The state Office of Mental Health has embarked on a major campaign to change the way mental health care providers do business. Officially dubbed "Winds of Change," the campaign declares that evidence-based practices are the way to go from now on for mental health services.

Historically, the basis for mental health programs has been their intentions rather than the track record of the services they provide. Also a lack of standards regarding what each program must do (combined with financial pressures) has often led to services that might "look good on paper" but are lacking in actual results.

In order to be "evidence-based," programs must be proven through scientific research to work. Futhermore, the elements that enable the programs to provide consistent results must be replicated according to measurable standards.

According to Sharon Carpinello, OMH Executive Deputy Director, researchers have identified a set of core practices that consistently promotes wellness. For adults, these include medication; training consumers in illness self-management; assertive community treatment teams, educating families to better support their ill loved ones (family psychoeducation); supported employment, and integrated treatment for co-occurring substance abuse and mental health disorders.

To this list OMH has added treatment for Post Traumatic Stress Disorder and self-help and peer support services, citing supporting research.

Evidence-based practices for children and adolescents include evidence-based prescribing practices; family education and support services; functional family therapy; home-based crisis intervention; home and community based waiver services; intensive case management; school-based mental health services and Post Traumatic Stress Disorder treatment.

OMH will establish specific requirements for each of these practices in order to meet specific quality standards. For example, standards for the use of medications will address how medications are selected, the measurement of their efficacy and side effects, and how to help patients to keep taking them. Standards for Assertive Community Treatment teams will address the team’s staffing, the ratio of clients to team members, the extent of services to be provided, etc. Standards for family psychoeducation will address the content and presentation of specific classes.

Detailed "toolkits," the basis for a major technical assistance effort to help providers carry out what is required, are in the works.

We at NAMI-NYS believe this initiative is long overdue. We have been advocating for several of the "core practices" for years, citing their track records in actually helping people.

Some programs simply don’t work as well as others. Part of the reason for this is that mental health care has evolved so rapidly, and unevenly. Some programs are so financially driven they offer only nominal services and leave people out in the cold. Investing in what works – and making sure it works – is the sure way to improve the system.

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