Letter to President Obama regarding the Importance of Appointing a Nationally Recognized Professional with a Strong Science Background to be the Admi

Dear Colleague:

I am copying below a letter from leading substance use and mental health professionals to President Obama calling on him to appoint a director of SAMHSA who is a respected professional with a scientific background in mental health, substance use disorders and public health. The letter discussed the agency's dysfunction in previous years under leadership lacking in this expertise.

If you support our point of view, please distribute the letter to your colleagues, listserves, blogs,contacts in the media and government and others with an interest in this critically important appointment. I am getting the letter to President Obama through several channels. Let's get the message to President Obama in as many ways as we can.

It is time for real change in how our government ensures high quality, evidence-based and theoretically sound treatment for all Americans struggling with substance use and mental health issues. Please support this effort!

Best,

Andrew Tatarsky, PhD


Letter to President Obama regarding the Importance of Appointing a Nationally Recognized Professional with a Strong Science Background to be the Administrator of Substance Abuse and Mental Health Services Administration (SAMHSA)

March 9, 2009

Dear President Obama

Virtually every family in America is affected by mental illness or addiction. The cost in personal suffering and economic loss is staggering. Part of the tragedy of mental illness and addiction is that these disorders typically strike in late adolescence and early adulthood, between 18-25 years of age. By contrast, most major medical illnesses occur much later in life. The World Health Organization found that mental illness and addiction were the leading causes of disability among Americans ages 18-45, confirming that these diseases rob young Americans of their most productive years.

The last two decades have witnessed dramatic scientific advances in understanding mental illness and addiction which have led to the development of effective treatments and prevention programs. Unfortunately, unlike standard protocols for advances in other areas of medicine, these treatments are not reaching the vast majority of the public who need them. For example, the United States spends about $120 billion annually on behavioral health care [1]. Yet, less than 25% of this care is evidence-based, with 75% of questionable value. The result of the mediocre quality of behavioral health care is that many Americans are suffering needlessly and some are dying because they are not receiving treatment has been shown to work.

What can be done to solve this problem? Most advocacy groups call for increased spending. While lack of resources is part of the problem, increasing funding alone will not solve the problem. Currently, Americans are not receiving adequate value for the $120 billion that are spent annually and much more could be accomplished using existing resources. This is the main conclusion of a landmark report on the state of behavioral healthcare issued by the Institute of Medicine of the National Academy of Science in 2006.

The federal government’s response to this situation has been woefully inadequate. The federal agency responsible for overseeing the quality of behavioral health care and prevention is the Substance Abuse and Mental Health Services Administration (SAMSHA). SAMSHA has a $3.3 billion budget. An OMB review of this agency rated the agency’s programs as largely ineffective; an assessment shared by most mental health and addiction experts. Many politicians including Congressman and Senators who sit on relevant oversight committees have never heard of SAMSHA, despite the fact that SAMSHA is on the same organizational level in the Public Health Service as CDC and FDA.

One major reason for SAMSHA’s obscurity and dysfunction has been the failure to appoint a person with significant scientific and professional expertise to the lead the agency. Past administrators have been drawn from the ranks of state government with experience in community action, but without recognized high level scientific mental health, addiction, and public health expertise. By contrast, the recent heads of FDA and CDC have been nationally prominent scientists with accompanying expertise and stature to effectively lead their agencies.

President Obama, you have a unique opportunity to improve the treatment and prevention of mental illness and addiction by breaking with the past tradition of placing a political appointee with regulatory and administrative experience as the Administrator of SAMSHA. Instead, your transition team should seek a professional with a national reputation of excellence as a scientist and innovator in implementing science-based mental health and addiction programs and public health models in communities. This move would be consistent with your approach to attracting the highest caliber professionals into government, has the potential to improve the lives of many Americans, and would elicit uniform praise from advocates, the scientific community, and the press.

[1] Behavioral health care means addiction and mental health services combined.

Respectfully,

Andrew Tatarsky, PhD, Founding board member and past president, Division on Addiction, New York State Psychological Association, New York, NY; Co-director, H
arm Reduction Psychotherapy and Training Associates

John H. Halpern, M.D., Assistant Professor of Psychiatry, Harvard Medical School, Director of the Laboratory for Integrative Psychiatry, Division of Alcohol and Drug Abuse, Associate Director of Substance Abuse Research, Biological Psychiatry Laboratory, Alcohol and Drug Abuse Research Center, McLean Hospital, Belmont, MA

Mark B. Sobell, Ph.D., ABPP, Professor, Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, Florida

Jon Morgenstern, Ph.D., Professor & Director, Substance Abuse Services, Department of Psychiatry, Columbia University Medical Center, New York , NY

Reid K. Hester, Ph.D., Director, Research Division, Behavior Therapy Associates, LLP
Albuquerque, NM

Linda C. Sobell, Ph.D., ABPP, Professor, Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, Florida

William R. Miller, Ph.D., Emeritus Distinguished Professor of Psychology and Psychiatry, The University of New Mexico, Albuquerque, NM

Richard Juman, PsyD, Representative to Council, Division on Addictions , New York State Psychological Association, New York, NY

Ernest Drucker PhD, Professor, Montefiore Medical Center, Albert Einstein College of Medicine and Columbia University Mailman School of Public Health, New York , NY

Debra Rothschild, PhD, CASAC, Past President, Division on Addictions, New York State Psychological Association, New York, NY

Tom Horvath, Ph.D., ABPP, Practical
Recovery, La Jolla, CA

Joe Ruggiero, Ph.D., Assistant Clinical Director, Addiction Institute of New York, Director,Crystal Clear Project, New York, NY

G. Alan Marlatt, Ph.D. , Professor and Director, Addictive Behaviors Research Center University of Washington, Dept. of Psychology, Seattle, WA

George H Northrup, PhD, President, New York State Psychological Association, New York, NY

Scott Kellogg, PhD, Department of Psychology, Faculty of Arts and Sciences, New York University, New York, NY

John Rotrosen, MD, Professor, Department of Psychiatry, NYU School of Medicine, New York, NY

Nicholas Lessa, Chief Executive Officer, Inter-Care, LTD, New York, NY

Randy Seewald, MD, Beth Israel Medical Center MMTP, Medical Director, Beth Israel Medical Center, New York, NY

Alexandra Woods, PhD, Psychologist/psychoanalyst in private practice, Board of Directors, Division on Addictions, New York State Psychological Association

Karen Frieder, PhD, Executive board member, Addiction Division, New York State Psychological Association, Private Practice, New York, NY

Ana Kosok, Ed. D., Executive Director, Moderation Management Network, New York

Julie Barnes, PhD, CASAC, private practice, Executive board member, Addiction Division, New York State Psychological Association

Genata Carol, PhD, Director of Mental Health Services, AIDS Service Center of Lower Manhattan New York, NY

Patt Denning, PhD, Director of Clinical Services and Training, Harm
Reduction Therapy Center, San Francisco, CA

Jeannie Little, CSW, Executive Director, Harm Reduction Therapy Center, San Francisco, CA

Laura Kogel, LCSW, The Women's Therapy Centre Institute, New York, NY.

Bryan Fallon, PhD, Clinical supervisor in mental health for Prison Health Services. New York, NY