POSITIVE OUTCOMES – AND FRESH CHALLENGES

By the end of the first evaluation period in September 2002, the summits had produced promising changes in most of the participating states and regions. Over 80 percent of the participating teams had remained intact, added new stakeholder groups, and continued to implement the action plans they developed at the summit.

Tangible results in the first 2 years following the initial summits included accomplishments such as increases in the number of clinicians, merging funding streams to better support new initiatives, and integrated services rolled out in one or more communities within individual states and regions.

For some, however, the summit work had not produced the large-scale changes that many teams envisioned in their bold action plans. Participants blamed a faltering economy and significantly reduced state and federal revenues needed for such changes to occur. Teams discovered other barriers, too, such as problems in garnering support from key stakeholders, insufficient planning data, and shifting public priorities brought about by national security threats in the wake of the 9-11 attacks.

Still, some states were able to produce exciting results at home, particularly at the community level. A Community Health Center (CHC) in Choppee, South Carolina has earned the “Exemplary Practice” seal of approval for being a model of integrated care at the local level. In addition to primary health care services, mental health, and alcohol and drug abuse services, Choppee’s CHC now also provides recreational opportunities and WIC services at its location.

Another Community Health Center in Lowell, Massachusetts, has worked closely with the Southeast Asian community to create culturally competent mental health and substance abuse care. What has emerged is an integrated model of culturally and linguistically accessible care combining primary health care, Cambodian traditional healing, Buddhist meditation, mental health services, acupuncture, and massage therapy—and all in a “one-stop” center called the Metta Health Center.

The “Over 60” Health Center in Berkeley, California integrates mental health, substance abuse and primary care services together so that consumers do not have to travel to receive treatment.  As the first community based geriatric health care center in the country, “Over 60” recognized the need for mental health and substance abuse expertise among their primary care staff, and all the primary care providers are trained to recognize mental health/substance abuse issues.

Programs that integrate mental health care and HIV/AIDS treatment services, services promoting mental health in children, and providing mental health services in the homeless population are other specialized areas where the HRSA/SAMSHA conference summits have helped shape positive mental health outcomes across the country.

Improvements and new directions are happening throughout the communities represented by the first 25 teams. Two states have seen large-scale changes become a reality. Virginia has sponsored its own in-state summit and developed The Virginia Initiative to integrate services, produce tools for clinicians, and increase the number of psychiatrists in rural areas. In Tennessee, The Tennessee Initiative has established a family practice fellowship in behavioral medicine through the University of Tennessee, with the Tennessee Primary Care Association and Cherokee Health Systems. Fellows will train in community health centers that provide integrated care.

As the most recent group of participants return home, we look forward to reporting on other exciting programs that take shape in their states. To all of our participants, we urge that we all continue to look for ways to broaden avenues of collaboration and keep communication channels open. Working together, we can bring down many of the barriers Americans continue to face when it comes to their mental health.

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