Substance Abuse and Mental Health Services Administration

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United States Substance Abuse and Mental Health Services Administration
Substance Abuse and Mental Health Services Administration logo.png
Agency overview
FormedJuly 1992;26 years ago (1992-07)
Jurisdiction Federal government of the United States
Headquarters North Bethesda, Maryland (Rockville mailing address)
Agency executive
Parent department Department of Health and Human Services
Website www.samhsa.gov

The Substance Abuse and Mental Health Services Administration (SAMHSA; pronounced /ˈsæmsə/ ) is a branch of the U.S. Department of Health and Human Services. It is charged with improving the quality and availability of treatment and rehabilitative services in order to reduce illness, death, disability, and the cost to society resulting from substance abuse and mental illnesses. The Administrator of SAMHSA reports directly to the Secretary of the U.S. Department of Health and Human Services. SAMHSA's headquarters building is located outside of Rockville, Maryland.

Substance abuse substance use leading to significant impairment in functioning

Substance abuse, also known as drug abuse, is a patterned use of a drug in which the user consumes the substance in amounts or with methods which are harmful to themselves or others, and is a form of substance-related disorder. Widely differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behaviour occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well. In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.

United States Secretary of Health and Human Services

The United States Secretary of Health and Human Services is the head of the United States Department of Health and Human Services, concerned with health matters. The Secretary is a member of the President's Cabinet. The office was formerly Secretary of Health, Education, and Welfare.

Contents

History

The front of the SAMHSA building outside of Rockville, MD SAMHSA.jpg
The front of the SAMHSA building outside of Rockville, MD

SAMHSA was established in 1992 by Congress as part of a reorganization of the Federal administration of mental health services; the new law renamed the former Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA). ADAMHA had passed through a series of name changes and organizational arrangements throughout its history: [1]

The National Institute of Mental Health (NIMH) is one of 27 institutes and centers that make up the National Institutes of Health (NIH). The NIH, in turn, is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical and health-related research.

National Institutes of Health Medical research organization in the United States

The National Institutes of Health (NIH) is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1870s and is now part of the United States Department of Health and Human Services. The majority of NIH facilities are located in Bethesda, Maryland. The NIH conducts its own scientific research through its Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program.

Congress directed SAMHSA to target effectively substance abuse and mental health services to the people most in need and to translate research in these areas more effectively and rapidly into the general health care system. [2]

Charles Curie was SAMHSA's Director until his resignation in May 2006. In December 2006 Terry Cline was appointed as SAMHSA's Director. Dr. Cline served through August 2008. Rear Admiral Eric Broderick served as the Acting Director upon Dr. Cline's departure, [3] until the arrival of the succeeding Administrator, Pamela S. Hyde, J.D. in November 2009. [4] She resigned in August 2015 [5] and Kana Enomoto, M.A. served as Acting Director of SAMHSA [6] until Dr. Elinore F. McCance-Katz was appointed as the inaugural Assistant Secretary for Mental Health and Substance Abuse. [7] The title was changed by Section 6001 of the 21st Century Cures Act. [8]

Terry L. Cline is an American psychologist and public health policy specialist from Oklahoma. Cline resigned on October 30, 2017 from the Oklahoma State Department of Health. He has served in various positions under Governors of Oklahoma Frank Keating (R), Brad Henry (D), and Mary Fallin (R). Cline resigned his position after financial mismanagement was discovered.

Elinore McCance-Katz

Elinore F. McCance-Katz is an American physician, academic, and government official who currently serves as Assistant Secretary of Health and Human Services for Mental Health and Substance Use. Prior to assuming her current role, she was the chief medical officer for the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals and a professor at the Alpert Medical School at Brown University. Her nomination was supported by the American Psychiatric Association, which released a statement saying "Dr. McCance-Katz has a wealth of experience in academic and public sector settings in addressing mental health and substance use disorders."

