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U.S. Department of Health and Human Services Department of Health and Human Services
Substance Abuse and Mental Health Services Administration

Substance Abuse & Mental Health Services Administration

Last Updated: 6/22/2012

SAMHSA’s Resource Center to Promote Acceptance,
Dignity and Social Inclusion Associated with
Mental Health (ADS Center)


Books, Articles and Research

Recovery Resources
This section of the Wellness Recovery Action Plan (WRAP) website presents a range of resources to help people recover from mental and physical health problems and addictions, primarily through WRAP. WRAP is an evidence-based practice in which people identify resources, learn about wellness tools, and use these resources and tools to create a personal action plan for recovery. This part of the WRAP website includes links to articles on topics including wellness tools, trauma, and using WRAP for specific health issues. It also features links to more than 30 webinars on topics such as writing grant proposals for WRAP, WRAP for kids, and how WRAP can be used in work with veterans and military personnel. The section also includes links to information on crisis and post-crisis planning and to a WRAP blog.

Understanding the Affordable Care Act
This section of the Peerlink National Technical Assistance Center website is designed to help people understand the Patient Protection and Affordable Care Act (ACA). It includes a glossary of key terms related to the ACA; a 5-minute video that explains the law; lists of resources on the ACA and how it affects those with mental health issues; and three fact sheets: The New Health Care Reform Law: A Summary of Provisions of Interest to Mental Health Advocates, Supreme Court and Mental Health Reform, and Medicaid and Mental Health.

A Basic Human Need: Ending Housing Discrimination for Mental Health Consumers
Provided by Peers Envisioning and Engaging in Recovery Services (PEERS), this video looks at the issue of exclusion from housing of people with lived experience of mental health problems. The video explores this issue through the story of a woman named Mary, who has lived experience both of mental health problems and homelessness, and who at the time of filming has secured housing. The video covers factors that may make it difficult or impossible for people with lived experience to obtain safe and stable housing, as well as the importance to overall well-being of having a place to live. The web page where the video is available includes a link to more information about PEERS' work in the area of social inclusion related to housing.

Community-Partnered Cluster-Randomized Comparative Effectiveness Trial of Community Engagement and Planning or Resources for Services to Address Depression Disparities
This study sought to bridge a gap in understanding of outcomes of quality improvement (QI) healthcare programs across diverse health and human services sectors. QI programs in health care involve "systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups" (Health Resources and Services Administration, 2011, Specifically, this study compared the effectiveness of two programs, Community Engagement and Planning (CEP) and Resources for Services, in supporting implementation of depression QI programs to improve clients' quality of life as it pertains to their mental health and increase their use of services. They found that the CEP programs were more effective in increasing mental health and well-being, physical activity, and use of services while decreasing homelessness risk factors, behavioral health hospitalization rates, and medication visits. These findings support the importance of community engagement for underserved populations in efforts to decrease health disparities.

Improving the Physical Health of Adults with Serious Mental Illness
This 3-year study looked at the impact of 56 programs funded by the Substance Abuse and Mental Health Services Administration's Primary and Behavioral Health Care Integration grants. One type of impact this study examined was how the 56 programs through their use of integrated primary care and behavioral health services made a difference in the physical health of people with mental health problems like schizophrenia, bipolar disorder, and major depression. The study found mixed success in each location's ability to successfully integrate behavioral health and primary care services, but that, once people were enrolled in the program, they were more likely to receive primary care services. Investigators found that health outcomes did improve for some chronic conditions, including diabetes, cholesterol, and hypertension, but outcomes did not improve for obesity and smoking. Researchers found that three traits were associated with greater access to care among program participants: co-location of services, integration of practices, and staff perception of themselves as being part of a team.

Evidence-Based Tools Improve Functioning of People with Bipolar Disorder
This press release announces findings from a study of an evidence-based clinical program, Advancing Standards of Care for People with Bipolar Disorder. Program participants at 10 pilot sites experienced significant improvements in their productivity, social networking skills, coping skills, health practices, communication, money management, problem solving, and leisure enjoyment. The program involves two components: a group curriculum to give participants better understanding and information on independent management of their mental health issues, and a functional assessment tool that measures everyday functioning. The study had an attrition rate of 50 percent.

Recovery Movement Endorsed by United Nations
This White House Blog post announces that a United Nations (UN) resolution, Supporting Recovery from Substance Use Disorders, was approved by the UN's Commission on Narcotic Drugs on March 21, 2014. This landmark resolution makes recovery a top priority by recognizing that substance use disorders should be treated like other chronic health conditions and that recovery support initiatives are vital to helping prevent relapse and facilitate long-term recovery for individuals. The resolution also makes an appeal for nations to be accepting, supportive, and inclusive of people in recovery and promotes the exchange of information on best practices and evidence-based support initiatives.

Social Inclusion of People With Severe Mental Illness Living in Community Housing Programs
As part of a large-scale cross-sectional study seeking to assess institutes for residential care in the Netherlands, this study sought to determine if individuals living in supported independent living versus those in residential care experienced any differences in social inclusion on a variety of measures. Researchers found that while individuals in supported independent living situations were more likely to participate in activities and to have visitors, there was no difference in vocational participation between the groups. Based on these findings, they concluded that it is important that vocational programs be made available for individuals in both types of housing settings. This study's findings also highlight the success of mental health policies often supported across Western Europe that aim to rehabilitate individuals in community-based facilities and support them in being active participants in their communities.

