Remarks by Charles G. Curie,
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
National Association of Drug Court Professionals
12th Annual Training Conference
June 23 , 2006
Below is the text prepared for delivery; however, some material may have been added or omitted at the time of delivery.
Thank you Karen (Freeman-Wilson) and good morning everyone. I am pleased to have this opportunity to join you today - we share the common goals of improving public health and public safety. And, it is most often the case that strong partnerships along a common ground gain more traction than going it alone.
For the past few years, SAMHSA has geared a lot of energy toward creating relationships and partnerships with judges, prosecutors, public defenders as well as treatment providers, researchers and public policy decision-makers who are committed to making sure those in the criminal justice system have a chance to restore their personal health through recovery.
People who are given the chance to attain and sustain recovery win battles over addiction. Resiliency grows and addiction shrinks when recovery takes hold.
Thankfully, we are well past the time when many Americans – and society at large – shared the belief that a person with history of drug use, alcohol abuse, prescription drug abuse and/or mental illness could not become productive, contributing members of the community.
In part, that is because as a nation, we have begun to talk about addiction and recovery more than ever before. It is an illness that is blind to race, religion, profession, socio-economic status, or other classifications. It is an illness that strikes the lawyer, the doctor, the dock worker, and every type of family in every type of setting.
What we know, definitively now, is addiction and mental illness are treatable illnesses and prevention and treatment are effective.
When these services are targeted to adult and juvenile offenders the benefits are three-fold. First, if we prevent addiction, drug related crime will decrease.
Second, if we intervene early and get the appropriate treatment services in place, recidivism rates drop. And third, as SAMHSA increases recovery support services, reentry success rates climb and public safety is increased.
It just makes sense for SAMHSA to strengthen partnerships with groups like the NADCP. SAMHSA has also been working diligently to strengthen collaboration with groups like the Association of State Correctional Administrators, the American Correctional Association, the National District Attorney’s Association, Governors’ Associations and many others.
Simply put, this makes good sense because there is an inescapable link between mental illness, substance abuse and crime. And, the related costs place a heavy financial burden on communities and the results often tear families apart and negatively impact children and adolescents.
Mental health and substance abuse issues are a matter of public health and public safety. They are a shared responsibility across all systems of care in all States and communities. At SAMHSA, we are working to make good on our efforts to share that responsibility by increasing and improving our investments in prevention and treatment services.
At SAMHSA, our agency vision is “A Life in the Community for Everyone.” Our vision was built around what consumers said they needed most to obtain and sustain recovery – a job, a home, and positive connections to family, friends, and their communities.
To achieve our vision – we created a mission around the truth – that recovery is real. Our mission, simply stated, is to build resilience and facilitate recovery.
To bring clarity to our work at SAMHSA and to bring both our vision and mission from concept to reality, I created a Matrix of agency program priorities and cross-cutting management principles.
The blue axis of the Matrix is what I call the Leadership Axis – making sure we are doing the right things. The red axis is the Management Axis – making sure we are doing it right. On the Leadership Axis, you’ll see Criminal and Juvenile Justice.
We have created a Criminal and Juvenile Justice Framework to focus squarely on the needs of consumers who are at risk of becoming involved in the criminal and juvenile justice systems as well as those who are already involved.
Criminal and Juvenile Justice has a place on our Matrix because we know that the rate of mental illnesses for people in jails and prisons is about twice that of the general population.
Approximately 8 percent of the American general population has some form of mental health disorder while the rate among the U.S. jail and prison population is double that at approximately 16 percent.
Further complicating the situation, roughly three-quarters of all persons with mental illnesses housed in our jails/prisons have a co-occurring substance abuse disorder.
At SAMHSA, we are focused on changing these numbers by improving services in three key areas: substance abuse prevention, substance abuse treatment, and mental health services.
I will highlight some of our activities and initiatives in all three of these key areas. With regard to substance abuse prevention, we are making significant progress - especially with youth. Under the leadership of President Bush we have embarked on a strategy that is working.
