NatCon20 is coming up fast – we can't wait to see you in Austin!

    This year, the National Council is introducing a new and exciting track: "Innovations at Work." Through this track, we will be showcasing members pushing the boundaries and adopting innovative approaches to solve some of behavioral health's greatest challenges.

    Is your organization doing innovative work to improve care delivery, increase collaboration across the continuum of care, or streamline processes across operations?

    If so, we want to hear from you! Providers interested in sharing their experiences should send a brief summary of their innovation and results (even if preliminary) to Samantha Holcombe, Senior Director of Practice Improvement.

  • Introducing Our New Special Interest Groups

    Looking to expand your behavioral health care perspective? Our Special Interest Groups are designed to accelerate your learning of – and impact on – historically marginalized populations. Throughout 2020, we will focus on the following groups: older adults, LGBTQ+, children and families, and individuals with intellectual and developmental disorders. Join us for a series of orientation webinars that will set expectations for each group:

  • Call for Content: Recovery-Related Stories for September

    In recognition of National Recovery Month, we will be highlighting the importance of recovery throughout the month—from social media to our newsletters and blog. Have an inspirational or educational story about recovery you’d like to share? Let us know, and we will consider it for publication in one or several of our publications.
  • Learn, Grow and Network at Free Technology Summit

    Eager to improve outcomes of addiction care? Join us for a free learning experience in Washington, D.C., on September 16—the day before Hill Day 2019—as we examine the technologies that are transforming the behavioral health care field. Our National Summit: Leveraging Technology to Improve Access to Addiction Care will teach you how to maximize technology to boost your practice. Register today!

  • August 5-9: Youth Mental Health First Aid Training Opportunity

    Mental Health First Aid and the National Council are hosting a Youth MHFA Instructor Training in Salt Late City, Utah, from August 5-9. This is a great opportunity for members to get internal employees certified to train others in Youth MHFA. Member discounts are available. Learn more!

  • National Council for Behavioral Health Announces New Board Members and Officers

    National Council for Behavioral Health Announces New Board Members and Officers

    WASHINGTON, D.C. (July 1, 2019) – The National Council for Behavioral Health is pleased to announce the results of its recent Board election.

    The National Council welcomes the newly elected directors:

    • Heather Jefferis, Oregon Council for Behavioral Health: Region 10 (AK, ID, OR, WA)
    • Doyle Forrestal, Colorado Behavioral Healthcare Council: Chair of the Association Executives Committee

    The following directors were re-elected by the membership for a second term:

    • Linda McKinnon, Central Florida Behavioral Health Network: Region 4 (AL, NC, SC, FL, GA, KY, MS, TN)
    • Mark Ishaug, Thresholds: Region 5 (IL, IN, MI, MN, OH, WI)
    • Pat Coleman, Behavioral Health Response: Region 7 (IA, KS, MO, NB)
    • Vitka Eisen, HealthRIGHT360: Region 9 (CA, Guam, HI, NV)

    The following Board officers will serve for the next two years:

    • Jeff Richardson, Sheppard Pratt Health System: Chair
    • Tim Swinfard, Compass Health: First Vice Chair
    • Victor Armstrong, Atrium Health: Second Vice Chair
    • Susie Huhn, Casa de los Niños: Secretary-Treasurer

    The Board is composed of elected volunteers from the staff and community boards of National Council member organizations. They are elected by National Council member organizations representing 10 regions covering the entire U.S. The Board of Directors represents the membership and is committed to diversity, leadership and promoting excellence in mental health and addictions treatment.

    Board Chair Jeff Richardson, vice president and chief operating officer of Sheppard Pratt Health System, said, “The National Council is at the frontlines of behavioral health, driving the conversations surrounding life-changing mental health and addiction services and advocating on behalf of their more than 3,000 members. I am delighted to work with our talented and dedicated Board members as we continue to address our nation’s health care issues and work toward improving the lives of others.”

    We are grateful to the following individuals for their service, departing the National Council Board are:

    • Vicker (Vic) DiGravio, III, Association for Behavioral Healthcare (Massachusetts): Former President and Chief Executive Officer
    • Brent McGinty, Coalition for Community Behavioral Healthcare (Missouri): President and Chief Executive Officer
    • David Johnson, Navos (Burien, WA): Chief Executive Officer, Ed.D. and Licensed Mental Health Counselor

    “We are grateful for the service of our three outgoing Board members who have been instrumental in the incredible growth of the National Council as a force in changing the direction of behavioral health in this nation and securing its role as an integral participant in the health care system,” said Chuck Ingoglia, president and CEO of the National Council. “Their contributions can be measured, not only in political and social gains, but in the lives of millions of Americans who are living fuller and more productive lives because of increased access to needed health care services.”

    The newly elected Board members assume their duties on July 1, 2019.

    Sophia Majlessi
    (202) 621-1631

  • The Journal of Behavioral Health Services & Research: New Issue Released

    Learn and grow through the Journal of Behavioral Health Services & Research, a member benefit. What can you expect in July’s issue? Peer-written articles on treatment retention, vocational peer support and care management intervention, among other topics.
  • National Council Continues Push for Behavioral Health Telehealth Solutions

    The National Council has been a longtime advocate for changing federal regulations that restrict how behavioral health medications that are controlled substances can be prescribed via telemedicine. Recognizing the urgent need to expand access to medication-assisted treatment (MAT) and other behavioral health medications, the National Council worked closely with Members of Congress to secure a provision in the opioid legislative package (SUPPORT Act) that would address this problem. The Drug Enforcement Administration (DEA) now has until October 1, 2019 to clarify when the agency can issue prescribers a special registration that would enable them to treat patients for the first time via telemedicine.


