Publications
AHP’s publications are designed to support those who manage and provide behavioral health services in planning and delivering effective, person-centered programs that support recovery. Our publications also speak directly to persons with behavioral health challenges, helping them to build the skills and find the resources they need to lead fulfilling lives in their communities.
To view or download the complete contents of a given publication, click on its title below.
Behavioral Health
This article reviews the literature on shared decision making in health and mental health and discusses tools in general health that are proposed for adaptation and use in mental health. It offers findings from literature and a product development process to help inform/guide those who wish to create or implement materials for shared decision making in mental health.
This Special Report provides a preliminary analysis of the Mental Health Parity and Addiction Equity Act (MHPAEA) Interim Final Rule and regulations. The Report is written for the benefit of diverse audiences including public and private health plans and insurers, payers, state and federal agencies, legislators, consumer advocates, mental health and substance use disorder providers, the medical community and business.
The report is organized to provide the reader with a detailed summary of the regulations; an in-depth review of the operational and strategic implications of the Interim Final Rule and regulations from the viewpoint of Plans, Payers and Providers; a review of the challenges and unanswered questions that remain as the MHPAEA is implemented; and the opportunities that are available to stakeholders in the field.
The goal is to provide readers with the preliminary analysis necessary to determine their immediate next steps in their respective roles.
Enactment of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (2009 Parity Act) signals the beginning of a new era, with new challenges. Private and public stakeholders in the mental health community are preparing for this important transition, which is taking place in the context of an uncertain economy and national health care reform.
To inform the development of regulations governing the 2008 Parity Act, and assist both payers and providers in their response, AHP produced a series of planning and implementation tools dedicated to Behavioral Health Parity. This environmental scan, conducted in May of 2009 is the first in the series. It is based on a review of research, Federal and state experiences with parity, and key informant interviews with leaders in the private and public sectors.
The paper introduces and summarizes the Mental Health Parity and Addiction Equity Act of 2008, providing an overview of issues that are particularly salient for healthcare payers and plan administrators. It then presents a situation analysis of state-by-state parity regulations and explains many of the implementation issues payers can expect, particularly those new to enhanced mental health and substance use disorder treatment and coverage. Finally, it offers a roadmap, an implementation outline, and next steps to assist healthcare purchasers in navigating the path to full implementation of the requirements of the Parity Act.
This White Paper provides an introduction to parity, its impact on behavioral health providers, and the opportunities it will provide for expanding behavioral health care and integrated it with primary health care. Impact Statements assess the impacts on administration, clinical operations, and executive management, culminating in a Call to Action for all providers.
Mental Health Policy and Services
The Model Scopes of Practice and Career Ladder for Substance Use Disorder Counselors was developed by AHP in March 2010 through a consensus group process of key stakeholders in the Substance Use Disorder field brought together by Substance Abuse and Mental Health Services Administration (SAMHSA). This document provides a framework for States and other stakeholders such as providers, professional associations, credentialing bodies, State consumer groups, and institutions of higher education to develop their own Substance Use Disorder Scopes of Practice and Career Ladders to meet the needs of their specific jurisdiction as well as to assess whether standards are keeping with the most up-to-date thinking in the field of SUD counseling.
The Patient Protection and Affordable Care Act, along with the Mental Health Parity and Addiction Equity Act, requires health plans that offer substance use disorder services to meet the same financial requirements and benefit limitations that apply to general medical and surgical care. It is anticipated that these changes will increase the demand for services and will require that we are aligned with other services providers in the health field. Therefore, the substance use disorder treatment profession needs to be ready to document and codify its services and service delivery systems.
Over time, the substance use disorder counseling field has continued to evolve and expand, though it has not fully articulated a Scope of Practice and a career ladder like other behavioral health disciplines. Healthcare reform has created the opportunity for the field to join together and, through consensus, develop a model scope of practice and career ladder for substance use disorder counselors that best meets the needs of organizations, States, or jurisdictions.
The Substance Abuse and Mental Health Services Administration (SAMHSA) develops toolkits to help move evidence-based practices to the field. AHP led the team that developed its newest toolkit, which is on Permanent Supportive Housing (PSH). PSH is decent, safe, and affordable community-based housing that provides residents the rights of tenancy under state and local landlord-tenant laws. The housing is linked to voluntary and flexible support and services designed to meet tenants’ needs and preferences. Manuals and resources included in the toolkit help communicate the principles of this important practice to policy makers, managers, and staff; they also include guidance in implementation, a review of pertinent research, and a fidelity scale.
