The Substance Abuse and Mental Health Services Administration (SAMHSA) and its parent agency, the U.S. Department of Health and Human Services (HHS), invited representatives from more than 40 U.S. states and territories to New York City in mid-November for a three-day national summit— "When Terror Strikes: Strengthening the Homeland Through Recovery, Resilience, and Readiness." The representatives were teams of agency administrators, providers, and consumer advocates selected by their governors. The purpose of the summit was to provide a forum for attendees to share the knowledge they have gained from dealing with disasters in their home states and to begin planning a mental health response to terrorism to be incorporated into each state's emergency management plan.
In opening remarks to more than 600 participants, Charles G. Curie, administrator of SAMHSA, said, "We're seeking equilibrium between how much of what we're facing is new and uncharted territory and how much of our past experiences can be instructive today…. In our fields of mental health and substance abuse, we're searching for that fine line that needs to be tread if we are to serve the people with the most serious illnesses for whom our mandate was created, and to reach the people whose mental health is being challenged—perhaps for the first time—by their capacity to adapt to the new reality in America."
In the keynote address, HHS Secretary Tommy G. Thompson stated, "One fact has become abundantly clear to us in the wake of September 11. Mental health support must be an integral part of emergency preparedness and our public-health infrastructure." Thompson spoke of the importance of partnerships between community organizations, a theme that was echoed in many of the plenary sessions and workgroups. He emphasized that the response plans will build on cooperative efforts that already exist.
In addition to the planning work groups, the summit featured sessions on early assessment and treatment of traumatic stress disorders; media relations during public health crises; peer support networks for personnel who are the first to respond to disasters; inclusion of faith-based organizations as partners in emergency response plans; ensuring cultural competency and civil rights in disaster response; building resilience among children; bioterrorism and its impact on behavioral health; and the need for research on and evaluation of disaster readiness plans.
The summit ended with a "listening session" for representatives of HHS agencies, during which participants gave an overview of some of their recommendations. SAMHSA Administrator Curie urged participants to convene team meetings in their states soon after they returned home.
The American Psychiatric Association was represented at the summit by Darrel Regier, M.D., M.P.H., director of APA's office of research, and Spencer Eth, M.D., of St. Vincent's Hospital in New York City. APA members who wish to have input into state response plans are encouraged to contact their APA District Branch. Contact information is available on the APA Web site at www. psych.org.
In December the Substance Abuse and Mental Health Services Administration (SAMHSA) announced its approval of four organizations to accredit substance abuse treatment programs that use methadone and other medications to treat heroin addiction. The four organizations are the Commission on Accreditation of Rehabilitation Facilities, the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation for Children and Family Services, and the State of Washington Department of Social and Health Services Division of Alcohol and Substance Abuse.
Selection of the organizations is part of an ongoing SAMHSA initiative to improve the availability of treatment for heroin addiction and the quality of oversight of opioid treatment. Implementation of the new accreditation process comes in the wake of an announcement in November that U.S. drug officials are preparing for an increase in the availability of heroin as a result of the U.S. military campaign in Afghanistan. A SAMHSA news release acknowledged that since the Taliban's loss of control to the Northern Alliance, farmers are ignoring last year's ban, imposed by the Taliban, on poppy cultivation and that cultivation has already begun in two key growing areas of the country. Before the ban, Afghanistan produced 75 percent of the world's heroin. According to the SAMHSA news release, opium prices have been falling in Afghanistan, which means a buyer's market in Europe and North America. A Reuters report noted that the price for 4 kilograms of raw opium has dropped from a peak of $2,000 to $300.
The first step in SAMHSA's initiative to improve treatment of the estimated 200,000 to 1 million untreated heroin addicts in the United States was the passage in October 2000 of the Drug Addiction Treatment Act, which permitted persons addicted to heroin to be treated in the privacy of a doctor's office rather than in highly regulated methadone clinics, as had been the practice for the previous 35 years (see Psychiatric Services, December 2000, pages 1583-1584). The legislation also allows doctors to prescribe buprenorphine, a promising new treatment drug that will be classified as a schedule IV controlled substance.
In announcing the selection of the accrediting process for opioid treatment programs, SAMHSA Administrator Charles G. Curie stated that accreditation will help reduce stigma and discrimination by moving treatment into mainstream medicine and will build community confidence in opioid treatment. SAMHSA officials also hope that accreditation will enhance the ability of treatment programs to contract with managed care organizations.
The Center for Substance Abuse Treatment, which oversees the accreditation program, is providing technical assistance to help programs meet the standards of the chosen accreditation body. Persons with questions about technical assistance should call 800-839-6120. Those with questions about federal regulations or the federal certification program should call 866-463-6687. Questions about the accreditation process for a given program should be directed to the accreditation organization the program has selected.
CMHS adds to series on child mental health: The Center for Mental Health Services (CMHS) has released three new volumes in its series called Systems of Care: Promising Practices in Children's Mental Health. The series examines promising practices in current use by CMHS grant sites that can be adapted by other sites to increase capacity to provide exemplary mental health services to the 3 to 4 million children in the United states who have serious emotional disturbances. Wraparound: Stories From the Field describes ten elements of the wraparound approach to individualizing mental health services and ensuring that needed services are provided. Learning From Families: Identifying Service Strategies for Success emphasizes key factors that enable families to be fully engaged in the systems of care developed for their children. Promising Practices in Early Childhood Mental Health identifies principles underlying effective early childhood services and describes strategies to incorporate these principles into community-based care. All 13 volumes in the series may be obtained free of charge by calling the CMHS Clearinghouse at 800-789-2647 or by visiting the CMHS Web site at www.cmhs.samhsa.gov and clicking on "Children's Campaign."
NAPHS releases 2002 directory: The National Association of Psychiatric Health Systems (NAPHS) has published its latest membership directory. The directory is a comprehensive referral resource providing information on the nation's behavioral health care systems. It is designed to help clinicians, admissions staff, employee assistance program directors, school counselors, legal system personnel, and others who must quickly identify sources of help for persons with psychiatric and addictive disorders. The directory includes each system's name, address, and telephone and fax numbers, along with the names of officers. The facilities operated by each system—including specialty hospitals, psychiatric units in general hospitals, residential treatment centers, partial hospital programs, and outpatient centers—are also listed. Copies of the 2002 NAPHS Membership Directory are available from the association for $35. To order, call 202-393-6700.
SAMHSA updates guide to treatment programs: The Substance Abuse and Mental Health Services Administration (SAMHSA) has released its updated National Directory of Drug and Alcohol Abuse Treatment Programs, a nationwide inventory of programs and facilities at the federal, state, and local levels as well as private facilities that are licensed, certified, or otherwise approved by substance abuse agencies in each state. Programs are listed for adolescents, individuals living with HIV-AIDS, and pregnant women, and the levels of care offered—hospital inpatient, residential, or outpatient—are described. Facilities listed in the directory provide assistance in 66 languages, including 37 American Indian and Alaska Native languages. The directory is organized and presented in a state-by-state format for quick-reference use by health care providers, social workers, managed care organizations, and the general public. This new volume complements SAMHSA's continuously updated Web-based Substance Abuse Treatment Facility Locator service at http://findtreatment.samhsa.gov. To obtain a free copy of the updated National Directory of Drug and Alcohol Abuse Treatment Programs, contact SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), P.O. Box 2345, Rockville, Maryland 20847, or call 800-729-6686.