MHW: McCance-Katz Discusses Plans to Establish National Center to Address SMI

NYAPRS Note: The following provides some details about plans to launch a Clinical Support System for Serious Mental Illness technical assistance center that new HHS Assistant Secretary for Mental Health and Substance Use Dr. Elinore McCance-Katz seeks to promote “access to a set of recovery support services that are provided by professionals, including peer support specialists, who work together with psychiatric medical staff and over time to seamlessly coordinate and optimize person-centered recovery.” Learn more about these and other new federal initiatives and priorities at NYAPRS April 19-20 Annual Executive Seminar, “New Strategies and Partnerships to Support the Most Challenged New Yorkers: The Way Forward” that will feature a keynote address by Dr. McCance-Katz. We’ll have the complete program schedule available in the coming days. 

McCance-Katz Discusses Plans to Establish National Center to Address SMI

Mental Health Weekly January 22, 2018 

Elinore McCance-Katz, M.D., Ph.D., assistant secretary for mental health and substance use in the Department of Health and Human Services (HHS), says the implementation of evidence-based practices (EBPs) to treat individuals living with serious mental illness (SMI) and providing training and education to providers to treat consumers with SMI is critical and at the heart of new efforts to promote effective treatment options.

In an interview with MHW, McCance-Katz discussed the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) plans to develop a Center of Excellence dedicated to the implementation of EBPs to treat consumers with serious mental illness. She also discussed the agency’s national registry and new approach to implementing those practices.

SAMHSA announced Jan. 17 that its Center for Mental Health Services is accepting applications for the FY 2018 Clinical Support System for Serious Mental Illness (CSS-SMI) grant. The program’s purpose is to provide technical assistance for the implementation and provision of evidence-based treatment and recovery supports for people living with serious mental illness. Additionally, the program aims to provide this technical assistance to providers, programs and communities across the country.

According to the Funding Opportunity Announcement (FOA), the CSS-SMI is intended to target localities and populations, particularly those with serious mental illness, who have limited access to good care that incorporates evidence-based practices. Officials say this is in alignment with the Interdepartmental Serious Mental Illness Coordinating Committee recommendations that more people with SMI get good care and that there are fewer gaps in obtaining treatment and recovery support services for persons with SMI.

McCance-Katz noted that treatment providers will work with peers who can help provide support and assistance to individuals entering recovery and needing that extra attention, particularly early on in their illness. “That’s really essential,” she said.

McCance-Katz said that in her own experience as a clinician in the field, peers and others don’t necessarily have contact with or interact often with treatment providers, she said. “That needs to change,” she said. “We’re trying to bring all groups together on the treatment side and the recovery side.”

The FOA states, “Good care also includes access to a set of recovery support services that are provided by professionals, including peer support specialists, who work together with psychiatric medical staff and over time to seamlessly coordinate and optimize person-centered recovery.”

SAMHSA will go beyond helping grantees, McCance-Katz said. This initiative is tied to the urgency around the opioid crisis and serious mental illness that this country is experiencing, she noted.

The Clinical Support System for Serious Mental Illness grant is funded at $2.9 million annually for up to five years. Providers, academic programs and other stakeholders are encouraged to apply. The application due date is March 19.

NREPP

In recent weeks, news reports have indicated that SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP) would be discontinued. SAMHSA and HHS issued a statement Jan. 11 regarding the use of NREPP and its new approach to implementing EBPs. The national registry, which has been in place since 1997, vetted practices  and  programs   submitted by outside developers  —  resulting in a skewed presentation of evidence-based  interventions  that  did not  address  the  spectrum  of  needs of those living with serious mental illness and substance use disorders, the statement said.

According to McCance-Katz, the plan is to develop a new online source with EBP resources already available from SAMHSA, review the current NREPP listings and add those listings that provide sufficient guidance in the available information provided by the developer to implement evidence-based interventions.

McCance-Katz acknowledged she has criticized NREPP publicly, noting that it may not be the best indication for a patient. Pointing to selection bias, she indicated it was not a good way to establish evidence-based programs. The result for a search term might come up blank (no results) or might return an entry that is outdated, based on a person’s dissertation, or that a developer, if contacted, might use as the basis of a sales pitch.

She added that instead, SAMHSA is moving toward evidence-based practices that cover a continuum of care. “It is also the case that every person is different with different needs and each needs evaluation and personalized care,” McCance-Katz said.

Policy Lab

The National Mental Health and Substance Use Policy Laboratory, a division within SAMHSA, is currently up and running and under the direction of Christopher Jones, Pharm.D. The Policy Lab represents the beginnings of a new way for SAMHSA to provide communities’ evidence-based practices and assistance on how to think about implementing this process, McCance-Katz said.

Jones and a staff of subject-matter experts are working to review and compile evidence-based practices for use by programs. They will also undertake study and review of evidence-based programs/practices that should receive greater study or be scaled up to serve more Americans, McCance-Katz noted, adding that this is a very different approach than having a contractor.

McCance-Katz wanted to make it clear that the NREPP is still available and will remain that way. Meanwhile, the Policy Lab is up and running, she said. The lab, she said, is considered a new way for SAMHSA to provide to all communities assistance on how to implement evidence-based treatment.  “My main concern is that it’s not enough to know about EBP; you’ve got to implement” those practices,” she said.

McCance-Katz said they plan to work with stakeholders and their technical assistance/training organizations supported by SAMHSA to assure that community providers get the assistance they need. “We want to build a system that makes it easy for the community and practitioners to implement these practices at little to no cost,” she said.

Evidence-based approaches

SAMHSA has a number of evidence-based approaches already available on its website in the form of Treatment Improvement Protocols (TIPs) and Technical Assistance Publications (TAPs). The TIP series can be found at http://bit.ly/2DtTldi. The TAP series can be found athttp://bit.ly/2FTXkye.

The SAMHSA store also has a number of toolkits that describe evidence-based practices, as well as provide instructions on how to implement them. Query “toolkits” in the   SAMHSA   store   (http://bit.ly/2FTXu8O) to access them.