Consumer and Family Psychoeducation: Assessing the Evidence
This literature review sought to examine the body of research assessing the impact of individual, group, and family psychoeducation models on various aspects of recovery including treatment adherence, relapse, and hospitalization rates. There was significant evidence to demonstrate that psychoeducation models, which are based on providing information regarding mental health and recovery to consumers, were effective in helping to promote positive recovery outcomes. The authors reviewed several studies that focused on multifamily psychoeducation groups, which they found to be linked to positive outcomes including greater problem-solving ability and lessened burden on families. The authors used these studies to make the case for psychoeducation services to be covered by insurance.

The Police-Based Crisis Intervention Team (CIT) Model: I. Effects on Officers? Knowledge, Attitudes, and Skills
This study sought to determine the officer-level outcomes of Crisis Intervention Training (CIT), which is designed to help police officers improve their responses to individuals experiencing mental health crises. Officers who took the CIT training were compared to officers who had not taken the training and were found, according to the abstract, to have "consistently better scores on knowledge, diverse attitudes about mental illnesses and their treatments, self-efficacy for interacting with someone with psychosis or suicidality, social distance stigma, deescalation skills, and referral decisions."

The Affordable Care Act: Overview and implications for county and city behavioral health and intellectual/developmental disability programs
Ron Manderscheid discusses how the Affordable Care Act (ACA) may shape the future of the behavioral health services as the insurance market is reformed. The author presents five key reform areas of the ACA: insurance, coverage, quality, performance, and information technology. He then examines how consumers and service programs may change as a result of these reforms. Suggestions are made for what city and county programs can do in the process to work towards ideal outcomes.

Social integration in global mental health: What is it and how can it be measured?
This article examines the need for a global measurement of social inclusion as an outcome for ongoing mental health campaigns and initiatives. While many programs seek to increase social inclusion of individuals with mental health issues into their communities, there are not yet measurements which are suitable for global, cross-cultural application. The authors discuss the four main conceptual frameworks of social inclusion which have emerged in the field and analyze challenges as well as potential methods for how a global measurement of social inclusion may be created.

Mental Health Crisis May Be Better Served in Homelike Environment Instead of Traditional ER, Says Study
This article describes a new concept in psychiatric emergency treatment through the Living Room, a program funded by the Illinois Department of Mental Health and provided as an alternative to utilizing a hospital emergency room for support during emotional distress. This drop-in support center is set up like a living room in a person's house and is staffed by a licensed professional counselor, registered nurse, and trained peer counselors who create a calm and respectful environment, focusing on recovery for the individual in crisis. In a study, they found that individuals came to the center for psychiatric issues similar to those for which they might otherwise have visited an emergency room. However, this setting was shown to be much more effective in providing needed support in comparison to typically hectic emergency room settings and received more positive feedback from consumers using the service.

National Study Of Peer-Run Organizations And Consumer-Operated Services
This webpage describes a study being conducted by Lived Experience Research Network staff at the Johns Hopkins School of Public Health. The study involves a nationwide survey of peer-run organizations and consumer-operated service programs. Its goal is to learn more about how these organizations can be integrated into local community mental health systems and what impact this integration may have. The study describes management practices of the models on which these organizations and programs are based, and uses this information to educate key stakeholders working to improve their local systems of care. Two reports were created from this survey. The first report presents a description of peer-run organizations' operations and their underlying characteristics in comparison to other, more traditional care models. The second report covers the ability and willingness of these organizations to accept Medicaid reimbursements.

Changing Knowledge and Attitudes with a Middle School Mental Health Education Curriculum
This study sought to examine the effectiveness of the Breaking the Silence: Teaching the Next Generation About Mental Illness curriculum, which was created to help increase youth's understanding and acceptance of people with mental health issues. Because many social attitudes are formed in the early years of life and rates of children diagnosed with mental health issues have risen, it is vital now more than ever that teachers, families, providers, and communities at large ensure that attitudes towards these issues are positive and recovery-oriented as opposed to negative and discriminatory. Researchers found that utilizing this curriculum with middle school students improved their knowledge of signs of and treatment for mental health issues, their attitudes toward these issues, and their overall willingness to interact with a person with a mental health issue.

The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid
This issue brief produced by the Kaiser Family Foundation outlines the difference between States that have expanded Medicaid and those that have not under the Affordable Care Act. It also explains how some individuals in States that have not expanded Medicaid will be stuck in what has been labeled the "coverage gap," as they will not qualify for Medicaid or for Marketplace subsidies. The brief includes a figure showing which States expanded Medicaid and which did not, a figure showing national median Medicaid eligibility limits, a table outlining the income eligibility limits by State, and a table showing the number of uninsured non-elderly adults by State.

Integrated Care: Wellness-Oriented Peer Approaches: A Key Ingredient for Integrated Care
This column defines whole health and wellness and provides an overview of the wellness and peer movement, peer wellness coaching, the role and potential roles of peers in integrated healthcare systems, and the differences between the wellness model and the traditional medical model. Implications of the Affordable Care Act and the changing face of the healthcare system are discussed alongside how these changes will redefine the experience of individuals in recovery and also bring new opportunities for peers working in the healthcare system.

