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U.S. Senate Subcommittee on Substance Abuse and Mental Health Services

Tuesday, July 15, 2003
Martha B. Knisley

(Washington, DC) DC Department of Mental Health Director Martha B. Knisley testified before the U.S. Senate Subcommittee on Substance Abuse and Mental Health Services to support the reauthorization of the federal Substance Abuse and Mental Health Services Administration. Director Knisley cited SAMHSA's role in overcoming the fragmentation in mental health and substance abuse service delivery as the most effective means of achieving recovery.

"SAMHSA could and should play the pivotal role in aligning these programs to more effectively and efficiently serve adults and children with mental health disorders and in leading an initiative for collaboration across various federal agencies so as to create greater unity in mission, objectives, and oversight in federal programs."

Director Knisley praised SAMHSA's work helping local jurisdictions, including the District, to build systems of care for children, youth and families that integrate the child-serving systems: juvenile justice, education, mental health and child welfare. "SAMHSA has been terrific in providing the necessary technical assistance." She continued, "There is a need for more leadership to produce the legislation to help these individual systems work together. The results will be so much more positive."

Ms. Knisley testified in behalf of the National Association of State Mental Health Program Directors, which represents the public mental health authorities in the 50 states, the District of Columbia, and the Territories. The subcommittee is chaired by Sen. Mike DeWine (R-Ohio).

During questioning, Ms. Knisley was asked by subcommittee member Sen. Jack Reed (D-R.I.) about the difficulties the District faces in providing affordable housing for people with mental illness and other disabilities. "The District is the fastest growing jurisdiction in 'unaffordability,'" she replied. "Now the cost of market rent housing is 183 percent of a person's disability income. We have the technology, the knowledge to treat mental illness but all that is for naught if a person is unable to afford to live in his or her own home and reap the long-term benefits that living independently affords."

In response to a question submitted by Sen. Edward M. Kennedy (D-Mass.), ranking subcommittee member, about SAMHSA's role in treating co-occurring disorders, Ms. Knisley stated that funding and policies addressing mental illness and substance abuse need to be integrated. In response to a follow-up question from Sen. DeWine, she said, "We need to look at the separation of block grants for these two disorders. I don't want to dilute them but we need to look at models of integration to link funding and structure." She added that in the District, "We see co-occurring disorders all the time in the criminal justice population and we look for counselors who can address both disorders upon a person's release from incarceration."