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2014 Toolkit


Policymakers

Download the Word version of "Policymakers" (1,098 KB).

Introduction…

Federal, state, and local policymakers are integral to reducing the impact of mental and substance use disorders and in fostering environments that support, health and wellness.  Every September, the Substance Abuse and Mental Health Services Administration (SAMHSA) (http://www.samhsa.gov), within the U.S. Department of Health and Human Services (HHS) (http://www.hhs.gov), sponsors National Recovery Month (Recovery Month) to increase awareness of behavioral health conditions.  This observance promotes the reality that behavioral health is essential to health and people recover.

The 25th annual Recovery Month theme, “Join the Voices for Recovery:  Speak Up, Reach Out,” encourages people to openly discuss mental and substance use disorders and the reality of recovery.  It aims to foster public understanding and acceptance of behavioral health conditions, including ways to help individuals seek prevention, treatment, and recovery support services.  As the voice of their constituents, policymakers are in a unique position to speak up about behavioral health conditions and influence policies that help people receive the support they need.

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Speak Up…

Constituents in every jurisdiction across this nation are affected – either directly or indirectly – by mental and substance use disorders, raising difficult and expensive public policy matters for policymakers and taxpayers.  According to the 2012 National Survey on Drug Use and Health (http://www.samhsa.gov/data/NSDUH.aspx), in 2012, 23.1 million Americans aged 12 or older needed treatment for an illicit drug or alcohol use problem (8.9 percent of persons aged 12 or older), and 43.7 million Americans aged 18 and older (18.6 percent) experienced a mental illness.1 

Untreated behavioral health conditions have widespread, adverse effects within their communities.  Mental illness may result in an increased risk of living in poverty, having a lower socioeconomic status, and having lower educational attainment.2  Major depression, as well as other mental disorders, can also impair family function, increase the risk of teenage childbearing, and increase the risk of domestic violence.3  Similarly, substance use disorders contribute to costly social, physical, mental, and public health problems, including:4

  • Motor vehicle crashes;
  • Domestic violence;
  • Child abuse;
  • Crime;
  • Homicide;
  • Suicide;
  • Teenage pregnancy; and
  • HIV/AIDS.

Untreated mental and substance use disorders lead to increased spending for state and local governments and in various settings, such as hospitals, correctional facilities, schools, and homeless shelters.5  In addition, low-income adults who received treatment for chemical dependency saw medical costs decrease by more than $2,000 in a year, with lower medical costs still observed four years later.6  

There are significant public policy and cost benefits to supporting prevention, treatment, and recovery support services.  There are many treatments for behavioral health conditions that are highly effective, as shown by these statistics:

  • Research shows that between 70 and 90 percent of individuals with a serious mental illness experience a significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments.7 
  • Substance use treatment benefits include increases in employment income and decreases in costs associated with criminal activities, incarceration, and hospitalization.8 
  • Substance use treatment can also lead to reductions in overall health care costs; one study found a 30 percent reduction in medical care costs among Medicaid patients who were treated for a substance use disorder.9  Additionally, one study found that managed mental health treatment was associated with a 20 percent decline in medical costs.10
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Reach Out…

Building relationships with policymakers is essential to promoting the benefits of prevention, treatment, and recovery, as well as ensuring that supportive policies are enacted to improve coverage and access to life-saving care.  Reaching policymakers and their staff may be challenging due to their busy schedules, but it is possible if you are persistent.  Here are some tips on how to reach out to policymakers and start the conversation:11 

  • Keep it simple – make your communications brief and keep any supporting materials easy to read.
  • Make your message relevant – include information that is important and helpful to the policymaker and your community.  Also introduce yourself as a constituent, if applicable.
  • Be compelling – consider telling a story (about yourself or someone in the community) to make your outreach personal and memorable.

Educating policymakers about mental and substance use disorders is the first step to establishing yourself, or your organization, as a link to the recovery community.  As you engage with policymakers, be sure to present actionable ways they can support Recovery Month’s mission and advocate for the recovery community.  A policymaker can help advocate for behavioral health wellness and recovery in the community by taking steps such as:

  • Encourage health insurance enrollment and promote awareness about the Affordable Care Act (ACA), which makes health insurance more affordable for individuals, families, and small business owners.  They can highlight that the Mental Health Parity and Addiction Equity Act (MHPEA) of 2008 requires insurance groups offering coverage for mental health or substance use disorders to make these benefits comparable to general medical coverage.  The ACA will significantly expand the reach of MHPEA’s requirements starting in 2014 by requiring certain small group and individual market plans to comply with Federal parity requirements.
  • Support interventions in the criminal justice systems that screen, treat, and place people with substance use and mental health disorders into appropriate clinical interventions in the community.  Through diversion programs, pretrial release programs, specialized problem-solving courts, and conditional probation with sanctions, the justice system can mandate individuals’ participation in community-based treatment while under criminal justice supervision.12
  • Back efforts to combat prescription drug abuse, a significant public health concern across the country.  This may include introducing legislation aimed at deterring improper access to prescriptions from health care providers, such as requiring prescribers to receive education on the appropriate use, proper storage and disposal of prescription drugs, prescription drug monitoring programs, and identification requirements before dispensing.  Resources to reduce nonmedical use of prescriptions, including recently released tools by SAMHSA, can be found in the “Targeted Outreach Resources” (http://recoverymonth.gov/Recovery-Month-Kit/Targeted-Outreach/2014-TO-Resources.aspx) section of this toolkit.
  • Sponsor legislation that encourages community support for people in need of prevention, treatment, and recovery services.  This may include backing legislation that calls for increased resources for behavioral health services.
  • Issue a proclamation to raise awareness of mental and substance use disorders in the community.  The proclamation can highlight significant issues that affect constituents, including the availability of coverage for mental and substance use disorder treatment services under health coverage programs created by the ACA.
  • Attend or plan a Recovery Month event, such as a rally or festival sponsored by a community organization, to support the cause.  Policymakers can also plan a town hall or public policy forum to raise awareness of mental and substance use disorders.  Topics of importance to the recovery community include reducing discrimination and encouraging social inclusion and promoting employment for those in recovery.
  • Support the recovery community online by sharing prevention, treatment, or recovery resources and events on digital platforms, or engaging with other behavioral health organizations online.  Policymakers can start by liking Recovery Month on Facebook (https://www.facebook.com/RecoveryMonth) and following Recovery Month on Twitter (https://twitter.com/recoverymonth).
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Make a Connection…

