eric B. Broderick, D.D.S., M.P.H., SAMHSA Acting Deputy Administrator. We first saw this shift towards healthier decisions when rates of tobacco use among young people began to go down. Now, we see a sustained drop in rates of drug use. We will see if the decline in drinking among 12 to 17 years olds becomes a continued pattern as well.
For young adults, ages 18-25, the picture is mixed. While there were no significant changes in overall past month use of any illicit drugs in this age group between 2002 and 2005, cocaine use increased from 2.0 in 2002 to 2.6 percent in 2005. Past-month nonmedical use of prescription drugs among young adults increased from 5.4 percent in 2002 to 6.3 percent in 2005, due largely to an increase in the nonmedical use of narcotic pain relievers. The rate was 4.1 percent in 2002 and 4.7 percent in 2003, 2004 and 2005.
Marijuana
The survey shows there were 14.6 million past month users of marijuana in 2005. Among those ages 12 and older, the rate of past-month marijuana use was about the same in 2005 (6.0 percent) as in 2004 (6.1 percent), 2003 (6.2 percent) and 2002 (6.2 percent).
Prescription Drugs
There were 6.4 million persons ages 12 or older (2.6 percent) who used prescription drugs nonmedically in the past month. Of these, 4.7 million used narcotic pain relievers, 1.8 million used tranquilizers, 1.1 million used stimulants (including 512,000 who used methamphetamine) and 272,000 used sedatives. Each of these estimates is similar to the estimates for 2004. Those who used prescription drugs nonmedically were asked how they obtained the drugs they used most recently. In 2005, the prevalent source for drugs used nonmedically was from a friend or relative for free. (59.8percent). Another 16.8 percent reported getting the drug from one doctor, while 4.3 percent reported getting narcotic pain relievers from a drug dealer or other stranger, and 0.8 percent reported buying the drug on the internet.
Methamphetamine
From 2002 to 2005, decreases were seen in lifetime (5.3 to 4.3 percent) and past year (0.7 to 0.5 percent) methamphetamine use, but not past month use (0.3 percent in 2002 vs. 0.2 percent in 2005) for those aged 12 or older. Although the number of past month users has remained steady since 2002, the number of methamphetamine users who were dependent on or abused some illicit drug did rise significantly during this period, from 164,000 in 2002 to 257,000 in 2005. The number of recent new users of methamphetamine, aged 12 or older, was 192,000 in 2005. Between 2002 and 2004, the number of methamphetamine initiates remained steady at around 300,000 per year, but there was a decline from 2004 (318,000 initiates) to 2005.
Cocaine
The rate of cocaine use was not statistically different between 2004 and 2005 (0.8 percent to 1.0 percent) and has remained unchanged since 2002.
Heroin
There was no significant change in the number of current heroin users in 2005 (136,000), nor in the rate of heroin use (0.1 percent), compared with estimates from 2004, 2003, and 2002.
Alcohol
More than one fifth (22.7 percent) of persons ages 12 and older participated in binge drinking in 2005, defined as having five or more drinks on the same occasion on at least one day in the 30 days prior to being surveyed. This translates as about 55 million people, comparable to the 2004 estimate. The binge drinking rate among young adults ages 18-25 was 41.9 percent, and the heavy drinking rate was 15.3 percent. In 2005, 6.6 percent of the population ages 12 and older (16 million people) engaged in heavy drinking. This rate is similar to the reported ate of 6.9 percent in 2004. Heavy drinking is defined as binge drinking on at least five days in the past 30 days. About 10.8 million persons ages 12-20 (28.2 percent) reported past month alcohol use in 2005. Nearly 7.2 million of these underage drinkers (18.8 percent) were binge drinkers and 2.3 million (6.0) were heavy drinkers. These figures have remained essentially the same since 2002. Most of the new initiates to alcohol use (88.9 percent) were younger than 21 at the time of initiation.
Tobacco
In 2005 there were an estimated 71.5 million Americans ages 12 and older who were current users of a tobacco product. Of these 60.5 million were current cigarette smokers; 13.6 million smoked cigars; 7.7 million used smokeless tobacco; and 2.2 million smoked tobacco in pipes. Between the years 2002 and 2005 past-month use of a tobacco product declined from 30.4 percent to 29.4 percent, and past-month cigarette use decreased from 26.0 percent to 24.9 percent. The rate of past month cigarette use among youth ages 12-17 declined from 13.0 percent in 2002 to 10.8 percent in 2005. There were also declines in use of cigars in this age group.