Will the Affordable Care Act Move Patient-Centeredness to Center Stage?
In 2001, the Institute of Medicine designated patient-centeredness as a top priority for healthcare systems, defining it as "care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions." The path toward implementing patient-centered care had started several decades earlier, as steps were being taken to ensure that patients played a central role in addressing the ethical, economic, and clinical considerations of their care. This article discusses the history of these trends and the infrastructure development required, as well as the new policies of the Patient Protection and Affordable Care Act, which mandate reporting measures to ensure patient satisfaction in quality of care and other performance areas. The Consumer Assessment of Health Plans Study will play a major role in this reporting, working with a consortium of both public and private healthcare organizations. The implications of this and how it will cause our healthcare system to evolve are discussed.

A Randomized Controlled Trial of Supported Employment Among Veterans With Posttraumatic Stress Disorder
This randomized controlled study sought to determine the difference in impact between individual placement and support (IPS) supported employment and Veterans Health Administration Vocational Rehabilitation Program (VRP) treatment for veterans experiencing posttraumatic stress disorder. Over the course of the 12-month study, 76 percent of IPS participants were able to find competitive employment compared to 28 percent of VRP participants. Furthermore, IPS participants were able to work for a longer period of time and get higher wages. With gainful employment recognized as a vital component of recovery and wellness, this study highlights the need for improved job placement services in conjunction with other kinds of support.

Mental Health Court Helps Save a Troubled Talent from the Street
Published in October 2013, this article shares an inspiring success story of San Francisco's Behavioral Health Court, which allowed a young woman to get treatment rather than putting her in jail and in the process helped her to bring music back into her life. Her success story highlights the value of programs such as these, which help to rehabilitate individuals who have run-ins with the law that are associated with symptoms of their mental health problems. These programs often are able to help people get back onto their feet and remain out of the criminal justice system while adhering to individual treatment plans and reclaiming their lives.

The Path Forward: Investing in the Illinois Community Mental Health System; Improving Lives, Saving Money
In this November 2013 policy brief, Illinois' largest mental health recovery provider, Thresholds, outlines the economic value of investing in community mental health services that provide a safety net and would help to lower emergency room visits for psychiatric or substance use crises. By investing the money in prevention services up front, the State could provide better mental healthcare services to community members while also significantly reducing the cost to the public of psychiatric emergency room visits, which between 2009 and 2011 was higher than the amount of money saved in budget cuts to prevention services. Recommendations are made for how these investments could be made to maximize services and cost effectiveness.

Integrated Care for Asian American, Native Hawaiian and Pacific Islander Communities: A Blueprint for Action; Consensus Statements and Recommendations
In this publication from January 2012, authors observe that in the United States there is a growing acknowledgment of disparities in health care in some communities relative to others, and that more people are taking action to remedy these disparities. Authors note that these trends are particularly relevant to Asian Americans, Native Hawaiians, and Pacific Islanders, who, like other underserved populations, often face a larger array of healthcare inadequacies than the general population. These inadequacies are compounded by limited English proficiency and unique cultural considerations. The publication outlines discussions within the National Asian American Pacific Islander Mental Health Association and proceedings from a 2011 national consensus meeting regarding steps that need to be taken to help alleviate healthcare system shortcomings and implement better services alongside government initiatives to improve health care for all.

Building Partnerships: Conversations with the Hmong about Mental Health Needs and Community Strengths
This resource from the UC Davis Center for Reducing Health Disparities discusses mental health needs and unique requirements that providers and policymakers need to address to ensure that healthcare systems best address the needs of Hmong communities in the United States, many of which were formed by refugees who fled Southeast Asia starting in 1975 as a result of the Vietnam War or during a second wave of immigration starting in 2004. This publication outlines findings from a project that engaged a spectrum of underserved populations in California to gain community perspectives as to what the mental health system could do to more effectively reach out to Hmong people in the United States and their communities. For these communities, these issues revolve around severe social disadvantages as a result of their resettlement in a completely new culture and society. These disadvantages include low levels of education, high poverty rates, and low English proficiency. The publication includes direct quotes and considerations gathered from project participants.

Building Partnerships: Conversations with Native Americans about Mental Health Needs and Community Strengths
Produced by the UC Davis Center for Reducing Health Disparities, this report discusses mental health needs and unique cultural considerations that providers and policymakers need to address to ensure that healthcare systems can more effectively serve Native American populations. Based on findings from a California project to engage underserved populations, the greatest concerns for Native Americans were the loss of their cultural roots, violence, substance use, depression, and suicide. The publication includes direct quotes and considerations gathered from project participants.

Building Partnerships: Conversations with African Americans about Mental Health Needs and Community Strengths
This report produced by the UC Davis Center for Reducing Health Disparities discusses mental health concerns and unique requirements that providers and policymakers need to address to ensure that healthcare systems can better serve African American communities. Researchers partnered with agencies, individuals, and advocates within the African American community to give them an opportunity to express their view of what is needed in their community with the goal of helping counties develop their plans and programs for the prevention of mental disorders. The greatest concerns voiced revolved around experiences of violence, family disruption, substance use, suicide, and homelessness.

Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos
This paper discusses the shortage of evidence-based practices for ethnic minorities within community healthcare systems and the reasons for this shortage. It proposes that partnerships be built between researchers and community practitioners to help run clinical trials and further develop and implement culturally relevant programs. The paper also reports on the process involved in building such partnerships, as well as the results of a pilot test implemented by a community-academic partnership. In this randomized clinical trial, cognitive behavioral therapy by telephone was adapted to serve a primarily Spanish-speaking patient base. The development and outcomes of the program are presented.

American Indian and Alaska Native Mental Health: Diverse Perspectives on Enduring Disparities
This review provides an overview of the state of mental health and substance use issues within the American Indian and Alaska Native populations in the United States. Specifically, the review discusses the disproportionate burden of substance use disorders, posttraumatic stress, violence, and suicide that these populations face and the disparities in health services, which are often underfunded and understaffed for these populations, relative to other U.S. groups. The increasing interest in research on these issues is discussed, along with the growing initiative within these populations to advocate for appropriate alternatives that are more culturally relevant.

Behavioral Health—Prevention, Early Identification, and Intervention: A Pathways Policy Brief
This policy brief developed by the American Public Human Services Association explores the role that prevention and early detection play in enhancing behavioral health. In addition to the potential benefits of prevention to communities, this brief also discusses challenges like decreases in funding that impact mental health agencies. Some of the recommendations proposed to address these issues include encouraging collaboration between public and private agencies and supporting information-sharing efforts between agencies and programs.

Prevention is Primary: Strategies for Community Wellbeing, Second Edition
The Prevention Institute's Prevention is Primary: Strategies for Community Wellbeing text presents effective methods and tools for preventing mental health and substance use problems, as well as other health problems, and improving the health of communities. It serves as a resource for health care providers and educators, as well as community-based organizations. This text discusses various social issues and also addresses mental health needs of returning veterans.

WHO Comprehensive Mental Health Action Plan Adopted by World Health Assembly
This article discusses the World Health Organization's adoption of the draft Comprehensive Mental Health Action Plan 2013-2020. This plan provides guidelines for entities including national governments, agencies that support economic and governmental development around the world, mental health organizations, colleges and universities, research institutions, and society as a whole. The article identifies four key objectives of the plan:
- "Strengthen effective leadership and governance for mental health,
- Provide comprehensive, integrated and responsive mental health and social care services in community-based settings,
- Implement strategies for promotion and prevention in mental health and
- Strengthen information systems, evidence and research for mental health."
The plan is available for download at the following link:

The Evolving Understanding of Recovery: What the Sociology of Mental Health Has to Offer
In this article, the author notes how central the concept of recovery has become to modern mental health policy. He attributes this shift to work by sociologists looking at mental health several decades ago, though he notes that sociology in the intervening decades did little work on the study of recovery. He discusses mental health recovery in depth, its role in policy and practice today, and recovery from the perspective of sociologists.

Press releases: President Obama calls for Mental Health First Aid in gun control proposal
Linda Rosenberg, President and CEO of the National Council for Behavioral Health, begins this January 2013 statement as follows: "As part of his recommendations to protect our communities from gun violence, President Obama today rightly called for Mental Health First Aid training to help teachers and staff recognize the signs of mental health disorders in young people and find them appropriate care." The statement defines Mental Health First Aid as an evidence-based training program that helps people identify mental health problems in youth and connect them with support as needed, and that also teaches individuals how to respond in a crisis situation. This approach to addressing mental disorders in youth provides an opportunity for the community to discuss mental health while also engaging young adults and their families.

Meeting the behavioral health needs of veterans: Operation Enduring Freedom and Operation Iraqi Freedom
With 30 percent of the 2 million active duty and reserve military personnel deployed since 2001 in need of mental health treatment, the challenge of addressing the mental health needs of veterans is a significant one. In this article, the National Council discusses different ways this challenge is being addressed. Although a number of approaches, including evidence-based care and cognitive behavioral therapy, have been shown to be effective in addressing posttraumatic stress disorder and major depression, the focus has also turned to increasing the number of veterans utilizing care and ensuring the availability of care for veterans. This article also explores the benefits of community-based mental health care investments in veterans and the potential economic benefits of addressing veterans' mental health needs.

Hyde: Health care reform to offer new opportunities for consumers
This article at the Web site of Peers Envisioning and Engaging in Recovery Services (P.E.E.R.S.) covers the opening keynote at the 2012 Alternatives conference. The keynote was presented by Pamela Hyde, the Administrator for the Substance Abuse and Mental Health Services Administration. In her talk, she shared her view on the Affordable Care Act and ways it will help support individuals with mental and substance use disorders in their recovery. Hyde discussed the importance of integrating behavioral and primary health care, emphasizing the impact that mental health issues can have on physical health. Beginning in 2014, the Affordable Care Act will mandate that mental and substance use disorder services be included in non-grandfathered individual insurance plans. Along with many other expectations of this new law, it is estimated that the law will provide access to coverage for 32 million uninsured Americans. Hyde shared her belief that this Act represents a significant shift in the way mental health treatment is viewed, in recognizing that individuals with mental and substance use disorders can take responsibility for their symptoms and make good treatment decisions for themselves.

