CENTER FOR MENTAL HEALTH SERVICES: OVERVIEW CMHS MISSION The Center for Mental Health Services (CMHS) was established with the 1992 ADAMHA Reorganization Act (Public Law 102-321). Congress created CMHS to bring new hope to adults who have serious mental illness and to children with serious emotional disorders. CMHS leads Federal efforts to treat mental illnesses by promoting mental health and by preventing the development or worsening of mental illness when possible. CMHS is a component of the Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. CMHS pursues its mission by helping States improve and increase the quality and range of their treatment and support services for people with serious mental illness and their families and communities. Through CMHS, Congress encourages a range of programs-such as systems of care-to respond to the increasing number of mental, emotional, and behavioral problems among America's children. CMHS supports outreach and case management programs for the thousands of Americans with severe mental illness who are homeless. CMHS also supports efforts to help States and communities expand their mental health rehabilitative services. CMHS encourages the development of effective consumer-run and self-help programs. CMHS works with other Federal agencies whose programs and policies enhance mental health services delivery and advance policy development. The Departments of Education, Housing and Urban Development, and Justice and the Federal Emergency Management Agency are among the agencies with which CMHS collaborates. CMHS ORGANIZATION CMHS is organized into the following Divisions and supporting Offices: The Division of Program Development, Special Populations and Projects identifies gaps in prevention and service delivery and designs, develops, and implements programs for underserved and at-risk populations. Among its constituencies are people involved with the criminal justice system, minorities, women, older people, and rural Americans. The Division of Demonstration Programs plans, implements, and evaluates knowledge development and application programs to determine which models will work best for what groups under what conditions. Target groups are adults with severe mental illnesses, children and adolescents with serious emotional disturbances and their families, and homeless people who have severe mental illnesses. The Division of State and Community Systems Development administers the Performance Partnership Grant Program (formerly known as the Block Grant), manages CMHS' data collection and analysis effort, and helps translate knowledge into practice. The Division monitors State implementation of planning requirements and provides technical assistance to States. The Office of External Liaison plans and implements knowledge exchange activities, such as a public awareness campaign on children's mental health. The Office has established the Knowledge Exchange Network (KEN) to facilitate public access to the latest research and most successful model service delivery programs and systems, and to provide information and referral services to the public. The Office's Consumer Affairs Specialist is charged with ensuring that CMHS programs and materials reflect the concerns and perspective of mental health consumers. CMHS ISSUES Adults With Severe Mental Illnesses-Each year, 5.5 million Americans experience severe mental illnesses, such as schizophrenia, bipolar disorder, and severe depressive disorders, which can be as debilitating as chronic heart disease or diabetes. During their lifetime, more than 41 million adults-22 percent-experience a mental disorder. Services for Children and Adolescents-Almost 8 million children and adolescents (12 percent of all children) experience serious emotional disturbances. Only about one-third of these children receive mental health services, and many do not get appropriate care for their condition. For example, many of the 54,000 children treated in hospitals and residential treatment facilities would be better served in less restrictive, community-based facilities within an integrated system of care. Services for Adults With Serious Mental Illnesses Who are Homeless- Even by conservative estimates, as many as 600,000 people are homeless on any given night. About one-third are adults who have serious mental illnesses. More than one-half also have an alcohol or drug problem. Emergency Services and Disaster Relief-Virtually all individuals who live and work in a disaster area are candidates for direct crisis counseling services. CMHS works with the Federal Emergency Management Agency to provide counseling and education to "normal people responding normally to abnormal situations." Jail and Prison Population-Congress is particularly interested in more effective ways to provide mental health services to individuals who come into contact with the criminal justice system. According to recent estimates, nearly 54,000 inmates-7 percent of all prison inmates-have serious mental illnesses, and 95,000 inmates-12.5 percent-have significant psychiatric problems requiring intermittent care. Human Resource Planning-More than 40 million adult Americans experience mental disorders during their lives, but only 1 in 4 receives treatment. There are approximately 329,000 mental health professionals in the U.S., including psychiatrists, psychiatric nurses, psychologists, social workers, and other mental health workers with a bachelor's degree or higher. CMHS develops training programs and funds fellowships for people pursuing careers in mental health. Data Collection and Reporting-CMHS collects and reports national statistical information on mental health services and consumers for use by other Federal agencies, legislators, State mental health agencies, national mental health organizations, researchers, academic leaders, and national media. Protection and Advocacy-Congress established the Protection and Advocacy (P&A) program to protect the rights of people with mental illnesses, who are vulnerable to abuse and serious injury and are subject to neglect. During fiscal year 1995, the 56 P&A systems served almost 17,000 clients to address more than 25,000 complaints about abuse, neglect, and rights violations. PAIMI represented nearly 122,000 people in class action suits, acted on behalf of 332 groups representing nearly 526,000 people and responded to 44,219 requests for information. It conducted education and training for 320,555 mental health administrators, legislators, P&A staff, mental health consumers, their families, and mental health organizations. HIV/AIDS Mental Health Care-As many as 1.5 million people in the United States are infected with HIV, and more than 300,000 have been diagnosed with AIDS. CMHS is developing programs to provide mental health services for these individuals, their families, and others who may experience severe psychological distress as a result of their diagnosis, and to identify models of effective mental health services for people with HIV/AIDS. CMHS trains mental health providers to identify and treat people with mental illnesses who may be at increased risk for HIV/AIDS. CMHS trains primary health care and support services providers to recognize, refer, and treat people with emotional trauma, depression, anxiety, severe mental disorders, and dementia associated with HIV/AIDS. Stigma-Although some progress has been made to counteract the myths, misperceptions, and stereotypes surrounding mental illness, stigma still prevents many people from seeking treatment and causes countless others to keep their conditions secret for fear of losing their jobs, health insurance, or homes. Mental Health Information and Education-Information on many aspects of mental health and mental illnesses is gathered and disseminated to the many constituencies interested in these subjects. CMHS informs and motivates the public through its Knowledge Exchange Network, health communication materials, special events, and presentations. Center- supported consumer advocacy programs and technical assistance centers encourage self-help efforts nationwide. 5/2/96