You Make SAMHSA Rock!
By: Pamela S. Hyde, J.D., Administrator, Substance Abuse and Mental Health Services Administration
After almost six fulfilling years of working for the Obama Administration and with all of you, I am resigning from the position of SAMHSA Administrator, effective August 22, 2015. As I contemplate leaving, I want to tell all of you how much SAMHSA’s work means to me and to the nation.
SAMHSA is an amazing federal agency. It is a leader in behavioral health grant-making, policy, and data. It works to inform the public, improve practice, and regulate critical functions affecting tens of millions of Americans. It has less funds and even less staff than many of its counterparts with whom it collaborates, and yet is very effective and efficient in what it does.
SAMHSA staff has expertise in issues ranging from prevention to trauma to evidence-based treatments for people with opioid addictions or with the most serious mental illnesses. SAMHSA staff has a firm belief in and commitment to the possibility and power of recovery — the ability of persons with the most devastating of disorders to get better and lead productive and satisfying lives, in spite of their health issues, their circumstances and the discrimination and misunderstanding they often face in their communities. SAMHSA has incredible partners with which it collaborates across the federal government and across the nation, from the Centers for Medicare and Medicaid Services (CMS), to the Health Resources and Services Administration (HRSA) and the Administration on Children and Families (ACF), to the Departments of Justice, Housing and Urban Development, Labor, Homeland Security, Education, Veterans Affairs, and Defense.
I am proud of SAMHSA and its employees. I am proud of what SAMHSA has accomplished for the people of the United States over its 25-year history and especially over the last few years. In the face of overwhelming need and limited budgets, SAMHSA and its staff have used its expertise and passion to advance the behavioral health of the nation. Through the work of SAMHSA staff, grantees, and technical assistance centers, limited amounts of strategically-placed federal funds have a significant and lasting impact on the delivery of prevention, treatment and recovery supports for persons with behavioral health needs. SAMHSA leads the way in the development of systems of care for children with serious mental disorders, trauma-informed care, medication-assisted treatment for opioid addiction, services for problem-solving courts, offender re-entry programs, suicide prevention, homelessness prevention, integration of health and behavioral healthcare services, and treatment capacity expansion through workforce development, parity implementation, and financing and health information technology policy work. All of these efforts help individuals, families, and communities build resilience, find and receive treatment, and secure a fulfilling future.
During my almost six years at SAMHSA, we have seen the emerging acceptance by general health care of mental illness and addiction as health conditions like any other. We have seen communities increasingly recognize the emotional and psychological needs of first responders and those experiencing natural or human made disasters. We have seen tragedies bringing to the forefront the issue of unrecognized and untreated mental illness and addiction. We have seen schools and communities engage in real dialogue about the needs of children and their parents. We have seen new research in intervention for young people with first episode psychosis implemented throughout the nation. And we have seen the military, the research community, health plans, businesses, tribes, and other public and private partners take on the growing issue of suicide among the nation’s youth and adults. SAMHSA has led and been a champion in each of these areas.
During this time we have also seen our President, First Lady, Vice President and Second Lady stand up and speak out against bullying, against unchecked gun violence, and against treating those with mental illness or addiction as second-class citizens. They have stood up for the behavioral health of our nation, and SAMHSA has stood by their side. I am proud to work for such an active and engaged Administration on matters affecting half of all Americans over their lifetimes.
I am also proud of the stakeholders who work with and challenge SAMHSA and its federal partners to do more. They have been instrumental in achieving parity legislation and its implementation, and now are demanding compliance with that law and all it means for Americans with behavioral health needs. They have championed integrated care, enrollment of persons with behavioral health needs into Marketplace and Medicaid health plans, and inclusion of mental illness and addiction in value-based purchasing models. They have also worked carefully and consistently with Congress to explain the need for more funding and services, rather than focusing on federal structures. They have been vocal about community prevention models and early identification and intervention models to help prevent substance use and mental health issues. They have advocated for those with these conditions and their families as well as for those who provide them services and care. I applaud them all.
Never in my wildest dreams would I have imagined that in six short years I would witness the repeal of “Don’t Ask, Don’t Tell” and the affirmation of all people’s right to marry the one they love, regardless of gender. And never would I have imagined that the American people would come to an understanding and acceptance of bisexual and transgender people as many have. SAMHSA’s work with stakeholders on the importance of family acceptance and the harm of conversion therapy are critical efforts to advance the behavioral health of LGBT youth and helps to assure they enjoy a more hopeful and healthy future. There is still a long way to go, but the change I have witnessed is astounding and gratifying. We truly are forming a more perfect union of diverse and varied individuals who make a rich tapestry and healthy collective whole.
And having come from a state with one of the highest rates of uninsured individuals and having worked at the state level work on seeking and providing health coverage for uninsured Americans, never would I have imagined how successful the Affordable Care Act would be in helping to dramatically decrease the uninsured rate in America and significantly reduce insurance rate increases experienced by America’s families. The Affordable Care Act, combined with the Mental Health Parity and Addiction Equity Act (MHPAEA) has had a profound impact on those with behavioral health needs, assuring young people can stay on their parents insurance and can get coverage on their own even if they do have a history of or current mental health or addiction issues. These laws together mean that America’s young people will grow up never having to choose to be on disability in order to have insurance coverage. And it means the next generation of Americans will not have to experience or think of behavioral health services as somehow different or separate from their overall health care. Challenges in access to quality behavioral health services remain, but SAMHSA will continue to lead in the effort to assure a high quality behavioral health workforce and to assure mental illness and addiction are seen and treated just like any other health and public health conditions.
Soon, I will no longer lead the small but mighty SAMHSA. Personal issues call me home to New Mexico where I will support from a different vantage point the work of this Administration to continue and expand the gains begun by and with SAMHSA to assure all America’s communities are healthy and everyone in America has their behavioral health needs met – because SAMHSA and all who work with us know that behavioral health is essential to health, prevention works, treatment is effective, and people recover.
I will be forever grateful to Secretaries Sebelius and Burwell with whom I have had the pleasure to serve, and to President Obama for his leadership and for giving me this incredible opportunity of a lifetime.
I wish all of you the best and much continued success.
Pamela S. Hyde
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