Final report of the World Conference on Social Determinants of Health
The World Conference on Social Determinants of Health, brought together in 2011 in Brazil by the World Health Organization (WHO), was a global conference that sought to encourage action on the social determinants of health. This event provided an opportunity for stakeholders to share their experiences with strategies for reducing health inequities and to discuss potential next steps of the WHO Commission on Social Determinants of Health. This final report, available for download, provides a full summary of this important conference.

United Nations convention on the rights of persons with disabilities: A roadmap for change
This study examines the United Nations Convention on the Rights of Persons with Disabilities as a means of advancing the social inclusion of individuals with mental disorders or intellectual disabilities. This convention focused on many social barriers that impact the full social participation of people with disabilities while also providing guidance on ways of incorporating disability policy in different countries. The researcher of this study goes on to discuss ways the mental health community will need to work on moving toward creating a new disability discussion that looks at services and supports needed to help people with mental disorders gain complete access to society.

Resolution on APA endorsement of the concept of recovery for people with serious mental illness
A significant body of data now shows a rise in numbers of individuals with mental disorders improving over time, leading full, independent lives. With Federal and State agencies recommending a shift to treatment that is less symptom-oriented, the concept of recovery is expanding. In this resolution, a rationale for the concept of recovery is explored and recommendations on promoting this concept through the American Psychological Association (APA) are discussed.

Housing for people with mental illness: Update of a report to the President's New Freedom Commission
This article summarizes many of the issues associated with the high rates of homelessness for individuals with mental disorders, all of which were reviewed by the Subcommittee on Housing and Homelessness of the President's New Freedom Commission. The article examines key subcommittee recommendations, as well as other topics related to preventing and responding to the issue of homelessness among people with mental disorders.

Dismantling the poverty trap: Disability policy for the twenty-first century
This article explores the high rate of poverty and unemployment that many individuals with disabilities experience and the role that economic reforms can play in addressing these issues. Researchers share recommendations for guiding such reforms.

Substance abuse prevention dollars and cents: A cost-benefit analysis
This report explores the importance of supporting substance abuse prevention programs. It analyzes substance use, including that of youth, costs of substance abuse to the country, and some potential cost savings of successful prevention programs and policies.

Models for developing trauma-informed behavioral health systems and trauma-specific services
This report explores some history of trauma-informed services in State mental health systems, describes guidelines for establishing a trauma-informed mental health service system, and also describes the variety of trauma-informed service models and approaches for State systems and providers. It includes a broad range of models including trauma-informed models for parenting, for working with child abuse survivors, and for developing trauma-informed service systems and organizations.

Population mental health: Evidence, policy, and public health practice
This book explores the evidence base for including issues related to mental disorders as a priority in the public health agenda. It discusses the connection between physical and mental disorders, the impact of health policies on the care of people with mental disorders, some of the barriers to developing a revised public health approach to mental disorders, and the use of public health intervention models.

Mental health and social inclusion: Making psychiatry and mental health services fit for the 21st century
For this publication, a group employed by the Royal College of Psychiatrists of the United Kingdom set out to examine social inclusion among individuals with mental disorders. It not only describes social exclusion, psychiatry, and current treatment of consumer/survivors in the UK but it expands on the importance of psychiatrists making an effort to adapt their skills to become more socially inclusive. This publication also discusses social inclusion of individuals with mental disorders and how it relates to recovery, treatment services, policy, and specific challenges for the 21st century.

Social inclusion and mental health
This article describes recent approaches to enhancing social inclusion for individuals with mental disorders. Specific limitations and benefits of these methods are discussed. The four approaches discussed include legislation, community-based supports/services, antidiscrimination initiatives, and system monitoring and evaluation.

Tenemos Voz National Latino Consumer Network
This network is comprised of Latinos with mental and substance use disorders who work to promote holistic approaches to health and wellness in recovery through equal access to treatment. The network engages in advocacy to influence policy, eliminate disparities, and improve treatment outcomes. It also provides educational and networking opportunities and support for consumer/survivors.

The Community Defined Evidence Project (CDEP)
This project is a collaborative effort between the National Latino Behavioral Health Association (NLBHA) and National Network to Eliminate Disparities in Behavioral Health (NNED) to advance understanding of effective community-based practices for Latinos. The project plans to develop an evidence base that uses key cultural and community indicators and to use this information to influence research, evaluation, policymakers, and funders to support efforts to implement and use community-based practices to reduce disparities and improve both access and quality of care for Latinos..

Policy Responses to Social Exclusion: Towards Inclusion?
This article defines social exclusion and addresses various aspects of life related to the concept including the labor market, education, health, housing, and access to services. This publication goes on to describe policy responses to social exclusion and identifies themes and issues influencing policy initiatives. The ways in which past policy interventions have created or contributed to current issues are discussed as well as recommendations for developing effective policies to reduce exclusionary practices and evaluate these efforts.

The Imperative of a New Approach to Warrior and Veteran Care
Recognizing the alarming rates of depression, brain injury, and suicide among active service members and veterans, this policy brief describes the need for: a new model for dispersing federal funds; changes to the relationship between the Department of Defense (DOD) and Department of Veterans Affairs (VA); and inclusion of private-sector stakeholders, such as nonprofit organizations, in addressing these issues. It provides current statistics on service member and veteran mental and substance use disorders and recommendations for the White House, the DOD, and the VA to improve care.

