SAMHSA: Transforming Mental Health Care in America - Federal Action Agenda 2005


The Federal Action Agenda: First Steps



Transformation of the mental health system in America is a monumental task, but one that cannot be delayed. This Federal Mental Health Action Agenda makes clear that the system must be redirected toward its primary goal-helping adults with serious mental illnesses and children with serious emotional disturbances achieve recovery to live, work, learn, and participate fully in their communities. This vision requires nothing short of a complete transformation of administrative policies, funding mechanisms, and the hearts and minds of everyone who has a stake in our nation's health care system. The time for action is now.

This Federal Mental Health Action Agenda represents the first "to do list" of a multi-year effort to alter the form and function of the mental health system from the top down and from the bottom up. This Action Agenda represents the Federal response to Executive Order 13263 and is informed by the New Freedom Commission's vision of a transformed mental health service system. However, transformation is a shared responsibility.


Federal agencies can act as leaders and as facilitators, promoting shared responsibility for change at the Federal, State, and local levels, and in the private sector, in such areas as public education, research, service system capacity, and technology development. States, however, will be the very center of gravity for system transformation; many have already begun this critical work. Their leadership in planning, financing, service delivery, and evaluation of consumer and family-driven services will significantly advance the transformation agenda. Finally, an emphasis on individual recovery and resilience will transform not only service delivery systems, but also hearts, minds, and lives for future generations.


With this Federal Mental Health Action Agenda, the U.S. Department of Health and Human Services (HHS) and its Federal partners make an unprecedented commitment to collaborate on behalf of adults with serious mental illnesses and children with serious emotional disturbances to:

  • Send the message that mental illnesses and emotional disturbances are treatable and that recovery is possible.
  • Act immediately to reduce the number of suicides in the Nation through full implementation of the National Strategy for Suicide Prevention.
  • Help States develop the infrastructure necessary to formulate and implement Comprehensive State Mental Health Plans that include the capacity to create individualized plans of care that promote resilience and recovery.
  • Develop a plan to promote a mental health workforce better qualified to practice culturally competent mental health care based on evidence-based practices.
  • Improve the interface of primary care and mental health services.
  • Initiate a national effort focused on the mental health needs of children and promote early intervention for children identified to be at risk for mental disorders. Prevention and early intervention can help forestall or prevent disease and disability.
  • Expand the "Science-to-Services" agenda and develop new evidence-based practices toolkits.
  • Increase the employment of people with psychiatric disabilities.
  • Design and initiate an electronic health record and information system that will help providers and consumers better manage mental health care and that will protect the privacy and confidentiality of consumers' health information.


The reason to begin is both simple and profound-people with mental disorders have a vital role to play in our families, our neighborhoods, our communities, and our country. Their ability to participate fully can no longer be derailed by outdated science, outmoded financing, and unspoken discrimination. They demand better, and they deserve better. Putting children and their parents, adults, and older adults with mental disorders at the heart of the health care system must be accomplished now.

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File Date: 2/12/2009