    Current regulations, established as the result of the Ryan Haight Act, prohibit the prescribing of controlled substances over the internet with narrow exceptions for telemedicine. In practice, meeting these exceptions typically requires that a patient being treated via telemedicine be physically located in a facility registered through the Drug Enforcement Administration (DEA) in order to receive a prescription for a controlled substance. These regulations stand as a barrier for many mental health and addiction treatment clinics as they may not meet the narrow requirements for registration with the DEA in all states. Thus, this leaves clinics unable to offer patients access to much-needed medications to treat certain mental illnesses and addictions via telemedicine.


    The National Council recently wrote a letter to the DEA urging the agency to act immediately to resolve medication access issues by using their existing regulatory authority or through the new special registration process mandated by the 2018 SUPPORT Act. While the SUPPORT Act’s special registration provision is a step in the right direction for allowing more providers to administer MAT via telemedicine, the final decision of which provider types will be included falls to the DEA and no draft guidance has yet been released. The National Council continues to work closely with the DEA on developing a registration pathway to be more inclusive of community mental health and addiction treatment providers across the country.

    Additionally, the National Council is aiming to bolster the actions already taken within the SUPPORT Act by reintroducing the Improving Access to Remote Behavioral Health Treatment Act of 2018. This bill, introduced in the last Congress by Representatives Gregg Harper (R-MS) and Doris Matsui (D-CA), would specifically name community mental health centers and addiction treatment centers as eligible sites to register with DEA to offer patients access to MAT and other medications via telemedicine. Although the DEA may choose to include these sites under the provisions included in the SUPPORT Act, this bill would ensure their inclusion regardless of the DEA’s final regulations.

    Stephanie Pasternak, National Council for Behavioral Health
  • Urgent Care On Demand, Except This Time For Mental Health

    Urgent Care On Demand, Except This Time For Mental Health

    April 19, 2019
     by Martha Bebinger

    The sleepless nights and dull, meaningless days began last summer. In the late fall, Grace, who asks that we just use her middle name, stopped taking her medication for depression and anxiety. It wasn’t helping. By mid-winter, Grace says she often struggled to get through a day.

    “If I had to do it over again, I wouldn’t be here. If I weren’t born, I wouldn’t care, if you know what I mean,” says Grace, looking up at a physician she has just met.

    Dr. David Kroll, a psychiatrist at Brigham and Women’s Hospital, nods. He continues an evaluation that includes deeply personal, sometimes painful questions. Has Grace thought about how she might kill herself? No, says Grace, just fleeting ideas. Has she thought about harming someone else? No.

    Grace has a regular psychiatrist, but even during one of her lowest periods, she couldn’t get an appointment to see that doctor right away.

    “A couple months ago I tried to book an appointment, and I was given a date in June,” Grace says with exasperation. “I’ve had it.”

    Kroll knows from experience why it's hard to squeeze patients in. Psychiatrists typically work alone rather than in teams that include a nurse practitioner and medical assistants. And the traditional approach is a thorough evaluation that builds toward a deep relationship.

    "But sometimes you just need a quick look to see if there's something that can be done in the moment that might get you back on track for your care," Kroll says.

    Long wait times for an appointment are one of the main reasons Kroll opened the unusual clinic where he sees Grace today. It offers walk-in visits with a psychiatrist one afternoon a week. There’s a social worker on staff to help arrange follow-up care. So far, the clinic is only open to patients whose primary doctor or specialist is affiliated with the Brigham.

    There are just a handful of clinics in Massachusetts where patients can get mental health care on demand and few examples around the country. Eight states are testing a free-standing community center model. Some hospitals are developing walk-in care for addiction during the opioid epidemic, which may include treatment for anxiety and depression. CVS and Walgreen's, two of the largest retail clinic networks, do not offer mental health care.

    A key obstacle is money. Danna Mauch, president and CEO of the Massachusetts Association for Mental Health, says having a psychiatrist available, waiting to see patients is expensive.

    "You can’t plan for the emergence of the urgent thing," says Mauch, "so people have to have staff there, whether somebody shows up at that day or that hour or not."

    Mauch is developing an urgent mental health care model for children. A recent report from the Blue Cross Blue Shield Foundation of Massachusetts says the state and private insurers must find ways to fund walk-in mental health visits and a more robust network of urgent care centers because too many patients can't find adequate or timely care.

    Kroll says the early numbers show that psych urgent care will pay for itself at the Brigham because demand is so high. The hospital plans to expand the clinic from one to at least three afternoons a week by October.

    Leading patient advocacy groups say they are excited about this emerging option for mental health treatment. Teri Brister, the director of information and support at the National Alliance on Mental Illness, says mental health services should be available in urgent care clinics just like blood pressure or stress tests. Delays, says Brister, trigger emergency room visits, hospital stays that could have been avoided and sometimes time in jail.

    "The stress on the person and the stress on the family and the potential for symptoms worsening when treatment isn't received immediately only make things more difficult," Brister says.

    Lisa Lambert, director of the Parent Professional Advocacy League, says providing mental health care in a retail or urgent care clinic will remove some of the stigma patients feel in seeking treatment for depression or anxiety.

    "When mental health care looks more like primary care or regular medical care and less like behavioral health care, for some people that's going to make a difference," Lambert says.

    But there are potential pitfalls.

    During Grace's appointment, Kroll scans dozens of drugs Grace has tried over the years. Grace sees a counselor, attends some groups and exercises, but can’t seem to find a medication that helps.

    "I don’t necessarily remember what I felt like on them," Grace tells Kroll. "I guess I switched off them because they weren’t working, but I don’t remember why."

    Kroll can review Grace’s medical record because she’s a Brigham patient. But what if he didn’t know what medicine Grace had tried, or what pills she still had in the medicine cabinet?

    "I think it’s a setup for long term confusion and bad care with errors in it," says Dr. Joseph Parks, medical director at the National Council for Behavioral Health, representing 3,000 mental health and addiction treatment programs. Parks says coordinating care will have to be a priority as interest in urgent care psych clinics grows.

    At the Brigham, Kroll says urgent care won't work if patients need a medication that requires careful monitoring. He mentions lithium, which is commonly prescribed for biopolar disorder.

