The Center for Mental Health Services (CMHS) within the Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services is pleased to support the development of this special issue of The Journal of Primary Prevention on homelessness and mental illness. We thank the Journal for its interest in homelessness prevention and the authors and guest editors for advancing the field with their knowledge and insights.
Provides financial resources to state mental health authorities and local communities through the Projects for Assistance in Transition from Homelessness (PATH) formula grant program;
Expands the nation’s knowledge base through strategic service demonstration efforts such as ACCESS and the Chronic Homelessness Initiative; and
Improves community-based responses through technical assistance and knowledge dissemination efforts like the Stepping Stones to Recovery: A Case Manager’s Manual for Assisting Adults Who Are Homeless, with Social Security Disability and Supplemental Security Income Applications (SAMHSA 2005a) and the CMHS Homelessness Resource Center.
These efforts are making a difference, but they are not enough. With approximately 2.1 million adults and 1.3 million children experiencing the desolation and disconnection of homelessness each year (Burt et al. 1999), there is much work to be done. We must continue to improve our targeted efforts to address the needs of individuals who are currently homeless, but also must direct our efforts toward the larger systems issues that put people living with mental illnesses at increased risk for homelessness. This two-pronged approach, which is laid out in this special issue of The Journal of Primary Prevention, is needed for us to prevent and end homelessness in the years ahead.
We recognize this need. Various efforts are underway to change how services and systems operate within both the homeless and mental health fields. Although distinct, these efforts share a common conviction that “business as usual” is no longer acceptable and that fundamental service and systems change is needed to bring about meaningful outcomes for individuals and communities.
Exciting and encouraging activities are emerging nationwide with the goal of ending long-term/chronic homelessness. Spearheaded by the U.S. Interagency Council on Homelessness, more than 200 communities nationally—at county, city, and State levels—have developed 10-Year Plans to eliminate homelessness or chronic homelessness. To help realize their visions, 55 States and Territories have participated in federally sponsored Homeless Policy Academies. Many have developed Action Plans to improve access to mainstream services and housing options for people who are homeless, with processes to reinforce collaborative relationships and strategic decision-making among community stakeholders. The shift in focus from responding to ending homelessness is notable and important.
The mental health system has undergone similar self-reflection and efforts are underway to transform it as well. In its final report, Achieving the Promise: Transforming Mental Health Care in America, the New Freedom Commission on Mental Health (2003) called for fundamental changes in the way mental health services are perceived, accessed, delivered, and financed with the goal of a full life in the community for all those living with mental health issues. The Commission envisioned a newfound partnership among service providers, consumers, and families to ensure that mental health care is accessible, individualized, and focused on recovery. We are working hard to make this vision a reality. The Federal Action Agenda: First Steps (SAMHSA 2005b) outlines a multi-year collaborative effort by CMHS, its parent agency HHS, and all its federal partners to engage in concrete steps that will bring to fruition the goals and principles of mental health transformation. As a part of this, CMHS has committed $47 million to help support the transformation of state mental health systems through the State Incentive Grants.
We must work to prevent and end homelessness in America. Transforming homelessness and mental health services are critical in this effort. Progress is being made, but more must be done. This special issue of The Journal of Primary Prevention offers us important knowledge and tools we will need to achieve this goal.
A. Kathryn Power, M.Ed., Director, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services