Over the past 18 months SAMHSA has experienced many changes, but no bigger change than the identification of the Eight Strategic Initiatives and making prevention SAMHSA’s number one initiative.  Earlier this year SAMHSA unveiled its 2012 budget, and in advancing the change occurring at all levels of SAMHSA, the 2012 budget has been changed to reflect SAMHSA’s new budget structure and policy focus that emphasizes meeting the behavioral health needs of people rather than focusing on the conditions that afflict them.  With this new approach, SAMHSA is expanding substance abuse prevention and mental health promotion through new formula-based grants to States and Tribes to bring evidence-based, practice based and traditional prevention strategies to scale.

The largest change among the prevention grants is the inclusion of prevention grants specifically targeted to Tribes, which would use funds from the Prevention and Public Health Fund authorized by the Affordable Care Act.  The funds will be provided to Federally-recognized Tribes that apply to implement strategies to prevent alcohol and substance abuse and prevent suicide in Tribal communities.  Prevention is an essential component of health care for everyone in America but SAMHSA recognized the responsibility it has to support, and the need Tribes have regarding prevention of substance abuse and mental health promotion.  Statistically American Indians/Alaska Natives[1]:

• Have death rates of two to five times the rate of Whites;
• Suicide is the second leading cause of death for American Indians/Alaska Natives in youth ages 15 – 24 years of age (a rate 2.5 times higher than the national rate;
• Have a higher rate of past month binge alcohol use than compared to the national average (30.6% vs. 24.5%);
• Have a higher rate of past month illicit drug use than compared to the national average (11.2% vs. 7.9%) ; and
• Only one in eight (12.6%) of American Indians/Alaska Natives adults (24,000 people) in need of alcohol or illicit drug use treatment in the past year received treatment at a specialty facility.

The proposed new formula grant would have a non-competitive application process every three years with reporting on an annual basis.  While the grant is formula-based, no formula has been established yet but will be determined after consultation with Tribal leaders is concluded.

The types of activities that can be expected by Tribes when using the prevention grant can include a public education campaign focusing on suicide prevention for Native American youth or a prevention campaign targeting adult binge drinking.  While these two activities only constitute a small piece of the prevention pie, the prevention grants have great potential to bring substance abuse prevention and suicide prevention to a community level.  Look out for more information in the future regarding this initiative!