RESEARCH WEEKLY: Our Research Recommendations for SAMHSA

samhsa-pic (Jan. 17, 2017) The mission of the nation's Substance Abuse and Mental Health Services Administration (SAMHSA) is to reduce the impact of substance abuse and mental illness on America's communities. Especially with regard to serious mental illness (SMI), the agency has been under intense fire from Congress, the General Accountability Office and others for failing to fulfill the mission.

The agency's decision to create a research portfolio focusing exclusively on SMI data, statistics and study creates hope the agency is beginning to respond to the criticisms and change course.

Important but Hard to Find

SAMHSA already collects valuable data about SMI through national surveys such as its annual National Mental Health Services Survey, and other internal and external activities. The Treatment Advocacy Center's recent study of state hospital length of stay, Released, Relapsed, Rehospitalized, was based entirely on an analysis of data that SAMHSA requires block grant recipients to report annually to its Uniform Reporting System.

However, most of SAMHSA's relevant and valuable data is difficult to find on the agency's website or inaccessible without specialized software. This means much of this primary source material remains unknown and unused, even by people working in the field.

More significantly, after years of neglecting SMI, there are substantial holes and gaps in the data. Without these data, reducing the impacts of SMI - and providing lawmakers with evidence to use in public policymaking around SMI - requires varying degrees of guesswork.

Our Recommendations

The Office of Research and Public Affairs and members of the Psychiatric Advisory Board to the Treatment Advocacy Center have identified areas where more complete or comprehensive data collection would make it possible to better analyze, understand and address roles and impacts of SMI on individuals and their communities. Among the areas are those listed in the following chart.

Topic	Needed
Psychiatric beds	Census of beds, by state and typ Census of existing but unoperated beds in public hospitals, by facility Census of subacute and mental health rehabilitation beds, by state Census of "treatment" beds in corrections systems ("beds behind bars"), by facility Length of stay and rehospitalization rates for psychiatric hospitals not operated by state governments, by state
Criminalization	Census of SMI in the US jail population, by state, type of criminal offense; mental health diagnosis; criminal justice status (incompetent to stand trial, not guilty by reason of insanity, etc.); and demographicsSame data for prison populations Same data for inmates in solitary confinement Average wait times from jail booking to initiation of services for evaluation and restoration of competency, by state Utilization rates of mental health courts, by county
Emergency services	Census of dedicated psychiatric emergency rooms Average wait times for admission to psychiatric beds from emergency rooms departments, by diagnosis and patient demographics
Community services	Utilization rates for evidence-based diversion programs and community services such as assisted outpatient treatment (AOT) and assertive community treatment (ACT), by county
Treatment	Prescription rates for evidence-based treatment interventions under-used in the US such as clozapine, by state and by diagnosis Prevalence of treatment engagement among individuals with SMI who are privately insured, insured by Medicaid/Medicare or not insured, by state
Suicide	Suicide rates and psychiatric diagnosis, by state
Homelessness	Prevalence of SMI in the transient and chronically homeless populations, by stat Prevalence of treatment engagement among homeless individuals with SMI
Personnel and insurance	Census of private psychiatrics who accept patients with public insurance (Medicaid, Medicare)
Economic impacts	Direct and indirect costs that result from the role of serious mental illness in public health and social issues

Doris A. Fuller
Chief of Research and Public Affairs

References:

Drug and Alcohol Services Information System (DASIS)

Follow ORPA on Twitter at @TACResearch.

Next Week: Mental Health Spending and Jail Populations

Research Weekly is a summary published as a public service of the Treatment Advocacy Center and does not necessarily reflect the findings or positions of the organization or its staff. Full access to research summarized may require a fee or paid subscription to the publications.

To comment, please visit our Facebook page.