Prevention Measures
Current marijuana use was much less prevalent among youths who perceived strong parental disapproval for trying marijuana or hashish once or twice than for those who did not (4.6 percent vs. 27.0 percent). Over 90 percent of youths report that their parents would strongly disapprove of this behavior.
Substance Dependence or Abuse
In 2005, an estimated 22.2 million persons (9.1 percent of the population ages 12 and older) were classified with substance dependence or abuse in the past year, based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Of these, 3.3 million were dependent on or abused both alcohol and illicit drugs; 3.6 million were dependent on or abused illicit drugs but not alcohol; and 15.4 million were dependent on or abused alcohol, but not illicit drugs. These numbers are basically unchanged since 2002. There were 2.3 million people who received treatment at a specialty facility in 2005. There were 1.2 million persons who reported that they felt they needed treatment for an illicit drug or alcohol use problem, but of these 865,000 reported making no effort to get treatment. There were 296,000 who reported they had made an effort to get treatment. These numbers were not statistically different from the numbers in the 2004 survey.
Adults ages 21 or older who had first used alcohol before age 21 were almost 5 times more likely than adults who had their first drink at age 21 or older to be classified with alcohol dependence or abuse (9.6 percent compared to 2.1 percent).
Driving Under the Influence
In 2005, an estimated 13.0 percent of persons ages 12 and older (31.7 million persons) drove under the influence of alcohol at least once in the past year. This percentage has dropped since 2002, when it was 14.2 percent.
Co-occurring Substance Use and Serious Psychological Distress
Serious psychological distress, as measured by the survey administered to adults ages 18 and older, was associated with past year substance dependence or abuse in 2005. Among the 24.6 million adults with serious psychological distress in 2005, 21.3 percent (5.2 million) were dependent on or abused illicit drugs or alcohol. The rate of substance dependence or abuse among adults without serious psychological distress was 7.7 percent (14.9 million people). Among the 5.2 million adults with both serious psychological distress and substance dependence or abuse in 2005, 47 percent received mental health treatment or substance use treatment at a specialty facility: 8.5 percent received both treatment for mental health and substance use disorder, 34.3 percent received only treatment for mental health problems, and 4.1 percent received only specialty substance use treatment.
Depression
There were 30.8 million adults who had at least one major depressive episode in their lifetime, and 15.8 million adults (7.3 percent of persons ages 18 and older) who reported a major depressive episode in the past year. This is a statistically significant decline from 17.1 million adults (8 percent) reporting past year major depressive episodes in 2004. Having a major depressive episode in the past year was associated with past year substance dependence or abuse. Among adults in 2005, 19.9 percent were dependent on or abused alcohol or illicit drugs, while among persons without a major depressive episode only 8.4 percent were dependent on or abused alcohol or illicit drugs. In 2005 there were 3.4 million youths ages 12 to 17 (13.7 percent of that population) who had at least one major depressive episode in their lifetimes and 2.2 million youths (8.8 percent) who had a major depressive episode during the past year. The occurrence of a major depressive episode in the past year among youths ages 12 to 17 was associated with a higher prevalence of illicit drug or alcohol dependence or abuse (19.8 percent). This compares to 6.9 percent for youths who did not report past-year major depressive episodes.
The National Survey on Drug Use and Health is an annual survey of approximately 67,500 people. The survey collects information from residents of households, residents of non-institutionalized group quarters and civilians living on military bases.
Recovery Month is observed in September to recognize the accomplishments of people in recovery, the contributions of treatment providers, and advances in substance abuse treatment. This year is the 17th annual observance. The theme "Join the Voices for Recovery: Build a Stronger, Healthier Community," emphasizes that addiction to alcohol and drugs is a chronic, but treatable, public health problem that affects everyone in the community.
The National Survey on Drug Use and Health is available on the web at http://oas.samhsa.gov/. Electronic versions of Recovery Month materials are available at www.recoverymonth.gov.
From a September 22 SAMHSA press release:
ADHD Medication Misuse by Those Aged 12 to 17 Results in Higher Number of Visits to Emergency Department
People ages 18 to 25 have a higher rate of nonmedical use of the two medications used to treat attention-deficit/hyperactivity disorder (ADHD), but those 12 to 17 may be at greater risk for adverse health effects, particularly from nonmedical use, a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows.