    Kroll prescribes two new medications for Grace, describes potential side effects, and tells her to follow up with her regular psychiatrist. Grace says she's relieved.

    "You’ve been so helpful I really, and very thorough, my goodness, for just seeing me on the quick," Grace tells Kroll as she leaves.

    The Brigham clinic is designed as a bridge between routine psychiatric visits, but Kroll acknowledges that on-demand care will appeal to many mental health patients.

    "That's been one of the big worries," Kroll says. "That's why we built this up gradually. We were worried that once you opened the flood gates, then it could become overwhelming very quickly. Most of the time that doesn't happen."

    Kroll says the clinic is busy some Wednesdays, but less so on others. The typical visit with a patient lasts from 20 to 60 minutes, which is longer than the average urgent care visit.

    The Brigham clinic sees a disproportionately large number of Medicaid patients. And it welcomes patients who've been kicked out of established psychiatry practices for repeatedly missing appointments. So called "no-shows" are common in mental health practices, says Karen Wrenn, a licensed social worker who manages the Brigham's urgent care psych clinic. It could be something as simple as navigating public transportation or finding parking. Some mental health conditions get in the way of seeking care.

    "With depression," says Wrenn, "folks will not be able to get out of bed. If you have more acute issues like psychosis, that's going to be a barrier."

    But less of a barrier, Wrenn says, if patients know they can walk-in and be seen, when they're ready.

    This segment aired on April 20, 2019.
  • California tests if addiction treatment can be incorporated into primary care - POLITICO - 4/5/19

    California tests if addiction treatment can be incorporated into primary care 



    04/05/2019 11:24 AM EDT

    PLACERVILLE, Calif. — California had just weeks to get a program that used medication to treat opioid use disorder up and running after receiving $90 million in federal grants in 2017. So officials found a model that was already working in Vermont, and supersized it to fit the sprawling state.

    The scaling up of the "Hub and Spoke" system, particularly in rural areas, has presented challenges but also delivered results in locales like this Gold Rush-era city east of Sacramento — and dovetailed with existing efforts to expand medication-assisted treatment to give the state a two-pronged approach to confronting the opioid epidemic.

    Hub and Spoke, first launched in Vermont in 2012, features a system of regional addiction treatment centers or "hubs" that are connected with "spokes" like primary care practices and local clinics. Patients have individual treatment plans. The system allows many patients to get help close to home, at clinics that offer buprenorphine, a drug seen as the gold standard for treating opioid abuse symptoms, and that employ behavioral health providers and nurse case managers. Those with more complex cases, who for example need to be treated daily with methadone, can be referred to a centralized hub.

    After starting with 18 hubs and 57 spokes, the California effort has expanded in a year and a-half to include more than 200 spokes statewide. The state has also layered on other programs, including one that treats people suffering from opioid withdrawal in an emergency room with buprenorphine, and then refers them to a nearby spoke, often the next day.

    California doesn't rank with opioid abuse hot spots like West Virginia, Ohio or New Hampshire. But rural pockets, particularly in the north of the state, have experienced alarming overdose death rates.

    Beth Tanzman, the Vermont state health official who manages Hub and Spoke there, told POLITICO that while states like Louisiana and New Hampshire have adapted the program, “it’s so important and impressive to see states like California figure out how to scale treatment” for opioid use disorder.

    As of last month, more than 13,000 patients in the state have used the model, and the number of physicians prescribing buprenorphine has increased by 82 percent since July 2017, according to the state Department of Health Care Services.

    The overarching goal in California is to create a framework for treating a range of addiction disorders, including alcohol, methamphetamines and other substances.

    “We know people with addiction are showing up in emergency rooms and clinics and they have mental health issues and they’re getting arrested and they go to jail,” said Kelly Pfeifer, a physician and addiction specialist at the California Health Care Foundation. “Why shouldn’t they get treated wherever they land?”

    As it builds out the hub-and-spoke system, California has taken advantage of several waves of federal grants totaling some $266 million to expand the use of medication-assisted treatment. The state may yet have to tap into other sources and find efficienciesonce the grants run out.

    Despite the short-term nature of the grants, California wanted to take an aggressive approach, said Marlies Perez, chief of substance use disorder compliance at the state's health care services department. “These federal dollars have been huge in making this happen.”

    The money has helped fund an innovative emergency department program, originally called the E.D. Bridge program, which offers patients experiencing opioid withdrawal symptoms immediate access to buprenorphine, also known by the brand name Suboxone. A form that dissolves under the tongue and can resolve symptoms within a matter of minutes is provided right in the emergency room.

    The programstarted a year ago in 12 hospitals and now includes 31 hospitals and one clinic, nearly half of which are located in rural areas of the state.

    “We want the entire state,” said Aimee Moulin, an emergency physician at the University of California, Davis who is a regional coordinator for the Bridge program. “Our overall goal is to make this the standard of care.”

    Placerville is one of the few places in California where the Hub and Spoke and Bridge programs are being deployed together, offering immediate overdose treatment in the small, rural hospital’s emergency department.

    “We’re a small county and a small organization, but we’re going to start seeing this take off across the state because of these two programs,” said Loni Jay, a physician who in November opened a new spoke, Marshall CARES, an outpatient clinic steps from the hospital, Marshall Medical Center in the foothills of the Sierra Nevada.

    The county — El Dorado — was quick to establish spokes, due primarily to providers at El Dorado Community Health Centers who were already prescribing buprenorphine well in advance of the hub-and-spoke federal grant. Marshall Medical Center was also one of the first hospitals in the state to sign on to the E.D. Bridge pilot. The hospital recently brought on board a substance use navigator to help guide patients.

    “What we’re doing is providing a full integration of care — behavioral health, a MAT [medication-assisted treatment] program, R.N. case managers, licensed alcohol and drug counselors, medical assistants,” said Terri Lee Stratton, CEO of the four-clinic El Dorado Community Health Centers.

