Making Strides to Improve the Mental and Behavioral Health Workforce and Meeting the Identified Mental Health Needs of Students

SAMHSA Reauthorization

The 110th Congress is currently considering the reauthorization of the Substance Abuse and Mental Health Services Administration (SAMHSA). The APA submitted a comprehensive association-wide set of recommendations intended to improve SAMHSA. These recommendations are available on the Education Government Relations Office (GRO) website (LINK). Within this set of recommendations, APA's Education GRO has promoted initiatives that will strengthen workforce training opportunities for mental and behavioral health professionals.

The Senate Health, Education, Labor and Pensions (HELP) Committee released a draft version of their SAMHSA reauthorization. APA secured some important language in this draft related to prevention and early intervention services and programs and services for older Americans. Critically important recommendations made by APA were not included as part of the SAMHSA draft.

Senate HELP Committee staff hoped to mark-up this legislation during the first few weeks of January 2008, but serious objections were raised by a coalition of organizations concerned about “charitable choice” provisions that were maintained from the current law. At this time, the SAMHSA reauthorization is on hold.

APA's Recommendations: Areas of Continued Focus

The initiatives briefly outlined below were not included in the Senate SAMHSA draft legislation. Education GRO will continue to promote these recommendations during discussions with Congressional staff and administrators from SAMHSA.

Promoting a Strong, Qualified Mental Health Workforce

Investing in a highly qualified mental and behavioral workforce is an area of critical national need. A ground breaking report by the Institute of Medicine in 2001, Crossing the Quality Chasm: A New Health System for the 21st Century, identified the pervasive problems of health care today. This study lead to a 2006 report entitled, Improving the Quality of Health Care for Mental and Substance Use Conditions, which identified the inadequacy of mental health and substance abuse care and recommended building, maintaining and ensuring a competent and qualified workforce.

Minority Fellowship and Workforce Training

The minority fellowship program is a proven effective SAMHSA program that supports pre and post doctoral fellowships for minority psychologists (See http://www.apa.org/mfp/). While this program has received funding from SAMHSA for over a decade, it does not have a specific authority in the current statute. APA continues to seek full authorization for the MFP during the review of SAMHSA programs.

In an effort to meet the workforce needs identified by the Institute of Medicine, the APA recommended providing an authorization for the Minority Fellowship program as well as significantly expanding CMHS workforce efforts.

These proposed initiatives include a loan repayment program and support for students of the eligible mental health professions in accredited graduate programs and internships. Those students receiving CMHS financial aid would be required to work in a designated underserved community. Students will also have the opportunity to specialize with specific underserved populations. The training would be interdisciplinary and focused on multi-cultural and evidence-based practice.

Garrett Lee Smith Memorial Act

During this reauthorization cycle, Education GRO has pushed to include a new use of funds that would allow for college counseling centers to strengthen and expand residency, internship or fellowship programs. While these changes were not included in the Senate HELP Committee's SAMHSA reauthorization draft, Education GRO will continue to educate House and Senate staff about the mental and behavioral health needs that exist on college campuses around the country in an effort to ensure that the federal legislation is better designed to address these problems.

Background and Grants

The Garrett Lee Smith Memorial Act authorizes a number of important federal programs that focus on suicide prevention. These programs; the Statewide Youth Suicide Early Intervention and Prevention Program, a Suicide Technical Assistance Center and the Campus Suicide Prevention program, are administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). The Campus Suicide Prevention program is an outgrowth of the Campus Care and Counseling Act (108th Congress); legislation championed by Senator Jack Reed, former Senator Mike DeWine and Rep Danny Davis and former Rep. Osborne. It was developed by members of the APA working in college counseling centers. The GLSMA programs have received full funding each year since their creation thanks to the significant work of Sen. Gordon Smith (R-OR)

To date, the Campus Suicide Prevention program has made grants to 55 institutions of higher education to assist colleges and universities in their efforts to prevent suicide and enhance services for students with mental and behavioral health problems that place them at risk for suicide. These grantees are working on campus to raise awareness and provide education to the campus community about the risks and warning signs of suicide. Further, they are communicating with each other and sharing best practices nation-wide with their colleagues in other colleges and universities. This program is meeting a critical need on college campuses around the country.

In early November 2007, SAMHSA announced that approximately $1.5 million would be made available for 15 new Campus Suicide Prevention grants with an average award of $100,000 for 3 years. The application deadline for this grant was January 18th and it is expected that SAMHSA will announce these new grants in the fall.