Addressing Behavioral Health Disparities Larke Nahme Huang, Ph.D. Sr Advisor, Administrator s Office of Policy Planning & Innovation Director, Office
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1 Addressing Behavioral Health Disparities Larke Nahme Huang, Ph.D. Sr Advisor, Administrator s Office of Policy Planning & Innovation Director, Office of Behavioral Health Equity 2011 CBC Spring Health Braintrust
2 SAMHSA s Vision & Mission Vision: SAMHSA provides leadership and devotes its resources toward helping the Nation act on the knowledge that: Behavioral health is essential for health Prevention works Treatment is effective, and People recover from mental and substance use disorders Mission: To reduce the impact of substance abuse and mental illness on America s communities
3 SAMHSA s Theory of Change 3
4 Office of Behavioral Health Equity Created by the Affordable Care Act Vision: All populations have equal access to high quality behavioral health care. Mission: To reduce the impact of substance abuse and mental illness on populations that experience behavioral health disparities by improving access to quality services and supports that enable these individuals and families to thrive, participate in and contribute to healthy communities. (draft)
5 Key Federal Policy Drivers Federal Survey Data HHS Secretary s Health Disparities Strategic Action Plan 2011 National Stakeholder Strategy for Achieving Health Equity AHRQ National Health Disparities Report HP 2020 Disparity Goals Secretary s Strategic Initiatives SAMHSA s 8 Strategic Initiatives White House Executive Orders
6 Trends in Disparities (AHRQ,NHDR) 6 Quality of Care Access to Care
7 Disparities in 2009 (AHRQ, Natl Health Disparities Report, 2009) 7 Quality of Care Access to Care
8 AMERICAN INDIAN/ALASKA NATIVE MORTALITY RATE DISPARITIES ( rates per 100,000 population, IHS) AI/AN Rate US All Races Rate 2005 Ratio: AI/AN to US All Races ALL CAUSES Alcohol Induced Diabetes Injuries Homicide Suicide Pneumonia/Influenza Infant Deaths * Per 100,000 population
9 Suicide rates by ethnicity and age group -- United States, (A Crosby, CDC,2011) Eur-Amer NonLatino Afr-Amer NonLatino Native American Asian-PI Latino Rate per 100,000 population Age Group in years
10 Latina/o Adolescent Suicide Source: Centers for Disease Control and Prevention, Data from: self-report survey. 15,214 students, grades 9-12: administered February-December 2003; 43 states
11 HHS Secretary s Strategic Action Plan to Reduce Racial and Ethnic Health Disparities (Release Date: April 8) Overarching Priorities Assess impact of all HHS policies, programs to reduce disparities (health disparity impact statements in grants) Use of data to improve health of minority groups (map high need disparity areas and HHS investments) Measure/incentivize better health care quality for minority groups ( SAMHSA/CMS measures related to burden of depression) ensure access to quality, culturally competent care for vulnerable populations.. Social determinants and health impact in all policies
12 SAMHSA: 8 STRATEGIC INITIATIVES 12 Prevention Trauma and Justice Military Families Recovery Support Health Reform Health Information Technology Data, Outcomes, & Quality Public Awareness & Support
13 OBHE Functions 1. Leadership - Provide and Develop Leadership 2. Disparities Policy and Practice Action steps in Secretary s Plan Disparities impact statement in grant programs OBHE review of SAMHSA Grant RFAs Action steps in SAMHSA Strategic Initiatives #1 Prevention: suicide prevention Latina youth and Tribal population #2 Trauma & Justice: address how BH issues add to disproportionate minority contact with justice system #5 Health Reform: 50% uninsured are people of color; strategy for outreach and enrollment; of 18-21yr olds of color 55%Latino; 32%Black; 25%white uninsured
14 OBHE Functions 3. Data Strategy (with Center for BH Statistics and Quality) Standardizing collection of race/ethnicity/sexual minority status (IOM Report Guidelines) SAMHSA surveys and reports (NSDUH, TEDS, DAWN, etc.) disaggregating by race/ethnicity to inform programming and policy Grants Data Geomapping highest needs and SAMHSA investments
15 Age of Illicit Substance Use Initiation by Race/Ethnicity (2009) Source: SAMHSA NSDUH 2009 Data N~ 26,000
16 Age of Illicit Substance Use Initiation by Race/Ethnicity (2009) Source: NSDUH 2009 Data N~ 26,000
17 Percentage of Past Month Illicit Drug Use among Persons Aged 12 or Older, by Race/Ethnicity*: 2004 and 2005 Any Illicit Drug Use Marijuaana Use Native Hawaiian/Other Pacific Islander American Indian/Alaska Native White Two or More Races Hispanic Nonmedical Use of Prescription- Type Drugs** Asian Black or African American Source: SAMHSA, 2004 and 2005 NSDUH Short Report June 21,
18 Percentage (%) Major Depressive Episode (MDE) in Adults (18-70) Lifetime, Past Year, and Treatment Rates (2009) *Received treatment, counseling, or prescription medication in the past year Source: NSDUH 2009 Data N~ 38,000
19 Percentage (%) Mental Health Service use Rates for Adults(2007) Source: NSDUH 2007 Data N~ 38,000
20 Percentage (%) Illicit Drugs Use among Adults during Past Year (2007) Source: NSDUH 2007 Data N~ 38,000
21 OBHE Functions 4. Communications Strategy (with Office of Communications) Public awareness campaigns (multicultural) Webpage Blog, social networking strategies etc. Internal SAMHSA, External groups, federal work groups
22 OBHE Functions 5. Support and Resources for Customers internal and external to SAMHSA Must Reads on webpage IOM Report on Unequal Treatment (2002); IOM Report on Standardizing Race, Ethnicity Data (2010) IOM Report on LGBT Health (2011); Joint Center on Political and Economic Studies: Advancing Health Equity for R/E Diverse Populations; (2010) AHRQ Health Care Cost and Utilization Project: State Documentation of R/E Health Disparities to Inform Strategic Action (2011) CDC Report on Health Disparities (2011) Training and Technical Assistance Opportunities
23 OBHE Functions 6. Quality Practice and Workforce Development National Network to Eliminate Disparities in Behavioral Health ( over 700 community-based organizations and affiliates serving c/r/e minorities and LGBT populations; resource sharing, communities of practice and learning communities Identify exemplary programs/practices/policies in communities and community-based organizations, exchange on network
24
25 National Network to Eliminate Disparities in Behavioral Health Purpose: To build a national network of diverse racial, ethnic, cultural and sexual minority communities and organizations to promote policies, practices, standards and research to eliminate behavioral health disparities. Web Address:
26 NNED Desired Outcomes LINK community providers, organizations, research/training centers and networks in diverse communities IDENTIFY and LINK effective innovation DEVELOP an infrastructure for collecting, analyzing and disseminating information, data, best practices, research, and policy BUILD WORKFORCE CAPACITY through learning collaboratives and communities of practice ENSURE ACCESS TO/AVAILABILITY of culturally appropriate, high quality, results-producing care
27 National Network to Eliminate Disparities (NNED) Partners Partners Partners Partners
28 National Network to Eliminate Disparities (NNED) Affiliates Affiliates Affiliates
29 NNED Geomapping Feature
30 OBHE Functions 7. Special Projects with Centers: HBCU Policy Academy Disparities Policy Summit Minority AIDS Initiative Faith based Initiative 8. Building capacity of SAMHSA staff Training and In-Services 9. Developing OBHE Strategic Plan with Benchmarks/Tracking Mechanism Thanks to Roslyn Holliday-Moore, Amanda Nugent, Trina Dutta
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