21st Century Cures Act bill enacted by the 114th United States Congress

The 21st Century Cures Act is a United States law enacted by the 114th United States Congress in December 2016. It authorized $6.3 billion in funding, mostly for the National Institutes of Health. The act was supported especially by large pharmaceutical manufacturers and was opposed especially by consumer organizations.

Organization

SAMHSA's mission is to reduce the impact of substance abuse and mental illness on American's communities.

Four SAMHSA offices, called Centers, administer competitive, formula, and block grant programs and data collection activities: [9]

The Centers give grant and contracts to U.S. states, territories, tribes, communities, and local organizations. [9] They support the provision of quality behavioral-health services such as addiction-prevention, treatment, and recovery-support services through competitive Programs of Regional and National Significance grants. Several staff offices support the Centers: [10]

Center for Mental Health Services

The Center for Mental Health Services (CMHS) is a unit of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services. This U.S. government agency describes its role as:

The Center for Mental Health Services leads federal efforts to promote the prevention and treatment of mental disorders. Congress created CMHS to bring new hope to adults who have serious mental illness and children with emotional disorders. [11]

As of March 2016, the director of CMHS is Paolo del Vecchio. [11]

CMHS is the driving force behind the largest US children's mental health initiative to date, which is focused on creating and sustaining systems of care. This initiative provides grants (now cooperative agreements) to States, political subdivisions of States, territories, Indian Tribes and tribal organizations to improve and expand their Systems Of Care to meet the needs of the focus population—children and adolescents with serious emotional, behavioral, or mental disorders. The Children's Mental Health Initiative is the largest Federal commitment to children’s mental health to date, and through FY 2006, it has provided over $950 million to support SOC development in 126 communities.[ citation needed ]

Center for Substance Abuse Prevention

The Center for Substance Abuse Prevention (CSAP) aims to reduce the use of illegal substances and the abuse of legal ones. [12]

CSAP promotes self-esteem and cultural pride as a way to reduce the attractiveness of drugs, advocates raising taxes as a way to discourage drinking alcohol by young people, develops alcohol and drug curricula, and funds research on alcohol and drug abuse prevention. CSAP encourages the use of "evidence-based programs" for drug and alcohol prevention. Evidence-based programs are programs that have been rigorously and scientifically evaluated to show effectiveness in reducing or preventing drug use.

The current director of CSAP is Frances Harding.

CSAP was established in 1992 from the previous Office of Substance Abuse Prevention by the law called the ADAMHA Reorganization Act. [13] Defining regulations include those of Title 42. [14]

Center for Substance Abuse Treatment

The Center for Substance Abuse Treatment (CSAT) was established in October 1992 with a Congressional mandate to expand the availability of effective treatment and recovery services for alcohol and drug problems. CSAT supports a variety of activities aimed at fulfilling its mission:

CSAT works with States and community-based groups to improve and expand existing substance abuse treatment services under the Substance Abuse Prevention and Treatment Block Grant Program. CSAT also supports SAMHSA’s free treatment referral service to link people with the community-based substance abuse services they need. Because no single treatment approach is effective for all persons, CSAT supports the nation's effort to provide multiple treatment modalities, evaluate treatment effectiveness, and use evaluation results to enhance treatment and recovery approaches.

The current director of CSAT is Kimberly Johnson, Ph.D.

Center for Behavioral Health Statistics and Quality

The Center for Behavioral Health Statistics and Quality (CBHSQ) conducts data collection and research on "behavioral health statistics" relating to mental health, addiction, substance use, and related epidemiology. CBHSQ is headed by a Director. Subunits of CBHSQ include: [15]

The Center's headquarters are outside of Rockville, Maryland. [15]

Regional offices

CMS has its headquarters outside of Rockville, Maryland [16] with 10 regional offices located throughout the United States: [17]

Strategic Direction

In 2010, SAMHSA identified 8 Strategic Initiatives to focus the Agency's work. Below are the 8 areas and goals associated with each category: [18]

Their budget for the Fiscal Year 2010 was about $3.6 billion. It was re-authorized for FY2011. Most recently, the FY 2016 Budget requests $3.7 billion for SAMHSA, an increase of $45 million above FY 2015.[ citation needed ]

Controversy

In February 2004, the administration was accused of requiring the name change of an Oregon mental health conference from "Suicide Prevention Among Gay/Lesbian/Bisexual/Transgender Individuals" to "Suicide Prevention in Vulnerable Populations." [19] [20]

In 2002, then-President George W. Bush established the New Freedom Commission on Mental Health. The resulting report was intended to provide the foundation for the federal government's Mental Health Services programs. However, many experts and advocates were highly critical of its report, Achieving the Promise: Transforming Mental Health Care in America.