The landmark 1999 U.S. Supreme Court decision in Olmstead v. L.C. held that unnecessary segregation of people with disabilities in institutions is a form of discrimination that violates the 1990 Americans with Disabilities Act (ADA). The decision highlighted the need for states to provide community-based services to meet the needs of all individuals who can benefit from living in the community.
To this end, the Substance Abuse and Mental Health Services Administration (SAMHSA) has created a National Coalition and statewide coalitions to promote community-based care for people with serious mental illnesses. In particular, the National Coalition has been charged with examining the characteristics and service needs of those individuals with serious mental illnesses who are inappropriately hospitalized or at risk of psychiatric hospitalization; delineating the barriers to serving these individuals in the community; and exploring strategies to ensure their successful transition to community living.
This report outlines some of the barriers and strategies that National Coalition members will review.
This 2005 report summarizes the activities that states are pursuing within the framework of the six goals articulated by the New Freedom Commission. The report includes the following:
- » A brief summary of overarching trends, including challenges states face in their transformation efforts
- » An overview of activities of the State Mental Health Planning Councils
- » Activities of the states discussed goal by goal, with 25 state programs featured in side-bars that represent signal accomplishments
- » A table of state-developed resources listed according to goals addressed
Criminal Justice
This report highlights promising practices currently employed around the United States and in tribal jurisdictions that represent innovative approaches to enforcing domestic violence firearm prohibitions. It provides brief descriptions of programs that are located primarily in law enforcement agencies, prosecutors’ offices, courts, and probation departments. Because comprehensive legislation represents the first step toward disarming abusers, the document also profiles the work of one state legislature in enacting statutes to protect victims of domestic violence.
The purpose of this work is to describe to practitioners what the research tells us about domestic violence, including its perpetrators and victims, the impact of current responses to domestic violence, and the implications of that research for day-to-day, real-world responses to domestic violence by law enforcement officers, prosecutors and judges.
This report details findings of an evaluation of a special initiative of the Office on Violence Against Women’s (OVW) Rural Domestic Violence and Child Victimization Grant Program. The program, which focused on Faith-Based and Community Organization Pilot Programs, was funded by the National Institute of Justice (NIJ). The Rural Pilot Program was designed to reach out to small faith-based and community organizations (FBCOs) not already addressing domestic violence in order to expand domestic violence services in rural areas for underserved populations.
This report includes a process evaluation, a capacity study, and an examination of faith-infusion and the value-added of the faith-based approach. The evaluation utilized a mixed-methods approach, including case studies, organizational assessments, surveys, interviews, and focus groups. It also compared the Rural Pilot Program with the nongovernmental agencies funded in 2005 through OVW’s ongoing rural domestic violence funding program, the Rural Domestic Violence and Child Victimization Enforcement Grants Program.
Stalking between intimate partners is widespread and often associated with lethal abuse. Despite the enactment of anti-stalking laws in every state, relatively few stalkers are cited or arrested by law enforcement, and even fewer are prosecuted. Consequently, it is unclear who law enforcement identifies as stalkers and how the criminal justice system responds to those identified. More important, it is unknown whether the under-identification and charging of stalking make any difference. Specifically, does it compromise either victim safety or offender accountability, or both?
Using a multi-methods approach including secondary data analyses of statewide datasets and qualitative methods, researchers examined who is identified by police for stalking across an entire state over multiple years and the impact of identifying stalking over multiple years. The research was designed to answer the following questions:
- » Are police fully identifying stalking cases from among reported domestic violence cases?
- » Do stalking cases differ from general domestic violence cases reported to police?
- » Does it make any difference if police identify a domestic violence case as stalking as opposed to any other domestic violence charges, such as assault or violation of a protective order?
AHP’s National Institute of Justice (NIJ)-funded study examined all police-reported cases of elder abuse by an intimate or family member across an entire state. This groundbreaking, first-in-the-nation study revealed significant findings, documenting the dramatic difference between abuse of older women, 50 to 59 years, and those 60 years and older. While the majority of abusers of the former were current or former intimates, the majority of the latter were adult children and grandchildren.
The study found that the latter were not overstressed caregivers but predators, many with criminal histories outside the family. The study also revealed a disturbing gap between law enforcement and adult protective services, with little exchange of information between the two agencies both legally responsible for the protection of vulnerable elders. The study not only made front page news in Rhode Island, the study state, but was featured in a joint NIJ-National Institute of Aging conference on elder abuse research.