Introduction to "Building communities from the inside out: A path toward finding and mobilizing a community's assets"
This publication is an introduction to a guide on rebuilding troubled communities that emphasizes identifying and building upon community strengths rather than focusing on deficits within the community. It includes success stories of communities that have thrived and the role that the asset-based community development strategy has played in developing steps toward community growth. This introduction explores ways the traditional approach has failed communities, identifies problems, and discusses solutions and assets of a community, including those of individuals, associations, and institutions.

Building the capacity of the homeless service workforce
This article discusses the importance of addressing the professional development needs of homeless service providers to strengthen this workforce and thereby facilitate improvement in the delivery of services to individuals who are homeless. Challenges of work in homeless services such as low wage environments and the need to confront negative public attitudes are discussed. Researchers also describe the role of developing supportive organizations, providing competency-based training, and encouraging collaboration among Federal agencies in enhancing and developing careers in homeless services.

Evidence-based practices and multicultural mental health
Current trends in the behavioral health field show a significant increase in the promotion of evidence-based practices (EBPs) and requirement that they be incorporated into health and behavioral health care services. This emphasis reflects efforts to increase quality and accountability in services provided. This article not only addresses the use of EBPs and what it means for health and behavioral health services but also how they relate to better care for multicultural populations. Some key factors discussed include the history of EBPs, cultural competence and adaptations of EBPs, and recommendations for policy.

Strategies for Strengthening Substance Use Prevention, Treatment, and Recovery Systems: Provider Networks and Impact on the Workforce
Due to diminished resources and high outcome demands, current trends of today suggest that addiction agencies must find new methods of collaborating in order to maximize resources, retain staff, and provide higher quality services based on evidence-based practices. This report explores the various collaborative efforts of nine successful addictions provider networks across the U.S. These nine case studies examined demonstrate strategies and solutions for addressing common challenges thoughout the addictions system. This report also includes recommendations viewed as important to consider in forming a network.

Leading Change: A Plan for SAMHSA's Roles and Actions 2011-2014
This publication describes SAMHSA's plans for 2011 through 2014 to help people with behavioral health problems and their families. Their main focus is to help in developing strong communities, prevent behavioral health problems, and promote better health for all Americans. This plan is outlined by the eight new Strategic Initiatives that will guide SAMHSA's work, each Initiative with its own purpose, specific goal, action step, and measure for determining success.

"A disease like any other?" A decade of change in public reactions to schizophrenia, depression, and alcohol dependence
Over the last 15 years, behavioral health conditions have increasingly been described as medical diseases by behavioral health professionals, advocates, and policy makers as a way to counter lack of service use and negative and harmful attitudes and misconceptions. This study examined the effects that this neurobiological explanation has had on the rate of those seeking treatment and on the general public's attitude toward people with mental health challenges during the period of 1996-2006. Results suggest that this medical disease approach to understanding behavioral health problems has led to increased support for services but has not significantly reduced negative and harmful beliefs and attitudes. Researchers suggest that to reduce negative attitudes and discrimination, providers and advocates must shift to an emphasis on competence and inclusion.

No health without mental health
This document from the United Kingdom discusses an outcome strategy for behavioral health, highlighting the significant influence behavioral health has on all other aspects of life. It describes ways in which quality behavioral health and wellness translate into social and economic benefits for society as a whole, stressing the need for both government and community support to ensure these outcomes. Some agreed-upon goals developed through collaboration of governmental departments, local organizations, and behavioral health professionals are that more people will have positive experiences while provided care and support, that there will be a reduction in negative and harmful attitudes towards people with behavioral health issues, and that more of those with behavioral health problems will have good physical health.

Ending chronic homelessness: Cost-effective opportunities for interagency collaboration
This article explores the opportunity for Federal policies and programs to change the approach to assisting people who are homeless. It discusses both cost savings that could be realized and improved outcomes in maintaining housing stability, outcomes that would benefit both individuals and the community. It suggests new ideas and approaches to directing policies and practices as a means of enhancing the current approach to addressing homelessness.

Joint Statement of the Department of Housing and Urban Development and the Department of Justice: Reasonable accommodations under the Fair Housing Act
This statement outlines the responsibilities of the Department of Justice (DOJ) and the Department of Housing and Urban Development (HUD) in enforcing the federal Fair Housing Act, which prohibits housing discrimination based on race, color, religion, sex, national origin, familial status, and disability. It describes some of the common complaints that HUD and DOJ respond to regarding the Fair Housing Act as well as common questions and answers regarding the rights and duties of people with disabilities and housing providers under the Act relating to reasonable accommodations.

Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction
This manual provides a strong basis for introducing the evidence-based Housing First approach in addressing homelessness. It includes guidance in developing policies and programs. The DVD offered with this manual demonstrates the concepts shared, also including success stories of clients, model teams in action, and useful tips.

Social Inclusion for the United States
This paper describes ways the concept of social inclusion is used throughout the United Kingdom and how it could be used within the United States. The paper highlights ways in which social inclusion has become a framework for addressing many social policy issues within the UK and the many dimensions of social inclusion including health, education, housing, skills, advancement, and opportunity.