    The nearest hub still is nearly an hour away, in Roseville. But most providers say they rarely have to refer patients, because they can typically be managed at the clinic level.

    Patients suffering from withdrawal who show up at the emergency room get treated on the spot with Suboxone. Then they’re set up with a next-day appointment at a nearby spoke.

    Though Marshall providers treat just one or two patients a week in this fashion, they say the program is already starting to have an effect.

    “We treat them quickly and effectively, and that doubles the likelihood of them being in treatment in 30 days,” said Arianna Sampson, a physician assistant who helped set up the Bridge program.

    For the 49 weeks starting in August 2017, 92 percent of the patients treated at the hospital with Suboxone followed up by seeking care at a spoke, according to Sampson, with the nearest one 15 miles away. After a year, 26 of those patients were still in treatment, accounting for a 74 percent success rate.

    Meanwhile, buprenorphine use in El Dorado County increased 89 percent from 2015 to 2017, according to state public health statistics. Statewide buprenorphine prescribing increased just 14 percent over that period.

    California still faces barriers to getting these programs up to speed around the state, including stigma from health professionals and resistance from traditional substance-abuse providers. To prescribe buprenorphine, doctors have to get special training and a federal license known as an “X-waiver.” Though that's created bureaucratic hurdles, the opioid legislationl Congress passed last October expanded who could prescribe it.

    The experience has professionals optimistic the region will have the infrastructure to treat other forms of substance abuse, including methamphetamines.

    “I truly believe we’re reversing this opioid epidemic,” Sampson said. “But what we know about the history of humankind, there will be something else.”
  • Congress Extends CCBHCs in OK and OR for Three Months

    Congress Extends CCBHCs in OK and OR for Three Months
    Last night, the Senate approved by voice vote a Medicaid bill that extends, among other programs, the Certified Community Behavioral Health Clinic (CCBHC) demonstration program in Oregon and Oklahoma. H.R. 1839, which passed the House last week, provides both states with an additional three months of participation in the CCBHC initiative, funding them both through June 30, 2019, and aligning them with the conclusion of the program in the other six states in the demonstration.
    This is an important win for National Council advocates who worked tirelessly to extend the CCBHC program in all eight states. The National Council thanks each and every advocate for all their hard work – the letters, the tweets, the outreach – that made this legislative achievement possible. 

    The National Council also thanks its legislative champions Sens. Roy Blunt (R-Mo.) and Debbie Stabenow (D-Mich.) and Reps. Doris Matsui (D-Calif.) and Markwayne Mullin (R-Okla.) for their support in passing this short-term extension. The bill now heads to the White House where President Trump is expected to sign it into law later this week. 

    Next Steps

    The fight continues to extend CCBHCs beyond the June 30, 2019, deadline. The National Council asks all advocates to continue working hard to drive co-sponsorship and support for the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767). This legislation would provide two additional years to the original eight states and expand CCBHCs to an additional 11 states across the nation.
    Questions about how to get involved? Please feel free to reach out to Michael Petruzzelli at

  • National Council Audience Gets Walk-through of Mock Injection Site - Alcohol and Drug Abuse Weekly

    Alcoholism and Drug Abuse Weekly

    April 1, 2019

    National Council audience gets walk-through of mock injection site

    Attendees of last week’s National Council for Behavioral Health annual conference in Nashville, Tennessee, received an unexpected chance to see how injection drug users might experience a leading-edge harm-reduction response to the opioid overdose epidemic — that is, if a U.S. community ever emerges to become the nation’s first to house a sanctioned safe consumption space.                                                                      

    A pop-up consumption room simulation was installed near the registration desk for the March 25–27 conference, allowing attendees to enter a tented area to observe how a drug user would proceed through the various stages within a staffed safe injection facility. The installation has been displayed at several national harm-reduction gatherings, state legislative awareness days and community education events across the country, but this is believed to be the first-time treatment professionals at a national behavioral health conference were exposed to it. There are around 100 safe consumption spaces in operation in 10 countries, but none to date in the United States.

    “It’s been wonderfully successful,” California-based harm-reduction advocate Andrew Reynolds said of the SafeShape installation from the site of the conference, where he was one of several guides for the pop-up space. “Ninety-nine percent of the people have been quite positive to the idea, even though most said they highly doubted it will ever happen here,” he told ADAW.

    Reynolds is used to some disappointment and the need for patience in seeing major harm-reduction initiatives come to pass. Over the past several months, he has seen former California Gov. Jerry Brown veto a bill to authorize safe injection facilities (that legislation has been reintroduced this year and likely has the support of California’s new governor), and he has witnessed the demise of the Bay Area organization where he worked as hepatitis C education manager, Project Inform.

    Reynolds, now working as a consultant, said the issue behind the closing of Project Inform was “money, money, money,” as funds for groups devoted to information and advocacy for people with HIV and hepatitis C are scarce. “It was the best job I ever had,” he lamented. The National Council paid for Reynolds’ travel to attend the conference.

    Walk-through of display

    The SafeShape installation (, Reynolds explained, was created by a medical sociologist who believed that giving someone a walk-through of a representation of a safe consumption space would be more instructive than a verbal explanation alone.

    Attendees at the National Council who approached the display first received an introduction to the concept of a safe injection facility and information on the facilities’ history in other countries.  Those who entered the tented pavilion came first to a safe supply table where an actual user would receive drug-using equipment but not the drugs themselves; visitors to an operational site have to have obtained the drugs previously on their own. “You can’t deal or purchase there,” said Reynolds.

    The SafeShape visitor was next taken to an injection/consumption station: one booth furnished with good lighting, a mirror and a place to sit. “It looks like a hair salon station,” Reynolds said. An actual safe consumption site might house more than a dozen of these spaces, each separated by dividers in order to ensure privacy and safety.