The most recent data confirm that we are steadily accomplishing the President’s goal to reduce teen drug use by 25 percent in 5 years. Now at the 4-year mark trend analysis for youth current use of any illicit drug from 2001 to 2005 among 8th, 10th and 12th graders shows a drop of 19 percent. This translates into nearly 700,000 fewer youth using illicit drugs in 2005 than in 2001.
We know that when we push back against the drug problem it recedes. Yet, underage drinking remains a serious, persistent, and stubborn problem. Alcohol is the most widely used substance of abuse among America’s youth.
A higher percentage of youth aged 12 to 20 use alcohol than use tobacco or illicit drugs, making underage drinking a leading public health problem in this country.
It is time to get real about preventing underage drinking. Last year, Health and Human Services Secretary Michael Leavitt convened a national meeting that brought together leaders appointed by the Governor of every State to make the prevention of underage drinking a reality.
Another major change, with the backing of the First Lady, is to increase prevention efforts and bring prevention to scale on a national level. The First Lady’s Helping America’s Youth Initiative is becoming the umbrella which pulls together multiple Federal prevention programs, including SAMHSA’s Strategic Prevention Framework (SPF).
The Strategic Prevention Framework is putting into place – in 40 states – a science-based approach to prevention that will help continue to reduce substance abuse and build resilience in our young people.
The SPF is built on the principle that communities must be empowered and that the best solutions to substance abuse problems often come from local communities. Its premise – local people solve local problems best.
To be certain that we are building a true community-based approach to substance abuse prevention and mental health promotion, SAMHSA requires that 85 percent of the SPF State Incentive Grant dollars go to communities to strengthen local prevention capacity.
The success of the framework rests in large part on the tremendous work that comes form grass-roots community anti-drug coalitions. That’s why SAMHSA will continue to work with the Office of National Drug Control Policy (ONDCP) to administer the Drug-Free Communities Program. This program has grown to support over 700 grantee anti-drug coalitions operating across the country.
Consistent with the Strategic Prevention Framework and the Drug Free Communities grant programs, we are transitioning our drug-specific programs to a risk and protective factor approach to prevention. This approach also provides States and communities with the flexibility to target their dollars in the areas of greatest need.
Although prevention is a critical component to building a healthy America, it is equally important to continue making progress in the substance abuse treatment field.
We are making progress, yet unfortunately there remains a vast unmet treatment need in America. Still today, too many Americans who seek help for their substance abuse problem cannot find it.
SAMHSA is working to increase access to treatment and recovery support services because we know treatment works and recovery is real -- even for people who abuse methamphetamines, which has become a growing national problem.
I know that many of you have been discouraged by the challenge of working with people who use methamphetamine and, in fact, you may have been told that “meth users cannot be treated” and “meth users cannot ever recover from brain damage” caused by this drug.
Many of you may have heard that “the success rate for methamphetamine users is only five percent.” Our SAMHSA data debunks this as myth. Those who use methamphetamine can be effectively treated and they can recover their neurological functions after a period of time.
Our data also show that treatment admissions for methamphetamine increased 286 percent between 1994 and 2004 with a total of 129,079 treatment admissions in 2004. However, results of SAMHSA-funded evaluations show that 59-69 percent of those who have been treated are free of methamphetamine after 6 months.
Furthermore, PET scans of brain activity show people who use methamphetamine and then are abstinent show a return to normal or near normal brain functioning within 18 months of abstinence.
SAMHSA recognizes that methamphetamine abuse goes beyond just the individual offender and touches the lives of those around the abuser.
In fact new funding for our Family, Juvenile and Adult Treatment Drug Courts, requires applicants to link their engagement with and treatment of methamphetamine abusers to existing Drug Endangered Children Team programs.
In addition to our efforts to specifically target meth, we continue our work to help increase substance abuse treatment capacity overall.
We have firmly established there are many pathways to recovery from addiction including the transforming powers of faith and we have broadened alliances with community and faith-based service providers through the Access to Recovery (ATR) Program.