Consider reaching out to policymakers in your area by making phone calls or through email. You may find yourself communicating mostly with staff members, which is a common practice.  Staff relationships are important and staff can be very helpful and influential.  Remember to be persistent and don’t get discouraged!  In some cases, you may have the opportunity to meet with a policymaker.  When you meet with a policymaker, keep in mind a few steps for success:

  1. Do your homework beforehand on the policymaker and their stance and voting record on behavioral health issues beforehand.  For Federal policymakers, you can visit Congress.org (http://congress.org).
  2. Identify up to four main points about behavioral health to deliver during your meeting, such as the impact of mental and substance use disorders on the community, as well as the positive effects of prevention, treatment, and recovery.
  3. Dress professionally and arrive early.
  4. Have an effective meeting that follows a structure, for instance:
    1. Begin with introductions.
    2. Ask them for their thoughts and perspectives regarding behavioral health issues, treatment, and recovery. Listen. Seek common ground.
    3. Offer a brief overview of the issue and your story (e.g., define key terms like mental and substance use disorders and your personal connection to the issues).
    4. Note compelling statistics or implications for their district (e.g., number of people with a behavioral health condition; how many residents might benefit from a treatment center).
    5. Offer to provide information that will be helpful to the policymaker and their staff.
    6.  State the “ask” and why their action is important (refer to the previous page for some ways policymakers can help).
    7. End with a question/answer session.
  5. Send a written thank you note afterwards, plus any information you promised to provide.
  6. Stay in touch by sending event updates and news articles about the impact of policy changes in your community, or examples of policy efforts that have proven effective in other communities nationwide.

Additional resources for policymakers are provided in the “Targeted Outreach Resources” (http://recoverymonth.gov/Recovery-Month-Kit/Targeted-Outreach/2014-TO-Resources.aspx) section of the toolkit. 

Inclusion of websites and resources in this document and on the Recovery Month website does not constitute official endorsement by the U.S. Department of Health and Human Services or the Substance Abuse and Mental Health Services Administration.

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SOURCES

  1. Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-47, HHS Publication No. (SMA) 13-4805. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 1.
  2. Russell, L.  (2010).  Mental Health Care Services in Primary Care: Tackling the Issues in the Context of Health Care Reform.  Center for American Progress.  Retrieved September 9, 2013, from http://www.americanprogress.org/wp-content/uploads/issues/2010/10/pdf/mentalhealth.pdf.
  3. Russell, L.  (2010).  Mental Health Care Services in Primary Care: Tackling the Issues in the Context of Health Care Reform.  Center for American Progress.  Retrieved September 9, 2013, from http://www.americanprogress.org/wp-content/uploads/issues/2010/10/pdf/mentalhealth.pdf.
  4. U.S. Department of Health and Human Services, Healthy People 2020.  (2013).  Substance Abuse.  Retrieved on September 9, 2013, from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=40.
  5. National Council for Behavioral Healthcare.  (n.d.).  The Spill Over Effect of Untreated Mental Illnesses and Substance Use Disorders on State Budgets.  Retrieved on September 9, 2013, from http://old.thenationalcouncil.org/galleries/policy-file/Spill%20Over%20Effect_State%20Budgets_NCSL.pdf.
  6. Shah, M., et al.  (2009).  The Persistent Benefits of Providing Chemical  Dependency Treatment to Low – Income Adults. Washington State Department of Social and Health Services.  Retrieved on November 18, 2013, from http://www.dshs.wa.gov//pdf/ms/rda/research/4/79.pdf.
  7. National Alliance on Mental Illness.  (n.d.).  What is Mental Illness: Mental Illness Facts.  Retrieved on September 9, 2013, from http://www.nami.org/template.cfm?section=about_mental_illness.
  8. Robert Wood Johnson Foundation, Substance Abuse Policy Research Program.  (n.d.).  Key Results: Substance Abuse Treatment Benefits and Costs.  Retrieved on September 9, 2013, from http://www.saprp.org/knowledgeassets/knowledge_results.cfm?KAID=1.
  9. Robert Wood Johnson Foundation, Substance Abuse Policy Research Program.  (n.d.).  Key Results: Substance Abuse Treatment Benefits and Costs.  Retrieved on September 9, 2013, from http://www.saprp.org/knowledgeassets/knowledge_results.cfm?KAID=1.
  10. Washington State Department of Social and Health Services. (2002). Medical Cost Offsets Associated With Mental Health Care: A Brief Review.  Retrieved on September 25, 2013, from http://www.dshs.wa.gov/pdf/ms/rda/research/3/28.pdf, p. 2.
  11. Society for Public Health Education.  (n.d.).  Guide to Effectively Educating State and Local Policymakers.  Retrieved on September 9, 2013, from http://www.sophe.org/ChronicDiseasePolicy/Full_Guide.pdf.
  12. National Institute on Drug Abuse.  (2006).  Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-Based Guide.  Retrieved from November 18, 2013, from http://www.drugabuse.gov/publications/principles-drug-abuse-treatment-criminal-justice-populations, p. 16. 

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