    The final stop is what is called the “chill room,” where a user may stay for anywhere from minutes to hours after using. “It is like a drop-in center,” said Reynolds, explaining that various sites in operation have a menu of services that might include laundry and showers, nursing care, full medical care, and referrals to human services and supports and specialty addiction treatment.

    Visitors to the display at the National Council also could watch a video and receive fact sheets about the sites. “It was the National Council’s idea to do this — they invited us,” Reynolds said.

    National Council spokesperson Sophia Majlessi explained to ADAW, “The National Council takes harm reduction seriously as [an] important public health response to the opioid epidemic.” She added, “We have received an overwhelming positive response from attendees.”

    Reynolds said of the behavioral health providers, “It’s a key audience.”  He added regarding the overall reaction, “Nobody has been angry. Even those who don’t think it’s an effective way to engage individuals can envision it as being on the harm-reduction spectrum.”

    On a couple of occasions when a conference attendee expressed misgivings, someone attending with that person quickly reminded the colleague that this falls under the harm-reduction perspective of preserving lives and meeting individuals where they are.

    Reynolds also co-presented a one-hour question-and-answer session about safe consumption spaces on the final day of last week’s conference.

    Uphill climb continues

    Municipal leaders in communities such as San Francisco, Seattle and Philadelphia have taken some important steps toward having a safe injection site open in their cities.  But various barriers, not the least of which is the federal government’s indication that it will seek to block the operation of such facilities, continue to stall momentum.

    Among the cities where leaders have embraced the idea, “Everyone’s very supportive of one another,” Reynolds said. “There is not a strong sense of ego to be the first. I wish we all would be able to start at the same time.”

    In the fall of 2017, Reynolds authored an article in the publication Positively Aware in which he cited research documenting numerous benefits from safe injection facilities, including improved access to clean injecting equipment, reduced overdose mortality and HIV/hepatitis C infection, increased linkage to substance use treatment, and a reduction in nuisance crimes that strain communities’ public safety resources. Yet he believes that despite this evidence, safe consumption spaces will prove to be an even tougher sell in the United States than syringe-exchange programs were. For many, “It has the feeling of enabling,” Reynolds said. “In syringe exchange, you’re talking about a needle. For a safe injection facility, it’s a space to use the drug.”

    He added, however, that “once these places open, if and when they open, people will see that, wow, this is no different than a syringe exchange program, or even a medication-assisted treatment program.”•

    copyright - 2019 Wiley Periodicals, Inc.
  • Highlights from NatCon19

    Parting Thoughts

    Linda Rosenberg

    For 15 years, Linda Rosenberg guided the National Council with wisdom, grace and innovation. This morning, she took center stage for the last time as president and CEO.

    How do you sum up 15 years of vision, leadership and advocacy in 45 minutes? As the roar of a standing ovation faded, Linda Rosenberg turned to the gentle wisdom of Winnie the Pooh.

    She spoke with gratitude as she recalled the highlights of her tenure leading the National Council and with affection and admiration for those she has worked with.

    “We’ve passed legislation. We’ve changed practice. We’ve saved lives. All the while, we’ve been kind to one another. We’ve shared our challenges and our successes. We’ve given a leg up and had a hand outstretched.”

    We face challenges in the years ahead and we have never backed away from a challenge – we know that the stakes are too high. Linda called on us all to have a bias toward action, to stay deeply engaged with the world and to make things better.

    “As I step down from the National Council, I’m not setting down my mantle,” she concluded, “This work is too important to me, to the people we serve, and to the nation … I will continue the fight for effective, respectful care for ALL people with mental illnesses and addictions.”

    The Future of Health Care

    A Conversation with Dr. Atul Gawande

    Dr. Atul Gawande is driven by a fundamental question: How do we fix health care systems to deliver better care for every person everywhere? The first step is simple: ask people what their priorities are.

    He told about a study that split patients with a terminal cancer diagnosis two groups – one received the usual oncology treatment, and one received oncology treatment plus regular visits with a palliative care clinician.

    The patients who saw the palliative care clinician were half as likely to still be on chemotherapy two months before the end of their lives. They also suffered less, had better physical and mental conditions and lived 25 percent longer than patients in the other group.

    Instead of focusing on how patients could live longer and giving prescriptive advice, the clinicians asked patients what their goals for their quality of life were and helped them achieve those goals.

    “Our purpose is to enable well-being, even in the face of [chronic] conditions,” Dr. Gawande said. And it all starts with prioritizing the quality of instead of quantity of a patient’s life.


    Safe Consumption Spaces: Community Strategies

    Joe Pyle, MA
    Thomas Scattergood Behavioral Health Foundation

    Vitka Eisen, MSW, EdD
    HealthRIGHT 360

    Tom Hill, MSW
    National Council for Behavioral Health

    Safe consumption spaces are common in Canada and Europe. There is overwhelming evidence that they can be effective in reducing new HIV infections, overdose deaths and public nuisance – and that they do not increase drug use or criminal activity.

    Proposals are pending to create safe consumption sites in Baltimore, San Francisco, Seattle and other cities, but there are none active in the U.S.

    Why hasn’t the U.S. embraced this promising concept? “I believe there is a moral imperative for us to figure out how can we can have many overdose prevention sites across the country,” said Joe Pyle.


    Solutions to Our Addictions Crisis
    Johann Hari

    A Smarter Health System: Paving the Road to Recovery
    Danielle Schlosser

    Addiction: Facts from Comforting Fictions
    Sally Satel, MD

    TED-style talks are personal, concise and challenge your perceptions – all in 18 minutes or less. If one speaker can have that much impact, imagine what three of them can do! We found out at today’s second General Session, in which every speaker challenged us to consider addictions from a different angle.

    In the first talk we heard from Johann Hari, bestselling author of “Chasing the Scream,” on rethinking our internal scripts about how addiction develops. Over the course of his research for the book, he visited countries with a range of drug policies. Through this, he found that he had profoundly misunderstood addiction.

