From the Administrator: Tracking Trends To Transform Health Care

Given the prevalence of morbidity and mortality related to mental and substance use disorders, and the wider societal impact they produce, it's important to know how much the Nation is investing in prevention and treatment of these disorders and to what extent prevention and treatment are having an impact in producing change.

A new report from SAMHSA, National Expenditures for Mental Health Services and Substance Abuse Treatment, 1991-2001, highlights the fact that over the last 10 years an increasing share of the payment for mental health and substance abuse treatment comes from public sources such as local, state, and Federal government, with Medicaid playing an increasingly prominent role. (See SAMHSA News, Public Spending for Mental Health, Substance Abuse Treatment Increases.)

In fact, for mental health services, Medicaid's spending is growing faster than that of any other payer. As a result, it has become the largest payer of mental health services in the Nation. State and local dollars grew fastest for substance abuse spending.

With private sources paying an increasingly small percentage of these costs, it's clear that the public sector is now the major financial driver.

Simultaneously, SAMHSA has embarked on a strategy to obtain the data needed to measure and manage the performance of our programs that provide services for substance abuse and mental health. Working in cooperation with states and focusing on a handful of carefully selected National Outcome Measures, SAMHSA will be able to monitor client outcomes and help direct improvements within the service delivery system. SAMHSA News will carry an in-depth article on the National Outcome Measures in the next issue.

Why is it so critical for us to track trends and outcomes? Budget makers and financial payers are increasingly basing funding decisions on outcome data. This is true within all sectors—Federal, state, local, and private.

It's no longer enough to show evidence of a need; we must be able to demonstrate results in order to assure funding for the services that we know work. That's public accountability.

Developing a clearer understanding of trends and outcomes is especially important right now, as SAMHSA leads the Administration's initiatives to transform the Nation's mental health services system, expand people's access to substance abuse treatment, and incorporate efforts to prevent substance abuse and promote mental health in community programs.

With these goals, it is imperative that we track expenditures and outcomes from prevention and treatment efforts. This information will inform us as we continue to improve access and quality of care and offer hope to the people we serve. 

Charles G. Curie, M.A., A.C.S.W.
Administrator, SAMHSA

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