See also

Notes

  1. "Records of the Alcohol, Drug Abuse, and Mental Health Administration [ADAMHA]". National Archives. U.S. National Archives and Records Administration . Retrieved 18 July 2012.
  2. "Who We Are". SAMHSA. 4 March 2016.
  3. "Rear Admiral Eric Broderick, D.D.S., M.P.H., United States Public Health Service: Deputy Administrator of SAMHSA". SAMHSA. 30 November 2010. Archived from the original on 17 February 2012.
  4. "Pamela S. Hyde, J.D.: Administrator, Substance Abuse and Mental Health Services Administration; United States Department of Health and Human Services". SAMHSA. 30 November 2010. Archived from the original on 13 February 2013.
  5. "Farewell from the SAMHSA Administrator". SAMHSA News. 12 August 2015.
  6. "Joint Meeting of the SAMHSA National Advisory Council (NAC), Center for Mental Health Services (CMHS) NAC, Center for Substance Abuse Prevention (CSAP) NAC, Center for Substance Abuse Treatment (CSAT) NAC, SAMHSA Advisory Committee for Women's Services, and SAMHSA Tribal Technical Advisory Committee Public Agenda" (PDF). SAMHSA. 27 August 2015.
  7. "PN608 — Elinore F. McCance-Katz — Department of Health and Human Services". Congress.gov. 3 August 2017.
  8. 130 Stat. 1202
  9. 1 2 3 "Offices and Centers". SAMHSA. 11 September 2014.
  10. "Agency Overview". SAMHSA. 13 August 2010. Archived from the original on 14 March 2012.
  11. 1 2 "Center for Mental Health Services". SAMHSA. 29 March 2016.
  12. Center for Substance Abuse Prevention official page at SAMHSA.gov
  13. ADAMHA Reorganization Act Summary
  14. Title 42, see §300x–32, p. 1117
  15. 1 2 Center for Behavioral Health Statistics and Quality at official SAMHSA web site
  16. https://www.samhsa.gov/about-us
  17. https://www.samhsa.gov/about-us/who-we-are/regional-administrators
  18. "SAMHSA's Eight Strategic Initiatives". Archived from the original on 24 October 2010.
  19. Crea, Joe (25 February 2005). "Suicide prevention workshop retains 'gay' title". Washington Blade. Archived from the original on 28 August 2008.
  20. "National Briefing — Northwest: Oregon: Workshop's Original Title Restored". The New York Times. 26 February 2005.

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Substance dependence, also known as drug dependence, is an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral addiction and drug addictions, but not dependence.

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Treatment Improvement Protocols (TIPs) are a series of best-practice manuals for the treatment of substance use and other related disorders. The TIP series is published by the Substance Abuse and Mental Health Services Administration, an operational division of the U.S. Department of Health and Human Services.

Dual diagnosis is the condition of suffering from a mental illness and a comorbid substance abuse problem. There is considerable debate surrounding the appropriateness of using a single category for a heterogeneous group of individuals with complex needs and a varied range of problems. The concept can be used broadly, for example depression and alcoholism, or it can be restricted to specify severe mental illness and substance misuse disorder, or a person who has a milder mental illness and a drug dependency, such as panic disorder or generalized anxiety disorder and is dependent on opioids. Diagnosing a primary psychiatric illness in substance abusers is challenging as drug abuse itself often induces psychiatric symptoms, thus making it necessary to differentiate between substance induced and pre-existing mental illness.

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References