    “If we want to understand why so many people are using so many painkillers, we’ve got to start understanding why people are in so much pain,” he said. “The opposite of addiction is not sobriety. The opposite of addiction is connection.”

    The core of addiction is often not wanting to be present in your life. Since pain is a driver of addiction, Hari encourages compassionate policies and understanding for individuals struggling with an addiction instead of punitive punishment, using Switzerland’s policies as a model

    Technology has changed our expectations in retail and transportation. How can we apply this logic to addictions?

    In the second session, Danielle Schlosser provided an intriguing example of how technological innovation can be used in treating addiction. OneFifteen, a state-of-the-art facility being built in Dayton, Ohio, by Verily and community partners is a new response to the national opioid crisis. This tech-enabled facility will include a variety of services that are critical for long-term recovery.

    Schlosser encouraged the field to challenge our assumptions about addiction: “There are too many gaps in our knowledge,” she said. “And too many people are falling through them.”

    Finally, we heard from Dr. Sally Satel about shattering commonly held, yet incorrect beliefs about addiction.

    Why is it important what we believe? Because, Dr. Satel says, without a realistic view of the nature of addiction, we can’t craft good policies and treatment. And people are literally dying for our help.


    How to Be Happy

    Laurie Santos, PhD

    A happiness class taught by Dr. Laurie Santos, professor of psychology and expert on human cognition, is the most popular lecture in Yale University’s history. Over the course of her TED-style talk, Dr. Santos shared tips from her course that anyone can use.

    We have more control over our happiness than we think. About half of our happiness is determined by our genes, about 10 percent by our environment and about 40 percent is within our control.

    Despite common expectations, money can only provide so much happiness. After $75,000, annual salary no longer correlated with happiness, depression or stress. In fact, altruistically spending money on others and spending time building social connections are a more worthwhile use of your time.

    Finally, if you feel grateful, write it down. Listing three-to-five things you’re grateful for daily for two weeks has been shown to statistically improve happiness.

    “If you really want to change your life, you have to put the work in,” Dr. Santos said.

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  • How to Be Happy - Laurie Santos, PhD, Yale University, 3/25/19

    How to Be Happy
    Monday, March 25
    2:45 PM - 3:45 PM
    Location: Tennessee Ballroom, Level 2

    Thought Leader

    Laurie Santos, PhD
    Head of Silliman College and Professor of Psychology
    Yale University

    It’s no wonder that Dr. Laurie Santos' TED talk has been viewed more than one million times. Her happiness class at Yale, where she is head of Silliman College and professor of psychology, is the most popular class in the university’s history. She is an expert on human cognition, its origins and the evolutionary biases that influence our all-too imperfect life choices. Dr. Santos will share her insights on the biases that prevent us from becoming as happy as we can be. You’ll leave with a set of empirically based tips for using the science of well-being to improve your own happiness.

    Learning Objectives:
    Identify some of the most common misconceptions about what makes us happy
    Recognize the psychological biases that make it hard for us to see what makes us happy and cause us to seek out the wrong sorts of things for achieving well-being
    Discuss and practice five behaviors that psychology research suggests can help us to live a more satisfying life

    presentation -
  • National Council Continues Fight Against Six Protected Classes Changes

    CMS recently released a proposed rule to weaken access to all six protected drug classes in Medicare Part D, which include antidepressants and antipsychotics. In response, the National Council has repeatedly spoken out against these changes including in an ad in USA Today that thanks Members of Congress that have weighed in with the Administration with concerns and calls on more Members of Congress to join a letter urging the Trump Administration to withdraw these proposed changes.
  • Landmark ruling sets precedent for parity coverage of mental health and addiction treatment

    Patrick Kennedy, Former U.S. Representative and Founder
    of The Kennedy Forum and will speak at NatCon19 on Tuesday, March 26

    Landmark ruling sets precedent for parity coverage of mental health and addiction treatment - Stat News - By Patrick J. Kennedy and Jim Ramstad - March 18, 2019

    For far too long, health insurers have been treating people with mental health and substance use disorders like second-class citizens. A federal court recently ruled that this must stop. Employers and regulators, take note.

    The ruling came in the case of Wit v. United Behavioral Health (UBH). A federal court in Northern California found that UBH, which manages behavioral health services for UnitedHealthcare and other health insurers, rejected the insurance claims of tens of thousands of people seeking mental health and substance use disorder treatment based on defective medical review criteria. In other words, the largest managed behavioral health care company in the country was found liable for protecting its bottom line at the expense of its members.

    What this case really boils down to, of course, is discrimination and the perpetuation of a separate and unequal system of care that would never be tolerated for the treatment of cancer or heart disease. For the mental health and addiction communities, this ruling shines a much-needed spotlight on the insidious nature by which insurers deny care for those most vulnerable to death by suicide or overdose.

    In Wit v. United Behavioral Health, 11 plaintiffs sued UBH on behalf of more than 50,000 individuals whose claims were denied based on the flawed review criteria. Natasha Wit had sought coverage for treatment for a number of chronic conditions, including depression, anxiety, obsessive-compulsive behaviors, a severe eating disorder, and related medical complications. UBH repeatedly denied coverage for her treatments. Like other families experiencing such denials, the Wits paid nearly $30,000 out of pocket for Natasha’s treatment, despite having health insurance coverage.

    The court found that UBH’s internally developed guidelines, specifically its level of care guidelines and coverage determination guidelines, were “unreasonable and an abuse of discretion” and “infected” by financial incentives meant to restrict access to care. At the heart of the case was UBH’s reliance on and manipulation of these internal guidelines and its failure to use national evidence-based guidelines for outpatient, intensive outpatient, and residential treatment of mental health and substance use disorders that have been developed by nonprofit, clinical specialty organizations such as the American Society of Addiction Medicine.

    For many individuals needing mental health or substance use disorder treatment, an insurer’s flawed criteria or guidelines can mean the difference between life and death. This case should prompt employers to take a closer look at their health plans and make important decisions about who they are doing business with. UBH isn’t the only offender.

