SAMHSA takes steps to fix a fractured mental health care system following report of congressionally mandated committee

Thursday, January 4, 2018

As part of a blue-ribbon panel that recently issued a report to Congress detailing problems within the American mental healthcare system, the Substance Abuse and Mental Health Services Administration (SAMHSA) is working to help transform that system and better serve people in need.

“The present system facing our country’s citizens with serious mental illness is unacceptable,” said Dr. Elinore F. McCance-Katz, the Assistant Secretary for Mental Health and Substance Use at the Department of Health and Human Services. “The Trump Administration is determined to address this issue head-on. This is a serious challenge, Americans deserve better, and we are focused on reforming the system to provide a better level of care.”

The Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), an advisory committee created by the 21st Century Cures Act, was established to address the needs of adults with serious mental illnesses (SMI) and children and youth with serious emotional disturbances (SED) and their families. Last month, ISMICC formally delivered to Congress a 108-page report that detailed deficiencies in the country’s treatment services for Americans living with serious mental illness. SAMHSA’s efforts to build upon the Report’s insights can be seen in policy implementations under way. Among them:

  • Assigning a full-time SAMHSA employee to help ISMICC’s federal members maintain progress on panel priorities in order to keep pace with the Administration’s drive for system transformation
  • Working on instituting a budgetary set-aside for mobilizing resources to help patients being treated for first episode psychosis, as early treatment of serious mental illness is important for patients’ recovery.
  • Implementing the Zero Suicide initiative as part of SAMHSA’s priority of advancing effective prevention strategies throughout the nation.

“Activities such as these,” Dr. McCance-Katz said, “pertain to the report’s sobering findings.” For example, an estimated four million American adults with the most debilitating mental disorders and an estimated 6.8 to 11.5 percent of children with serious emotional disturbances are not being helped. Instead, many adults with illnesses such as schizophrenia are ending their lives, are being inappropriately incarcerated or are becoming homeless, and children and youth are slipping through the cracks.

Among the Report’s findings:

  • National data on the treatment gap reveals that 50 to 90 percent of those in need of mental health treatment are not receiving services.
  • Among adults diagnosed with schizophrenia, 1 in 20 dies by suicide. The suicide rate for individuals with mood disorders such as depression or bipolar disorder is 25 times higher than for the general population.
  • Approximately two million people with SMI are booked into U.S. jails annually, often for minor offenses such as trespassing.
  • About a quarter of adults with SMI, an estimated 2.6 million people, also have a substance use disorder, including opioid addictions. But only 14.3 percent are receiving specialized, substance use treatment.
  • For an estimated 50 percent of people with mental illness, the onset of mental illness happens before age 15; onset happens before age 25 for 75 percent of people with mental illness. Yet diagnoses may not be made for years after onset of symptoms.
  • People with SMI die roughly 10 years earlier than their age-matched counterparts who have no mental illness.
  • There are only 8,300 child and adolescent psychiatrists in the United States and an estimated 15 million youths in need of one (American Academy of Child and Adolescent Psychiatry). Most counties in the United States face severe shortages of mental health professionals.  From 2003 to 2013, the number of practicing psychiatrists decreased by 10 percent.
  • Only about one in three people with mental illness in jails or prisons is currently receiving any treatment.
  • Of the 70 percent of people with SMI who are unemployed and want to work, only 2 percent receive support to find and keep employment.

Dr. McCance-Katz is the first Assistant Secretary for Mental Health and Substance Use, a role created by the 21st Century Cures Act, which was signed into law last year to better coordinate and streamline more than 100 mental health and serious emotional disturbance programs administered by eight federal agencies. That same law created an oversight panel called the Interdepartmental Serious Mental Illness Coordinating Committee, or ISMICC, comprising representatives from federal agencies and 14 nationally recognized mental health experts.

Congress has given the Committee five years to implement reforms. In the panel’s first report to Congress, officially delivered December 13, the non-federal members made 45 specific recommendations for improving federal programs.

“The Trump Administration supports this timely, crucial opportunity to reform and to streamline our system,” Dr. McCance-Katz said. “This report is our first step. Unlike some types of congressional reports, the ISMICC report is the beginning and not the end of a process – the committee will continue to work for four more years toward the implementation of its recommendations.”

Video of the public release of the report –   including personal statements by non-federal members Mary Giliberti, executive director, National Alliance for Mental Illness; Pete Earley, author and father of a son with serious mental illness; and Eric D. Hargan, acting secretary of the U.S. Department of Health and Human Services; as well as Dr. McCance-Katz – can be seen at https://youtu.be/_ubhgwAF3XA. More information about the ISMICC can also be found on SAMHSA’s website, https://www.samhsa.gov/about-us/advisory-councils/ismicc

For more information, contact the SAMHSA Press Office at 240-276-2130.


The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (DHHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.

Last Updated: 11/20/2019