On Friday, President Trump nominated psychiatrist Elinore McCance-Katz, MD, PhD, as the new Assistant Secretary for Mental Health and Substance Use—a post created late last year that is essentially meant to serve as a watchdog over SAMHSA.
What’s interesting is that Rep. Tim Murphy (R-Pa.), who authored the provision in the 21st Century Cures Act to establish this role of the assistant secretary, pushed back against the nomination in a statement today. Murphy’s beef is that McCance-Katz previously worked at SAMHSA as its chief medical officer, and he specifically wants SAMHSA to reinvent itself, which he believes can’t be done with the old leadership.
”She was the key medical leader when the agency actively lobbied against any change or accountability,” Murphy said in the statement.
He wants accountability and return on investment from SAMHSA, not programs that he believes are too soft to have impact, such as music programs or nutrition classes, which he has often cited as wasteful. I’ve spoken to him about this in the past, and he’s pretty earnest about wanting to get individuals into effective treatment programs. He’s been on the soapbox since the Sandy Hook tragedy in 2012.
Murphy wants to see SAMHSA drive treatment, evidence-based approaches and a practical focus on addressing serious mental illness and overdose deaths.
Even more interesting is that McCance-Katz is endorsed by the American Psychiatric Assn. and herself has spoken out against the very thing Murphy criticizes: the lack of action on SAMHSA’s part to drive treatment for mental health and substance use disorders. Just a year ago, she wrote a commentary in the Psychiatric Times saying SAMHSA “ignores the treatment of mental disorders” and only has “the occasional vague reference to treatment.”
How ironic that McCance-Katz and Murphy might actually be speaking the same language here. As for the behavioral health community, there is a wide variety of opinions on SAMHSA. The agency manages a huge $4 billion budget and provides state block grants for life-saving programs, meanwhile, it also creates a lot of education and awareness campaigns that some see as a weak approach to the not-so-benign reality of serious mental illness, suicide and overdose that has reached a crisis level in the United States.
Whether McCance-Katz is the watchdog that Murphy envisioned remains to be seen. The real question is when we put politics aside, what does the treatment and recovery community need from SAMHSA right now? It’s time to present specific strategies that include the accountability federal leaders are looking for.
Editor's Note: This blog was updated 4-26-17 to include this clip of Murphy on C-SPAN this morning talking about McCance-Katz here.