Recovery: A Philosophy of Hope and Resilience
This newsletter emphasizes programs that support recovery from substance abuse and addiction, research on recovery, and National Alcohol and Drug Addiction Recovery Month.

Shelter from the storm: Trauma-informed care in homelessness services settings
As the field of homeless services has advanced, providers have increasingly realized the importance of addressing long-term healing for people who have experienced homelessness, many of whom are trauma survivors. Trauma-Informed Care (TIC) provides a framework that can be used to support trauma survivors in homeless service settings and represents a promising area for increasingly effective and sensitive service approaches for highly vulnerable people. This paper explores the evidence for TIC within homelessness service settings and examines implications for providers, programming, policy, and research.

Transforming the nation's health: Next steps in mental health promotion
In this commentary, A. Kathryn Power, Director of the SAMHSA Center for Substance Abuse Prevention, advocates for a public health approach to behavioral health promotion and behavioral disorder prevention. She discusses the relationship of behavioral health to overall health and presents a strategy to build resilience at the individual, family, and community levels. She also describes SAMHSA's work to attain the goals within the strategy.

Mental health promotion in a reformed health care system
This article discusses the opportunity that the 2010 health care reform law provides for public health, health promotion, and disease prevention to become more central to U.S. health care. Because a cornerstone of public health is behavioral health promotion, the authors consider how this important element could fit into a reformed health care system.

Mental health, social exclusion and social inclusion
This article outlines a social systems approach to understanding social exclusion of people with behavioral health problems. The author notes that social exclusion and inclusion are not opposites and offers an alternative way of thinking about them both. She asserts that society needs policy initiatives to eliminate structural barriers that lead to social exclusion and to challenge negative ideas and misconceptions about people with behavioral health problems.

Consumer-delivered services as a best practice in mental health care delivery and the development of practice guidelines
This article examines evidence related to using consumer-delivered services in behavioral health care. Based on a review of available literature, the author recommends ways to implement this type of service and discusses how the evidence and these recommendations may affect policymakers and providers.

Towards an agenda for disability research in Europe: Learning from disabled people's organizations
This policy statement from the European Research Agendas for Disability Equality (EuRADE) project makes the case for including people with disabilities at every stage of social policy research, from the planning stages to completion. The authors assert that disability must be mainstreamed in research and disability-related research must be grounded in the social model of disability. The statement notes the challenges and opportunities for integrating people with disabilities into European research and outlines ways to promote acceptance and disability equality in research.

Mental health self-help: Consumer and family initiatives
This book includes an overview of the mental health self-help movement, which is a movement for behavioral health consumers and advocates to provide or improve treatment for people experiencing behavioral health problems. The authors provide a history of the movement, consider issues in training and funding for treatment, and suggest future directions for the movement. This book will be useful for community, clinical psychology, and public health researchers, as well as clinicians, counselors, social workers, case managers, and policymakers.

The role of peer support services in the creation of recovery-oriented mental health systems
Research shows that peer-provided services encourage a recovery-oriented mindset that empowers mental health consumers. This position statement from Mental Health America (MHA) promotes the use of peer-provided services and calls on behavioral health professionals to incorporate peer support in community-based services.

Mental health reform in the Russian Federation: An integrated approach to achieve social inclusion and recovery
This article describes a multifaceted, comprehensive approach to mental health interventions and policy reform, which included training, policy discussion, multidisciplinary collaboration, and support for nongovernmental organizations. Through a 3-year action-research project, the approach was piloted at three sites in a Russian region. Investigators found promising results, as hospital admissions decreased at two sites and the rate of readmission decreased at all sites.

The Department of Defense Plan to Achieve the Vision of the DoD Task Force on Mental Health: Report to Congress
Presented to Congress in September 2007, this document describes the U.S. Department of Defense's (DoD's) plan to address the categories of recommendations in the DoD Task Force on Mental Health's vision of change through a focus on six key areas: (1) leadership, culture, and advocacy; (2) access to care; (3) quality of care; (4) building of resilience and inclusion of people with mental health problems; (5) surveillance, research, and evaluation; and (6) care transition and coordination.

Q&A: First lady Rosalynn Carter on America's mental health crisis
TIME interviewed Former First Lady Rosalynn Carter, advocate for improving the mental health system and ending the negative perceptions that keep many people from getting proper care. In the interview, Mrs. Carter comments on topics including psychiatric drugs for children and the needs of returning service members.

Within our reach: Ending the mental health crisis
This book, written by former first lady Rosalynn Carter with Susan Golant and Kathryn Cade, offers an assessment of the current state of mental health. The book focuses on both the progress Mrs. Carter has seen during her 35 years of advocacy and the serious issues that must still be addressed before the mental health system can adequately meet the needs of people with mental health problems.

Pillars of peer support: Transforming mental health systems of care through peer support services
This report summarizes the results and findings of the Pillars of Peer Support Services Summit, held at The Carter Center in November 2009. The Summit brought together representatives from States that currently provide formal training and certification for peer providers working in mental health systems. The purpose was to examine the multiple levels of support States need to provide in order to create a strong and vital peer workforce that is able to engage in mental health systems transformation.

