Address unrecognized and untreated depression

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Its time to change the way we think about,
develop, and deliver mental health services 

• Address unrecognized and untreated depression
• Break the cycle for children of depressed
  parents
• Improve systems of care in jails and prisons
• Understand and address the impact of violence and
  trauma

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Surgeon Generals Workshop
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Women, Violence, and TraumaA SAMHSA-wide
Priority 

• National Center on Women, Violence, and Trauma
• The SAMHSA Womens Coordinating Committee
• Women, Co-Occurring Disorders, and Violence Study

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Surgeon Generals Workshop
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What do we know about the impact of trauma?   

• Results in major and costly human service systems
  failures
• Creates a legacy of lifetime disabilities for
  children
• Has intergenerational and historical costs
• Treatment as usual for consumers with trauma
  histories thwarts recovery 

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Surgeon Generals Workshop
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What do we know about trauma interventions?

• Multitarget, multimodal treatment approaches and
  coordinated community responses have had the most
  positive impacts (Shepard Briere)
• Proven models and tools for intervening and
  treating trauma-related problems have been
  developed (Harris Najavits Miller Ford)
• To fully address the needs of trauma survivors
  requires a systemic approachincluding
  trauma-specific services and a trauma-informed
  environment
• Hope and self-determination are essential
  elements for consumer recovery 
• Consumers have established champion roles in
  developing trauma-informed systems and services

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Surgeon Generals Workshop
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What do we know about trauma outcomes?

• SAMHSAs Women and Violence Study is the most
  comprehensive study to date on the impact of a
  trauma-integrated approach
• Findings at both 6 and 12 months suggest that
  integrated counseling is the key element
  associated with better outcomes
• Gains at 6 months in substance use behaviors and
  mental health and trauma symptoms were maintained
  or improved between the 6- and 12-month followup
• At 12 months, the effect sizes for mental health
  and posttraumatic symptoms show statistically
  significant improvements
• At 12 months, the mental health effect size
  doubles and the posttraumatic symptoms effect
  size increases by almost half

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Surgeon Generals Workshop
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Achieving the Promise
Transforming Mental Health Care in America

• Mental health services must actively facilitate
  recovery
• A call for system transformation
• The goal Hope for a full life in the community
• Services and supports are consumer/child/family
  centered
• Focus of care must increase illness
  self-management and build resilience

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Defining Transformation
a continuous process, without endmeant to
create or anticipate the future identifies,
leverages, and even creates new underlying
principles for the way things are done new
sources of power emerge once the process is
begun, a profoundly different organization
materializes, including changes in structure,
culture, policy, and programs
Retired Vice Admiral Arthur Cebrowski Director,
Force Transformation, U.S. Department of Defense
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RecoveryA Critical Concept to Transformation

• The process by which people are able to live,
  work, learn, and participate fully in their
  communities
• The ability to live a fulfilling and productive
  life despite a disability
• A reduction or complete remission of symptoms
• The ability to make important decisions affecting
  ones own life

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