ATR is a key addition to the demand reduction infrastructure. Thousands of people seek treatment each year and sadly, many are unable to find care. With the leadership of the President, access to recovery is now a reality for thousands of Americans.
ATR expands consumer choice through a unique voucher program aimed at increasing recovery options by focusing on both clinical treatment and other recovery support services.
We have gained significant ground on this priority and Access to Recovery is up and running in 14 States and one tribal organization.
We have also provided the flexibility to States to use these dollars to focus on emerging trends, like the devastation that methamphetamine use has brought to individuals, families and communities.
In short, the President’s ATR initiative and New Freedom Initiative has helped all of us operationalize recovery in both public policy and public financing.
At the same time SAMHSA is improving our nation’s substance abuse and prevention services, we are also committed to transforming our Nation’s mental health delivery system. Last July, we released the Federal Action Agenda that contains 70 specific action steps to guide the transformation process.
When we close the gaps in fragmented systems of care, fewer individuals with mental illnesses will come into contact with the criminal justice system.
In addition to funding States to create new, comprehensive State plans to improve their mental health systems, SAMHSA supports a Jail Diversion grant program. The grant program has funded 26 sites across the country to develop model jail diversion programs that will be replicated nationwide.
Preliminary results of a SAMHSA study on jail diversion for non-violent offenders indicate reduced rates of re-arrest, decreased incidence of substance abuse and psychiatric symptoms, and increased quality of life among people who are diverted from the justice system.
SAMHSA also funds the National GAINS Center for Evidence-Based Programs in the Justice System and the Technical Assistance and Policy Analysis (TAPA) Center for Jail Diversion.
Last year, SAMHSA and the Bureau of Justice Assistance sponsored the first meeting of the Judges Leadership Institute. At the Institute, 90 judges with an interest in mental health court issues met to discuss best practices and to support one another in their leadership roles with regard to mental health-criminal justice issues.
These are just a few examples of SAMHSA’S efforts to strengthen prevention and treatment services. And, although, I have recently announced my resignation as the SAMHSA Administrator, I want to assure you that the inroads already made are solid enough to well outlast my post.
Working together, we can do the right thing for adults and youth with mental illnesses, and with co-occurring substance use disorders, who come in contact with the criminal justice system. Our communities deserve no less. The people we serve deserve no less.
Thank you for your continued investment in the health and hope of our nation. The work you do is filled with passion. I have seen that passion first hand. I have been in the judges’ chambers while the fate of an individual is debated.
I have listened as prosecuting attorneys, defense attorneys, caseworkers and judges try to piece shattered lives back together by giving treatment a chance. I have witnessed the cycle of crime, arrest, incarceration, release and recidivism be broken when mental health and substance abuse treatment are presented as options.
In essence, when you make those types of decisions and clear a path to recovery you are bringing the wires back up for people who are very often isolated, alone and without hope.
General Douglas McArthur once spoke about keeping the wires up and in closing I would like to share his words with you because I believe they speak to dedication behind your work.
Macarthur said, “In the Central place of every heart there is a recording chamber. So long as it receives a message of beauty, hope, cheer and courage so long you are young. When the wires are all down, and your heart is covered with the snows of pessimism and ice of cynicism, then and only then are you grown old.”
If these words of Macarthur are true, then the person with mental illness, distracted by the voices, devastated by moods which are out of their control, or the individual trapped by addiction are the people who become more and more cut-off, more and more isolated and truly do have all the wires down and in may ways grow old before their time.
This then tells us that once treatment begins to take hold, once medications have their effect, once symptoms are alleviated, once the wires start to come up, we must do everything in our capacities as a system to assure messages are sent to that central place in the heart…messages which convey beauty, hope, cheer and courage.
For when those messages come through and ring true, they melt away the snows of pessimism…they melt away the ice of cynicism…they can melt away a glacier of despair. This then invites recovery.
Thank you for your tremendous efforts and the important work you do.