Interdepartmental Serious Mental Illness Coordinating Committee The Way Forward: Federal Action for a System That Works for All People Living With SMI and SED and Their Families and Caregivers December 13, 2017 , 2017 TableDecember of Contents 13 Section Page , 2017 , December 13 December Introduction ..................................................................................................................................... 1 Role of the ISMICC .................................................................................................................... 2 The 2017 ISMICC Report to Congress ...................................................................................... 4 ISMICC Vision Statement ..........................................................................................................5 Families and Caregivers WorksRecommendations for All From People the Non-Federal Living MembersWith SMI Summary and (See SED Chapter and 4 for Their Full TheRecommendations) Way Forward: .............................................................................................................. Federal Action for a System That 5 Families and Caregivers Caregivers and Families Focus 1: Strengthen Federal CoordinationTheir and to ImproveSED Careand ..............................................SMI With Living 5 People All for Works Coordinating Committee The Way Forward: Federal Action for a System That That System a for Action Federal Forward: Way The Focus 2: Access and Engagement: Make It Easier to Get Good Care .................................5 Serious Mental Illness Focus 3: Treatment and Recovery: Close the Gap Between What Works and WhatCommittee Is Coordinating InterdepartmentalOffered ........................................................................................................................... 6 Serious Mental Illness Illness Mental Serious Focus 4: Increase Opportunities for Diversion and Improve Care for People With SMI and SED Involved in the Criminal and Juvenile Justice Systems ........................ 7 Interdepartmental Focus 5: Develop Finance Strategies to Increase Availability and Affordability of Care . 7 References .................................................................................................................................. 9 Chapter 1: The Current Needs of Americans With Serious Mental Illnesses and Serious Emotional Disturbances .................................................................................................................11 Serious Mental Illnesses ...........................................................................................................11 i , 2017 , , 2017 December 13 Table of Contents (continued) 13 December Section Page , 2017 December 13 Serious Emotional Disturbances ............................................................................................ 20 References ................................................................................................................................ 30 Chapter 2: Improving Practice Related to Serious Mental Illness and Serious Emotional Disturbances ................................................................................................................41 Families and Caregivers Federal Presentations .............................................................................................................. Caregivers and Families 40 Works for All People Living With SMI and SED and Their Works for All People Living With SMI and SED and Their NationalTheir and InstituteSED of Mentaland Health:SMI SupportWith of Living Advances toPeople Address All for Works The Way Forward: Federal Action for a System That That System a for Action Federal Forward: Way The The Way Forward: Federal Action for a System That Families and Caregivers Challenges of SMI and SED ........................................................................................ 42 Works for All People Living With SMI and SED and Their Coordinating Committee Substance Abuse and Mental Health Services Administration:Committee Support of Coordinating The Way Forward: FederalAdvances Action to Addressfor a System Challenges ofThat SMI and SED ..................................................... 44 Serious Mental Illness Illness Mental Serious Serious Mental Illness Coordinating CommitteeDepartment of Veterans Affairs: Support of Advances to Address Challenges of SMI and SED ........................................................................................................... 46 Interdepartmental Interdepartmental Interdepartmental Serious MentalDepartment Illness of Justice: Support of Advances to Address Challenges of SMI and SED ..47 Interdepartmental Non-Federal Stakeholder Presentations ................................................................................. 51 Challenges and Opportunities in Improving Children’s Mental Health Care ................ 51 Key Advances in the Clinical Care of People With SMI and SED ...................................52 Disparities and Closing the Treatment Gap .................................................................... 54 The Challenges and Opportunities for Improving the System That Supports the Care of People With SMI and SED ........................................................................55 ii , 2017 DecemberAreas to Be 13 Explored by the ISMICC .................................................................................57 Chapter 3: Setting the Stage for Evaluation of Federal Programs Related to SMI and SED ...... 61 , 2017 , December 13 December Direct and Indirect Levers of Federal Influence .....................................................................63 The ISMICC Role in Evaluating Federal Programs and Enhancing Coordination to Improve Outcomes ................................................................................ 66 What Is Known to Date About Federal Programs ................................................................. 69 Future Work of the ISMICC to Evaluate Federal Programs .................................................. 76 Families and Caregivers ChapterWorks 4: Recommendations for All People From Non-FederalLiving With ISMICC SMI Members and ........................................ SED and Their77 The Way Forward: Federal Action for a System That Full Recommendations ........................................................................................................... 78 Caregivers and Families Works for All People Living With SMI and SED and Their Their and SED and SMI With Living People All for Works Coordinating Committee Focus 1: Strengthen Federal Coordination That to Improve System Care a ...........................................for Action Federal 78 Forward: Way The Serious Mental Illness Focus 2: Access and Engagement: Make It Easier to Get Good Care ...............................Committee 81 Coordinating Interdepartmental Focus 3: Treatment and Recovery: Close the Gap Between What Works and WhatIllness Is Mental Serious Offered ............................................................................................................................... 84 Interdepartmental Interdepartmental Focus 4: Increase Opportunities for Diversion and Improve Care for People With SMI and SED Involved in the Criminal and Juvenile Justice Systems .................. 87 Focus 5: Develop Finance Strategies to Increase Availability and Affordability of Care ................................................................................................................................ 90 iii , 2017 , , 2017 December 13 Table of Contents (continued) 13 December Appendices Page , 2017 December 13 A Members ............................................................................................................................ 94 B Glossary of Terms Used in Report ...................................................................................104 Tables 1.1. Populations Receiving Select Evidence-Based Practices in Selected State Mental Health Systems in 2016.......................................................................................... 15 Families and Caregivers Caregivers and Families Families and Caregivers Works for All People Living With SMI and SED and Their Works for All People Living With SMI and SED and Their 1.2. WeightedTheir and Data SED From 2016and NationalSMI SurveyWith of Children’sLiving HealthPeople ...................................All for Works 22 The Way Forward: Federal Action for a System That That System a for Action Federal Forward: Way The The Way Forward: Federal Action for a System That Families and Caregivers2.1. Areas for the ISMICC to Explore During Future Meetings ............................................. 58 Works for All People Living With SMI and SED and Their Coordinating Committee Committee Coordinating Coordinating Committee The Way Forward: Federal3.1. Federal Action Programs for Related a System to SMI and That SED Programs That Can Support People With SMI and SED ............................................................................................................ 70 Serious Mental Illness Illness Mental Serious Serious Mental Illness CoordinatingFigures Committee Interdepartmental Interdepartmental Interdepartmental Serious Mental1. Estimates Illness and Unmet Needs of Persons With Serious Mental Illnesses and Serious Emotional Disturbances .....................................................................................................