    Wit v. United Behavioral Health is a landmark case that sends a powerful message about the fight for parity to health insurers regarding how they make coverage determinations. It was filed under the Employee Retirement Income Security Act of 1974 (ERISA), the federal law that governs group health insurance policies issued by private employers, alleging that UBH violated its obligations under this federal law.

    ERISA requires plan administrators to function in a fiduciary capacity when overseeing employee benefit plans, including insurance coverage for mental health and substance use disorder treatment. In this case, the court held that UBH breached its fiduciary duties by developing and employing flawed medical necessity criteria for behavioral health services.

    Among other concerns, the judge highlighted how UBH was circumventing the Mental Health Parity and Addiction Equity Act of 2008, also known as the Federal Parity Law (we were its lead bipartisan sponsors). It requires insurers to cover illnesses of the brain, such as depression or addiction, no more restrictively than illnesses of the body, such as diabetes or cancer. In his ruling on Wit v. United Behavioral Health, Judge Joseph C. Spero wrote that “the record is replete with evidence that UBH’s Guidelines were viewed as an important tool for meeting utilization management targets, mitigating the impact of the 2008 Parity Act” in order to keep benefit costs down.

    Due to UBH’s flawed approach, the court ruled in favor of the plaintiffs, stating that under generally accepted standards of care, chronic and comorbid conditions should be effectively treated, even when those conditions persist, respond slowly to treatment, or require extended or intensive levels of care.

    UBH’s medical-necessity criteria failed to provide coverage in such situations. Instead, its guidelines were designed to approve coverage solely for “acute” episodes or crises, such as when individuals are actively suicidal or suffering from severe withdrawal. We wouldn’t dare treat someone with type 1 diabetes who went into insulin shock, then send her home without further treatment and expect a full recovery. Why are those with mental health and substance use disorders treated differently?

    The court also ruled that UBH’s guidelines improperly required reducing the level of care, such as removing patients from residential treatment programs to some form of outpatient therapy, even if the providers who were treating them believed — consistent with generally accepted clinical standards — that maintaining a higher level of care was more effective.

    Insurers should not be calling the shots when it comes to treatment options.

    In addition, the court found that UBH failed to follow specific guidelines mandated by certain states for evaluating the medical necessity of behavioral health services. For example, Connecticut, Illinois, and Rhode Island require that when reviewing substance use disorder claims for medical necessity, insurers must apply criteria consistent with the American Society of Addiction Medicine’s standards of care.

    It is important to note that the Wit v. United Behavioral Health ruling applies only to individuals covered by employer-sponsored insurance plans, due to the scope of ERISA. What will happen to those covered by non-ERISA plans, such as government employees, families and individuals with non-group policies, and those in plans managed by Medicaid or Medicare when their mental health and substance use disorder treatment is improperly denied coverage because of defective “medical necessity” criteria? Who is looking out for them?

    Although just a handful of insurers manage behavioral benefits across the board, the regulation and oversight of these companies is fragmented and meager. Federal and state regulators should not accept self-reports by insurers as evidence of compliance with anything — let alone with parity laws intended to protect those with mental health and substance use disorders. Given UBH’s violations, regulators must immediately start examining the market conduct of all health plans across the country.

    Insurers should also be barred from creating or buying special behavioral health review criteria developed for managed care when generally accepted medical-necessity criteria are readily available from nonprofit, clinical specialty organizations such as the American Society of Addiction Medicine.

    We must apply the lessons learned from Wit v. United Behavioral Health to the entire behavioral health care system in the U.S. And the Federal Parity Law must be enforced far more vigilantly than it is today.

    Insurers should now get the message loud and clear that there will be major consequences for discriminating against those with mental health and substance use disorders. Thanks to Wit v. United Behavioral Health, the tide is turning. Families are now being empowered with the knowledge and inspiration they need to stand up for their rights.

    Patrick J. Kennedy is the founder of The Kennedy Forum and, while serving as a U.S. representative (D-R.I.) from 1995 to 2011 was a co-sponsor of the Federal Parity Law. The forum’s Don’t Deny Me campaign educates consumers about their rights under the Federal Parity Law and connects them with essential appeals guidance and resources. Jim Ramstad is a former U.S. representative (R-Minn., 1991 to 2009) and a co-sponsor of the Federal Parity Law. He is a former fellow of the Harvard Institute of Politics.
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  • Download the NatCon19 App

    The NatCon19 app contains everything you need to know to have an impactful and memorable experience at the conference, including: schedules, bios, presentations, and directions, as well as info on shuttle busses, on continuing education credits and more.  

    To download our conference app, search for “Natl Council” in your app store.

    You can also visit the following sites to download the app:
    ▪ For iPhones:
    ▪ For Androids: o

    You will see our logo on the left and thumbnails of the conference app beneath it.  Our app is called “NatCon Nashville”.

    • You user name is the email you used to register for the conference.
    • Your password is the registration code you received with your confirmation email.  This code will also be in a separate email you will receive tomorrow about the app, and can be found on the back of name badge you will get onsite.
    If you need help with the app onsite, please go to one of the Navigator Booths which can be found on each level of the conference hotel. 

    We look forward to seeing you in Nashville next week!
  • Reintroductrion of Excellence in Mental Health and Addiction Treatment Expansion Act

    Statement from Linda Rosenberg, President and CEO, National Council for Behavioral Health On the Reintroduction of Excellence in Mental Health and Addiction Treatment Expansion Act

    Sophia Majlessi
    (202) 621-1631

    WASHINGTON, D.C. (March 14, 2019) — The National Council for Behavioral Health is pleased the Excellence in Mental Health and Addiction Treatment Expansion Act was reintroduced today. We thank the original sponsors, Sens. Roy Blunt (R-Mo.) and Debbie Stabenow (D-Mich.), with Reps. Doris Matsui (D-Calif.) and Markwayne Mullin (R-Okla.), as well as the new bipartisan co-sponsors.

