From Exclusion to Belonging:

Transforming Mental Health Care in America

The Vision: A Life in the Community for Everyone

The Substance Abuse and Mental Health Services Administration

The Centers and Offices
Transforming Mental Health Care in America
The New Federal Leadership
The Challenge
Highlights of the Federal Action Agenda
Components of Recovery
National Consensus Statement on Mental Health Recovery
Programs of Transformation
Making It Count






Highlights of the Federal Action Agenda

Highlighted Action Steps to Transform the Mental Health System

Principle A: Focus on the Outcomes of Mental Health Care, Including Employment, Self-Care, Interpersonal Relationships, and Community Participation

Action Steps

  • Initiate a National Public Education Campaign.
  • Launch the National Action Alliance for Suicide Prevention.
  • Educate the Public about Men and Depression.
  • Respond to refugees' mental health needs.
  • Develop prototype individualized plans of care that promote resilience and recovery.
  • Provide technical assistance on resilience and recovery.
  • Promote the use of customized employment strategies.
  • Promote the transition of youth with serious emotional disturbances from school to post-secondary opportunities and/or employment.
  • Develop an employer initiative to increase the recruitment, employment, advancement, and retention of people with psychiatric disabilities.
  • Assist youth with serious emotional disturbances involved with the juvenile justice system to transition into employment.
  • Promote the employment of people with mental illnesses who are chronically homeless.
  • Establish a DOL Work Group to promote quality employment of adults with serious mental illnesses and youth with serious emotional disturbances.
  • Provide treatment and vocational rehabilitation that supports employment for people with mental disorders.
  • Conduct outreach to homeless individuals with mental disorders.
  • Initiate a national effort focused on meeting the mental health needs of young children as part of overall health care.
  • Create a comprehensive action agenda for implementing throughout the Veterans Health Administration all relevant recommendations of the President's New Freedom Commission on Mental Health.
  • Launch a user-friendly, consumer-oriented Web site.
  • Promote ADA compliance, support and work to eliminate unnecessary institutionalization, and help eliminate discrimination.

Principle B: Focus on Community-Level Models of Care that Coordinate Multiple Mental Health and Human Service Providers and Private and Public Payers

Action Steps

  • Include issues critical to mental health in health care reform.
  • Launch the Federal Executive Steering Committee on Mental Health.
  • Build on and expand criminal and juvenile justice and mental health collaborations.
  • Support the Interagency Autism Coordinating Committee.
  • Review standards and set guidelines for culturally competent care.
  • Create a National Strategic Workforce Development Plan to reduce mental health disparities.
  • Initiate a project to examine cultural competence in behavioral health care education and training programs.
  • Advance efforts to integrate mental health and primary care services for racial and ethnic minorities.
  • Participate in HHS "Close the Gap Initiative."
  • Develop a National Rural Mental Health Plan.
  • Promote strategies to appropriately serve children at risk for mental health problems in high-risk service systems.
  • Develop a demonstration project for children in foster care.
  • Foster joint responsibility and implementation strategies for children, youth, adults, and older adults with co-occurring disorders.
  • Focus on children in the juvenile justice and child welfare settings.
  • Include mental health in Community Health Center consumer assessment tools.

Principle C: Maximize Existing Resources by Increasing Cost Effectiveness and Reducing Unnecessary and Burdensome Regulatory Barriers

 Action Steps

  • Educate employers and benefits managers on the practicability of paying for mental health care.
  • Evaluate and report the impact of mental health parity.
  • Initiate Medicaid Demonstration Projects.
  • Convene Directors of State Mental Health, State Medicaid, and Regional Medicare Programs.
  • Help parents avoid relinquishing custody and obtain mental health services for their children.
  • Support the Ticket to Work Program.
  • Address reimbursement in primary care.
  • Develop a strategy to implement innovative technology in the mental health field.
  • Explore creation of a Capital Investment Fund for Technology.

Principle D: Use Mental Health Research Findings to Influence the Delivery of Services

Action Steps

  • Accelerate research to reduce the burden of mental illnesses.
  • Foster a research partnership.
  • Expand the "Science-to-Services" agenda.
  • Conduct research to understand co-occurring disorders.
  • Harness research to improve care.
  • Support research to develop new medications.
  • Expand the National Registry of Evidence-based Programs and Practices to include mental health.
  • Develop new toolkits on specific evidence-based mental health practices.
  • Develop the knowledge base in understudied areas.
  • Conduct research to reduce mental health disparities.
  • Review the literature and develop new studies on mental illness/general health.
  • Conduct mental health services research in diverse populations and settings.
  • Test new treatments for co-occurring disorders in community settings.
  • Disseminate findings of the Juvenile Justice and Mental Health Project.

Principle E: Ensure Innovation, Flexibility, and Accountability at All Levels of Government and Respect the Constitutional Role of the States and Indian Tribes


  • Award State Mental Health Transformation Grants.
  • Provide technical assistance to help develop comprehensive State Mental Health Plans.
  • Award Child and Adolescent State Infrastructure Grants.
  • Track State mental health system transformation activities.
  • Establish a foundation for the Samaritan Initiative.
  • Establish the Re-Entry Initiative for ex-prisoners with psychiatric disabilities.
  • Award Seclusion and Restraint State Incentive Grants.
  • Develop statewide systems of care for children with mental disorders.
  • Provide technical assistance to States on systems of care for children with serious emotional disturbances and their parents and other family members.
  • Convene State leadership to develop statewide plans to serve children with serious emotional disturbances.
  • Expand the Partnerships for Youth Transition Grant Program.
  • Provide technical assistance on Early and Periodic Screening, Diagnosis, and Treatment (EPSDT).
  • Facilitate linkages between DOL/SSA's joint Disability Program Navigator Initiative, SAMHSA, and related State and local mental health systems.
  • Disseminate information on mental health issues through DOL grant and program initiatives.