The latest Drug Abuse Warning Network (DAWN) Report, Emergency Department Visits Involving ADHD Stimulant Medications, explains that during 2004 almost 8,000 visits to the emergency department involved methylphenidate (marketed as Ritalin or Concerta) or amphetamine-dextroamphetamine (marketed as Adderal), two medications used to treat ADHD. The rates of emergency department visits resulting from use of either of these two drugs by patients aged 12 to 17 were higher in 2004 than the rates for patients aged 18 or older. In addition, the data suggest that polydrug use-one or more drugs being used in addition to ADHD medication-was common in the emergency department visits involving the misuse of ADHD medication and may increase the possible health risks.
"These findings suggest an alarming level of nonmedical use that could have life-threatening consequences, such as heart attack or stroke. Parents need to help break this dangerous pattern of behavior by carefully monitoring their child's use of ADHD medication," said Assistant Surgeon General Eric Broderick, D.D.S., M.P.H., SAMHSA Acting Deputy Administrator.
For patients aged 12 to 17 taking methylphenidate for medical use, there were 1.6 visits to the emergency department per 100,000 people in this age group, compared to 0.4 visits per 100,000 people in the18 to 24 age group. Among the emergency department visits related to the nonmedical use of methylphenidate, there were 1.7 visits per 100,000 people in the12 to 17 age group, compared to 1.0 per 100,000 people in the18 to 24 age group.
For patients aged 12 to17 taking amphetamine-dextroamphetamine for medical use, there were 1.2 visits to the emergency department per 100,000 people in this age group compared to 0.6 per 100,000 people in the 18 to 24 age group. The rate of emergency department visits involving nonmedical use of this drug was 2.8 visits per 100,000 people aged 12 to 17, compared to 1.7 visits per 100,000 people aged 18 to 24.
For all age groups reporting nonmedical use of ADHD medications, 32 percent of patients had ingested the ADHD medication alone. For the 68 percent using one or more drugs in addition to the ADHD medication, 20 percent reported using alcohol, 26 percent used an illicit drug, and 57 percent used another pharmaceutical.
Findings from another SAMHSA report, the National Survey on Drug Use and Health, have shown that those aged 18 to 25 had a higher rate of nonmedical use of ADHD stimulant medications than those who were younger or older, largely because college students, who fall within this age group, are believed to use these drugs for their stimulant properties as study aids.
A January 2006 Food and Drug Administration advisory panel recommended that ADHD medication carry a warning of an increased potential for cardiac problems, such as hypertension, cardiac arrests, and stroke. The possibility of experiencing medical problems may be exacerbated by using ADHD medication improperly or in combination with other drugs.
The National Survey on Drug Use and Health shows that nonmedical use of ADHD stimulant medications is still relatively low (0.3 percent of the population aged 12 or older during the past year). This new DAWN report examines the reasons for the ED visits and the relative frequency of these visits for different age groups.
SAMHSA's Drug Abuse Warning Network (DAWN) is a public health surveillance system that measures some of the health consequences of drug use by monitoring drug-related visits to hospital emergency departments. The short report is available on the web at www.oas.samhsa.gov.
From a September 14 SAMHSA press release:
SAMHSA Awards $25.7 Million in Suicide Prevention Grants to Universities, States
SAMHSA has announced the award of 46 grants, totaling $25.7 million to support a broad array of activities across the country to prevent suicide, enhance services for youth depression, other mental health problems, and substance abuse that put them at risk for suicide.
Suicide is a preventable tragedy for individuals, for families and for communities," said Assistant Surgeon General Eric Broderick, DDS, MPH, Acting Deputy Administrator of SAMHSA. These grants to programs across the country are an important part of the solution to suicide in our nation. Education about suicide risk factors, such as depression and drug abuse, is another part of the solution. So is early intervention, such as our national suicide prevention lifeline, 1-800-273-TALK. By working on suicide prevention in schools and on athletic fields, in workplaces and places of worship, and at home, we can save thousands of lives.
The grants are being awarded under both the Campus Suicide Prevention Grant program, with up to $75,000 per year for up to 3 years, and the State-Sponsored Youth Suicide Prevention and Early Intervention Program, with up to $400,000 per year for up to 3 years. The former program, funded for $2.3 million in 2006, assists colleges and universities in their efforts to prevent suicide and to enhance services for students with mental health problems and substance abuse that place them at risk for suicide. The latter program, with almost $4.8 million in 2006 funding, supports statewide and tribal activities to develop and implement youth suicide prevention and early intervention strategies that are grounded in collaborations between the public and private sectors.
In addition, SAMHSA has made almost $1 million in supplemental grant funds available this year to the ongoing National Suicide Prevention Resource Center that provides training, resources and prevention support information to organizations and individuals developing suicide prevention programs, interventions and policies. Similarly, SAMHSA supplemental funds of $369,000 in 2006 will continue the grant program that manages the National Suicide Prevention Lifeline and networks and certifies local suicide prevention hotlines that are linked to the National Lifeline. Combined 2006 funding for all of these suicide prevention grant programs is $8.5 million. Continuation of these awards is subject to both availability of funds and progress achieved by awardees.