    Congress created the Certified Community Behavioral Health Clinic (CCBHC) program in 2014 as an eight-state, two-year, demonstration project for states to improve access to evidence-based care, addiction treatment and mental health care; improve care coordination; and provide 24/7/365 access to emergency care. Today’s reintroduction of the Excellence in Mental Health and Addiction Treatment Expansion Act seeks to renew the CCBHC demonstration program in the original eight states for two years and expand it to 11 additional states.

    The passage of the Excellence in Mental Health Act began to address the desperate demand for treatment of addictions and mental illnesses. The eight states are leading a bold shift in this country, transforming community services from a patchwork of underfunded and overburdened organizations into a thriving array of clinics that provide patient-centered care. This important legislation would allow current innovation to continue for another two years, expand the opportunity so others struggling can get effective care and enable important analysis and learning that can be shared nationwide.

    The CCBHC model represents a critical advance in coordinating and integrating addiction care. Early results from the two-year program demonstrate that 94 percent of CCBHCs report an increase in the number of persons receiving treatment for an opioid use disorder (OUD) and 92 percent of CCBHCs offer at least one type of FDA-approved medication-assisted treatment (MAT), either on-site or via referral to an outside program. Expanding the model will allow more communities to respond to the opioid epidemic that is ravaging the country.

    Once again demonstrating their leadership and ongoing commitment to science-based community treatment, the National Council looks forward to working with Sens. Stabenow and Blunt and with Reps. Matsui and Mullin to pass the bipartisan Excellence in Mental Health and Addiction Treatment Expansion Act.

  • Press event today on the Excellence in Mental Health and Addiction Treatment Expansion Act

    Today at 12 p.m. ET, Senator Debbie Stabenow (D-MI), Senator Roy Blunt (R-MO), Congresswoman Doris Matsui (D-CA), and Congressman Markwayne Mullin (R-OK) will host a press conference to reintroduce the Excellence in Mental Health and Addiction Treatment Expansion Act - legislation that would extend and expand the Certified Community Behavioral Health Clinic initiative.

    The expansion legislation will extend the initiative in the original eight states by two years and expand the groundbreaking program to 11 others states for two years. The press conference will feature remarks from the four bill authors, First Lady of New York City Chirlane McCray, National Council member Laura Heebner from Compass Health Network in Missouri, Assistant Chief James Willyard from the Pryor Creek Police Department in Oklahoma, and Dea Duggan, a consumer receiving care at National Council member BestSelf Behavioral Health in Buffalo, New York.

    Please join the National Council at 12 p.m. ET livestreaming the press conference

    You can also engage in the conversation on social media with the following tweets:
     The #ExcellenceInMentalHealth Act is crucial to expanding community based mental health and addiction services. We thank @SenStabenow, @RoyBlunt, @DorisMatsui, and @RepMullin for their leadership in re-introducing this bill today.
     Reach out to your legislators to encourage them to support the #ExcellenceInMentalHealth Act. It will extend and expand CCBHCs which are improving access to mental health and addiction treatment in communities across the U.S.
     The passage of the #ExcellenceInMentalHealth Act is the needed investment in community based mental health and addiction services.
     If you want to improve our country's mental health care, CCBHCs are one of the most effective ways to do it. Ask your legislator to support the #ExcellenceInMentalHealth Act.
     Funding for CCBHCs is scheduled to end in 2019. If this happens, more than 9,000 patients will lose access to medication-assisted treatment, 3,000 staff will be laid off and CCBHCs will be forced to turn people away. We must pass the #ExcellenceInMentalHealth Act.
  • Chuck Ingoglia Next National Council President and Chief Executive Officer

    National Council for Behavioral Health Board of Directors Appoints Chuck Ingoglia Next President and Chief Executive Officer

    WASHINGTON, DC (March 11, 2019) - The National Council for Behavioral Health, today announced that its board of directors unanimously selected Chuck Ingoglia as the next president and CEO for the organization. He will succeed Linda Rosenberg, the current president and CEO on June 1, 2019.

    “On behalf of the National Council Board of Directors, I am pleased to announce that after a comprehensive national selection process, the board is delighted to appoint Chuck Ingoglia to the role of president and CEO, " said Jeff Richardson, chair of the board of directors. "With more than 20 years of experience in behavioral health, working as a provider, advocate and educator for government and public sector organizations, we are fortunate to have a leader with Chuck’s skill and deep knowledge. He is the clear choice to lead the National Council into the future.”

    Since joining the organization in 2005, Ingoglia has served as the National Council’s senior vice president of policy and practice improvement. He has directed federal and state policy efforts and overseen practice improvement programs offered to behavioral health professionals across the U.S. His efforts have centered on key issues such as parity, health care reform and improving access to behavioral health treatment in communities.

    Prior to joining the National Council, Ingoglia provided policy and program design guidance to the Substance Abuse and Mental Health Services Administration. He also directed state government relations and service system improvement projects for the National Mental Health Association (now Mental Health America), served as a policy analyst for the National Association of Social Workers and designed educational programs for mental health and addictions professionals at the Association for Ambulatory Behavioral Healthcare.

    "We are very grateful to Linda for 15 years of outstanding leadership and fortunate that Chuck has accepted the position. Chuck is a proven leader and the best choice from a deep pool of interested and highly qualified candidates from across the country," said Richardson. “His vision and strategy are exactly what the National Council needs as we enter our next chapter.”

    “I am honored and humbled to have been selected as the next president and CEO,” stated Ingoglia. “With the support of the phenomenal board and staff, I look forward to furthering the mission of the National Council. Together, we will continue to protect and expand access to community behavioral health to ensure that all Americans have access to quality mental health and addiction services. And together we will continue the growth of Mental Health First Aid, our nation’s premier public education program focusing on mental health and addiction.”