After three decades of service, Ronald W. Man-derscheid, PhD, retired from the federal government in December, having served at various posts in the National Institute of Mental Health (NIMH) and SAMHSA. But he hardly is ready to let go of his passion for the behavioral health field.
“I don't just want to tune out and say good-bye and that's it,” stresses Dr. Manderscheid, most recently chief of the Survey and Analysis Branch at SAMHSA's Center for Mental Health Services (CMHS). “I want to keep pushing these issues.”
Dr. Manderscheid intends to continue to be active in behavioral healthcare through his new position at the professional health consulting firm Constella Group, LLC, where he will serve as director of mental health and substance use programs. He will develop behavioral health demonstration and research projects focusing on services, systems, financing, program support, statistical information, and information technology. He is the first person with behavioral health expertise at Constella (a firm twice SAMHSA's size). Expect to continue seeing Dr. Manderscheid at the field's conferences. And Dr. Manderscheid will continue to be an active partner with the behavioral health field's Software and Technology Vendors’ Association (SATVA).
Information technology, in fact, is one of Dr. Manderscheid's areas of expertise. In his years with the federal government, he has gone from using Hollerith cards for data analysis to developing Decision Support 2000+, a set of mental health data standards and an information infrastructure designed to improve quality of care. As the field prepares for implementing electronic health records (EHRs), Dr. Manderscheid says major leadership will be needed to assist organizations with the crucial technologic changes ahead. He points out that “Many [behavioral health] programs and facilities have a primitive level of IT. In many of these facilities, the most they have is a desktop computer and a dial-up connection.”
Dr. Manderscheid foresees information technology being used to create “personal independence accounts” to revolutionize care delivery and reimbursement. In his vision, consumers would use government-issued debit cards to pay for services such as housing, mental healthcare, and more. The debit cards would access funding streams from various government agencies, thereby integrating all these bureaucracies at the service output level.
Personal independence accounts would give consumers a greater role in decisions about their care, says Dr. Manderscheid, who helped advance consumer and family empowerment while in the federal government. He notes that in the 1970s, government committees on mental health had no consumer involvement or input. “I am very proud that I was able to play a role in moving this agenda so that it's now commonplace that consumers and family members are part of every group CMHS and SAMHSA operates,” he says. However, Dr. Manderscheid says it's important for the federal government to move beyond “tokenism” and toward true consumer parity on behavioral health committees.
Dr. Manderscheid points out that the federal government's view of behavioral health consumers also has changed over the past 30 years. When he started with NIMH in 1975, data collection focused on diagnosis based on age, sex, and race, he says, and, “In 1975, a person who was part of a survey never even knew we were collecting data on him.” Now consumers—no longer viewed simply in terms of their diagnosis—are integral to the data collection process, and more than just demographic information is collected.
Dr. Mander-scheid's retirement from the federal government coincided with the release of reports from the National Business Group on Health and the Institute of Medicine. He says such work will help advance the field's move toward a more consumer-focused, technologic savvy future. And Dr. Mander-scheid isn't worried he'll get bored: “I've never lacked for things to do. I was not worried that when I left the federal government I'd have nothing to do.”
RON MANDERSCHEID is Director of Mental Health and Substance Use Programs at Constella Group, LLC. He served in the federal government for three decades, most recently as Chief of the Survey and Analysis Branch at SAMHSA's Center for Mental Health Services. He is also a member of Behavioral Healthcare's Editorial Board.