Grading the States

NAMI’s Report to the Nation on State Public Mental Health

Service Systems

Ron Honberg, Director of Policy and Legal AffairsLaudy Aron, Director of ResearchKatrina Gay, Director of Communications

NAMI 2008 Annual Convention, Orlando, Florida

June 14, 2008

NAMI’s History of Assessing State Systems

1986, 1988, 1990 editions ofCare of the Seriously Mentally Ill:

A Rating of State Programs

... and in 2006,Grading the States

Grading the States 2006Purpose

• Increase transparency/accountability

• Educate the public (support learning across states)

• Move transformation agenda from rhetoric to reality

• Support state-specific action agendas

• Create baseline for future performance measures

• Put consumers/families at the heart of reform efforts

Grading the States 2006Findings - The Grades

National average was a D

B 5 states C 17 states D 19 states F 8 states U 2 states

Grading the States 2006Findings - Positive Trends

• Greater focus on evidence-based and promising practices

• Consumers and families more involved in service design and delivery

• Strong linkages with (and even leadership from) partners such as law enforcement, ER docs, etc

• Pockets of innovation in virtually every state, even those receiving an “F”

Grading the States 2006Findings - Negative Trends

• Budget cuts or flat funding • Changes to Medicaid (e.g. restricted eligibility,

cost-sharing)• Inpatient bed shortages, esp. for acute-care • Cost shifting to other systems (e.g. criminal

justice, emergency systems, homeless services)• Long waiting lists for housing and other vital

community services

Grading the States 2006Advocacy Impact

• Focused public attention on mental illness and mental health systems

• Increased visibility/advocacy impact of NAMI state organizations

• Helped define critical state issues (including strengths and areas of need)

• Served as a catalyst for mental health reform/ transformation initiatives in certain states (e.g., Georgia, Kansas, Kentucky)

• Test Drive opened eyes about need to improve customer service & access to information

Grading the States 2008Additional Goals

• Assess nation’s public mental health system (ongoing)– Has the national “D” grade improved?

• Compare states’ performance in 2006 vs. 2008

• Provide NAMI members and others with up-to-date information, advocacy, and communications tools

Grading the States 2008How will it differ?

• Refine grading/scoring methodology– Use data from existing, secondary data sources– “Tighten” questions to SMHAs

• Maintain some consistency with 2006 measures (for comparability etc.)

• Obtain methodological input from national experts and other stakeholders

• Pave the way for future rounds of GTS (streamline measures; consumer outcomes)

Grading the States 2008Welcome your input on...

• Measures we should include in the grade• Other information for education/context• Data sources• Lessons learned from GTS-06 • Hopes for GTS-08• Thoughts for future rounds of GTS

• Laudan@nami.org tel. 703-600-1110

Grading the States 2008NAMI State Liaisons

• Each state has identified a “State Liaison” or “point person” for the purpose of GTS

• A knowledgeable person with solid judgment who can coordinate input from state/local NAMI & provide in-state perspective/context

• First communication to all State Liaisons was sent out via e-mail on April 24th (responses were due back May 15th)

• Please send us responses if you haven’t yet!

Grading the States 2008Consumer/Family Survey

• Partnering with TeleSageTM on a web-based survey of consumers and their family members

• All respondents will be anonymous (we ask for respondents’ zip code)

• Small number of basic questions about access to & quality of public mental health services

• Survey will be “live” in July • Help us get the word out (e-Advocate etc.)• Not limited to NAMI members...

Grading the States 2008Timetable

• Study design/data collection plan – now!• Data collection/analysis – mid/late-2008• Draft report - late 2008• Final report/dissemination materials - late 2008 • Release date - early 2009

Grading the States 2008Communications: Informal/Formal

– Who, what, when, why, how… or, needs, frequency, and mode

– The informal, or more social, communications sets the scene, builds momentum, and establishes insurance against potential conflict

– Spheres of influence:• Mental health partners and other leaders• Affiliate and board relations• Key legislative and other political allies• Key media relations• And for those who have them, staff members

Grading the States 2008 Summer-Fall 2008—Checklist

Build your story bank Cultivate media relationships Consider a session for your NAMI State Conference Reprint articles from the Advocate in your state newsletters, with commentary OR mention in Presidents/Executive Directors letter OR write your own article Engage regularly with your GTS liaison Place on the agenda for board meetings Communicate, communicate, communicate

Grading the States 2008 Winter 2008 – What to Expect

• Teleconference briefing sessions

• Talking points and strategy assistance

• Template media materials

• Networking opportunities with other NAMI leaders

• Media event technical assistance and coaching