The Importance of Community Development For Health and Well-Being
This report examines the key role that environmental and community forces play in promoting health and preventing disease. In addition, the authors assert that social and public works programs will be more successful if people living in impacted neighborhoods are afforded the opportunity to participate in the creation and management of the initiatives that affect them.

Action towards healthy living-for all
This journal article suggests that remedial measures are necessary to ensure that public policies become more closely aligned with the findings of biomedical and social research regarding the key essentials of health and well-being.

Fair society, healthy lives: Strategic review of health inequalities in England post 2010
This paper describes British issues in health equity, social determinants of health, and UK-style societal interventions in both mental health and overall health with mental health playing a critical role.

EMCI think tank: Mental healthcare media blueprint
This document details the recommendations from a 2008 roundtable discussion brought together leaders from entertainment, media, and mental health to discuss potential strategies to change the national dialogue regarding mental health problems.

Implementation of mental health parity: lessons from California.
This article reports the experiences of health plans, providers, and consumers with California's mental health parity law and discusses implications for implementation of the 2008 Federal parity law.

Vision and Progress: Social Inclusion and Mental Health
This report examines the progress of the National Social Inclusion Programme as it works to implement the activities outlined by the 2004 Mental Health and Social Exclusion Report. Details are given on the progress made so far and on the work still to be done.

Mental Health and Social Exclusion: Social Exclusion Unit Report
This report examines the impact mental health problems have on increasing social exclusion. The report also developed a 27-point action plan to address this problem.

Closing the gap in a generation: Health equity through action on the social determinants of health
This report examines the final findings from the World Health Organization's Commission on Social Determinants of Health.

The Social Determinants of Health: How Can a Radical Agenda Be Mainstreamed?
This article is a commentary on the World Health Organization's Report on the Social Determinants of Health (SDOH).

SESAMI study of employment support for people with severe mental health problems: 12-month outcomes
In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group.

Transformation of children's mental health services: The role of school mental health
This article examines the intersection of school mental health programs and the New Freedom Commission's recommendations in order to highlight the role of school mental health in the transformation of the child and adolescent mental health system.

School mental health promotion: MindMatters as an example of mental health reform
In this article, a historical review of the development and implementation of MindMatters is used to exemplify the changes and outcomes of shifting policy and practice in school mental health promotion. Achievements include a conceptualization of mental health as a positive concept, addressing prejudice and discrimination, building capacity in the education sector and developing evaluation strategies to address complex, whole-school change.

Twelve month use of mental health services in a nationally representative, active military sample
This article findings indicate that military institutions should continue public education campaigns to raise awareness and acceptance of mental health issues and should make necessary changes in health delivery systems to gain the trust of military members. The primary objective of this study was to examine the patterns and predictors of mental health service use in active Canadian Force members while also identifying barriers to service use.

Chapter 5 of "Mental health: A report of the Surgeon General": Older adults and mental health
This chapter of the Surgeon General's report on mental health addresses various areas of interest for the older adult population, specifically considering mental disorders in older people - their diagnosis and treatment, and the various risk factors that may complicate the course or outcome of treatment.

Evaluating the effectiveness of a consumer-provided mental health recovery education presentation
The current study investigated the effectiveness of the In Our Own Voice (IOOV) mental health education program in improving knowledge and attitudes about mental illnesses.  

Solutions to discrimination in work and housing identified by people with mental illness
This study examines perceived solutions to discrimination in housing and employment situations.

Mental health: culture, race, and ethnicity: A supplement to Mental health: A report of the Surgeon General
This report is a supplement to the first ever Surgeon General's Report on Mental Health, Mental Health: A Report of the Surgeon General. This supplement covers the four most recognized racial and ethnic minority groups in the United States and the barriers to services that are encountered by persons of certain social and cultural groups.

American with Disabilities Act of 1990
The current text of the Americans with Disabilities Act of 1990 ["ADA"], as amended.

President's New Freedom Commission on Mental Health
The Commission's mission was to study the United States mental health service delivery system, including both private and public sector providers. The Commission advised the President on methods to improve the system. The Commission's goal was to recommend improvements that will enable adults with a serious mental illness and children with a serious emotional disturbance to live, work, learn, and participate fully in their communities.

New York City Voices
New York City Voices includes articles on many mental health topics, such as recovery from mental health and substance use challenges, support resources, wellness practices, and public policy. Authors include mental health consumers, ex-patients /survivors, family members, and mental health and substance use treatment providers. Currently in blog format, the publication was previously at a different Web site; archived issues are now available at this Web site:

Report of the Surgeon General's Conference on Children's Mental Health: A National Action Agenda
This Web page presents a report on the Surgeon General’s National Action Agenda on Children’s Mental Health. The agenda was developed in two U.S. Government meetings, both in 2000, one attended by more than 300 stakeholders in the area of mental health, including mental healthcare providers, scientists, and advocacy groups. The agenda encompasses eight goals, the first of which involves increasing awareness of children’s mental health issues and reducing biases, inaccurate perceptions, and exclusion associated with mental health problems.

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This Web site was developed under contract with the Office of Consumer Affairs in SAMHSA’s Center for Mental Health Services. The views, opinions, and content provided on this Web site do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS. The resources listed in this Web site are not all-inclusive and inclusion on this Web site does not constitute an endorsement by SAMHSA or HHS.