For a complete list of the 34 Campus Suicide Prevention grants support programs, see the press release at www.samhsa.gov.
Recipients of 2006 grants under the State-Sponsored Youth Suicide Prevention and Early Intervention Program are:
Arizona: Tohono odham Nation, Sells -- $400,000 in first-year funding to implement a public private partnership-built program to address the risk factors leading to youth suicide, including substance abuse, using evidence-based practices appropriate to the Tohono Oodham Nation.
Colorado: Colorado Department of Public Health and Environment, Denver -- $400,000 in the first year to build a comprehensive suicide prevention that targets adolescents and young adults at heightened risk for suicidal behaviors, including a public awareness campaign and a training initiative that results in the establishment of safety nets of adults and peers able to recognize and respond to warning signs of suicide in four counties and on the campus of the University of Colorado at Boulder.
Kentucky: Kentucky Cabinet for Health and Family Services, Frankfort -- $400,000 in first-year funding to undertake a statewide effort to raise awareness, enhance effective interventions and utilize research and data collection methodologies to reduce the number of successful suicides by youth in the state. The effort will include not only public and professional education about risk factors for suicide and protective factors to help prevent suicide but also training in prevention, early intervention and post-intervention.
Maryland: White Mountain Apache Tribe, in collaboration with Johns Hopkins University, White River -- $400,000 in the first year to collaborate to expand its suicide prevention initiative by implementing an integrated three-tier suicide prevention approach using culturally adapted, piloted and evaluated evidence-based interventions that address youth suicide risk and protective factors on the individual, family and community levels. Tier one focuses on community education about suicide risk factors and prevention. Tier two addresses the needs of youth with suicide risk factors. Tier three serves youth who have attempted suicide.
Michigan: Michigan Department of Community Health, Lansing -- $400,000 in the first year to enable programs and individuals to expand suicide prevention efforts in the state, with a focus on primary prevention and early intervention, by supporting community efforts to better coordinate service delivery, providing a cadre of trainers expert in gatekeeper and professional training on suicide prevention, undertaking a suicide prevention health communication campaign to reach 19-24 year olds not in academic settings and building an even more coordinated state suicide prevention infrastructure.
North Dakota: North Dakota Department of Health, Bismarck-- $400,000 in first-year funding to reduce and sustain the reduction of youth suicide mortality in high-risk areas of the state by implementing community-based programs, both in communities and on campuses with high rates of youth suicide mortality, providing population-based training about risk factors for suicide and intervention strategies, and increasing public awareness about youth suicide in the state. Standing Rock Sioux Tribe, Fort Yates $400,000 in the first year to implement Okolakiciye Unyukinipi that will bring together tribal leaders, service providers, youth and faith community leaders to implement a comprehensive tribal youth suicide prevention and early intervention plan that will identify and increase youth referral to mental health services and programs, increase protective factors and reduce risk factors for youth suicide, and improve access to prevention and early intervention programs.
Ohio: Ohio State University Research Foundation, Columbus -- $399,873 in the first year to assist state suicide prevention programs with training to initiate or expand research-based, culturally competent approaches to early intervention of youth at risk for suicide and those who may be experiencing undiagnosed, untreated mental disorders. Parent-approved risk assessment will be made available for youth ages 11-18. To increase the number of trained professionals in suicide assessment, the trainer's approach will be implemented for qualified personnel in the state.
South Dakota: State of South Dakota, Pierre-- $400,000 in the first year to implement suicide prevention and early intervention programs in high schools and universities targeting youth ages 14-24, parents, staff and community gatekeepers providing awareness, training and education and establishing linkages among schools, mental health centers and substance abuse treatment providers through referral and post-intervention protocols. Among the partners are Sinte Gelska University on the Rosebud Indian Reservation and Wakanyeja Pawicayapi on the Pine Ridge Indian Reservation.
Washington: Washington State Department of Health, Olympia-- $400,000 in first-year funding to reduce suicides among high-risk groups, including Native American youth by establishing and sustaining a statewide coalition to coordinate prevention activities and to provide opportunities for traditional and nontraditional partners to collaborate on suicide prevention strategies, by implementing specific strategies targeting youth suicide with Native American- and youth-serving organizations, and by implementing evidence-based suicide prevention strategies on university campuses across the state.
