The Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Department of Health and Human Services (HHS), was established by an act of Congress in 1992 under Public Law 102-321. With the stroke of a pen, an agency, separate and distinct from the National Institutes of Health or any other agency within the HHS, was created to focus attention, programs, and funding on improving the lives of people with or at risk for mental and substance abuse disorders.

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Much has changed since then in the mental health and substance abuse fields, and so, too, has SAMHSA. To that end, SAMHSA’s mission and vision have been more sharply focused and aligned with HHS goals and President Bush’s administration priorities. It is a vision consistent with the President’s New Freedom Initiative that promotes a life in the community for everyone. Moreover, SAMHSA is achieving that vision through a mission that is both action-oriented and measurable: to build resilience and facilitate recovery for people with or at risk for substance abuse and mental illness. In collaboration with the States, national and local community-based and faith-based organizations, and public and private sector providers, SAMHSA is working to ensure that people with or at risk for a mental or addictive disorder have the opportunity for a fulfilling life that includes a job, a home, and meaningful relationships with family and friends.

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To bring that mission and vision from paper to practice, SAMHSA’s budget and its policy and program activities – including discretionary grant programs and communications initiatives – have been aligned to reflect a series of core priority areas, among them: co-occurring mental and substance abuse disorders, criminal justice, children and families, aging, substance abuse treatment capacity, strategic prevention framework for substance abuse, mental health system transformation, homelessness, disaster readiness and response, seclusion and restraint, and HIV/AIDS. The priority program areas are linked to crosscutting principles that help ensure that SAMHSA’s work will meet the highest standards, driven by a strategy to improve Accountability, Capacity, and Effectiveness – ACE. With this strategy, SAMHSA can assure that its resources are used both wisely and well in State and community programs to treat addiction and dependence, to prevent substance abuse, and to provide mental health services.

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Promoting Accountability: To promote accountability, SAMHSA tracks national trends, establishes measurement and reporting systems, develops and promotes standards to monitor service systems, and works to achieve excellence in management practices in mental health services, addiction treatment, and substance abuse prevention.

Enhancing Capacity: By assessing resources, supporting systems of community-based care, improving service financing and organization, and promoting a strong, well-educated workforce, SAMHSA enhances the Nation’s capacity to serve people with or at risk of mental and substance abuse disorders.

Assuring Effectiveness: The Agency also helps assure service effectiveness through the continuous improvement of services and workforce by assessing service delivery practices, identifying and promoting evidence-based approaches to care, implementing and evaluating innovative services, and providing workforce skills training. Through these practices, SAMHSA supports a science-to-services cycle in which new knowledge helps inform new community-based services and in which service needs help inform the next generation of scientific inquiry.

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With a Fiscal Year 2003 budget of just under $3.2 billion, SAMHSA’s program dollars support formula grant programs, primarily the Mental Health and Substance Abuse Prevention and Treatment Block Grant Programs. Under both programs, SAMHSA encourages the States and Territories to address the substance abuse prevention, addiction treatment, and mental health services needs both by supporting specific services programs and by assessing and reporting on progress, needs, and ongoing activities. Based on a mandate in SAMHSA’s reauthorizing statute, the nature of the formula grant program is changing to focus on Performance Partnership Grants (PPGs). Instead of accountability based on documentation of compliance, PPGs rely on evidence of performance. Through PPGs, States will have greater flexibility in how they use block grant funds to meet State needs. That flexibility is balanced with greater accountability based on performance. Neither the eligibility for funding nor the formula for fund distribution is altered. Rather, the nature of the Federal-State relationship is being altered to better help achieve the shared goal of improved services for people with mental illnesses or substance abuse disorders, or both.

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SAMHSA’s Programs of Regional and National Significance – its discretionary grant portfolio – focuses on the priorities and principles in the matrix already described. Both the Targeted Capacity Expansion (TCE) program and the State Incentive Grant (SIG) program provide community officials resources to address emerging substance abuse treatment and prevention trends, and mental health service at the earliest possible stages. These programs help provide new information and best practices to guide how local communities identify and develop needed services. SAMHSA’s National Household Survey on Drug Abuse (NHSDA) and other data-related activities gather, aggregate, assess, and report on trends related to mental health services, addiction treatment, and substance abuse prevention.