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Agencies across the board have been turning to innovation challenges to come up with fresh answers to old problems. Now the Substance Abuse and Mental Health Services Administration, part of the Department of Health and Human Services has launched a challenge. SAMHSA is looking for new approaches to behavioral health recovery. With details, SAMHSA Administrator Miriam Delphin-Rittmon spoke to the Federal Drive with Tom Temin.

Interview transcript:

Tom Temin: Dr. Delphin-Rittmon, good to have you on.

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Miriam Delphin-Rittmon: Hi. Thank you for having me.

Tom Temin: And let’s talk about behavioral health recovery. And the innovations required, what is the problem precisely you’re trying to get at with this challenge?

Miriam Delphin-Rittmon: So you know, we are so excited about this challenge. It is an opportunity to hear from peer run or community based organizations in the field, and to hear about the innovative recovery work that they’re doing across the country. And so that’s that’s what we’re looking for, we’re looking for innovation. We’re looking for creative ways that peer or community groups are working with individuals struggling with substance use or mental health challenges and the ways in which they’re implementing SAMHSA’s definition of recovery and helping people to live full home meaningful lives.

Tom Temin: And I wanted to ask you about what is SAMHSA’s definition of recovery. Because when it comes to substance abuse and mental health, your agency mission areas very often those seem to be taken as afflictions or conditions that are mitigated and maintained and managed, but not necessarily cured for good.

Miriam Delphin-Rittmon: Yeah. So you know, we see recovery as sort of a process or experience in which individuals are able to live, as I mentioned, full meaningful lives, despite any limitations of mental health challenges, they may experience. We see it as individuals, being able to experience you know, health, home, community and purpose. And those are four key pillars of recovery, that people are connected to help and homes and community and have purpose.

Tom Temin: And what is the scope of the problem, nationally? Do you think? Because it’s kind of hard to get a sense of the numbers here, because of how many different I guess organizations at the state and local level, are involved in mental health issues?

Miriam Delphin-Rittmon: Yeah, I mean, you know, certainly what we know is that, that mental health and substance use challenges is a function of a pandemic, we certainly have seen increases, and we’ve seen additional struggles there. And so one goal with our work is to help people connect to services and support, we want people to know that, you know, recovery is real recovery is possible, in fact that some of the reason why we’re doing this innovation challenge, to be able to hear about some of the innovative work that’s happening at the community level to be able to address people’s mental health or substance use needs.

Tom Temin: To have an innovation challenge, though, the implication is that what is out there now, in system delivery, may not be totally efficacious. For example, you’re not looking for an innovative challenge to replace aspirin, because that’s so well understood, so well distributed. We don’t need that. What’s the missing element do you feel in mental health services that happened through this very complex system we call the health care system?

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Miriam Delphin-Rittmon: Yeah. So you know, in terms of recovery work, I mean, recovery work is probably a newer area or component of the mental health field. And recovery work is about sort of individuals with lived experience. So individuals who are in recovery with mental health or substance use challenges, leading peer led organizations in some instances, or other community organizations, you know, employing individuals in recovery to lead components of their programming and work that they have within their organization. It is definitely an evidence based practice, but certainly a somewhat newer evidence based practice if we compare it to other things like CBT, for example. But what we have seen already is that people in recovery, are able to connect with other individuals that are struggling, they’re able to give people hope, often they share their own experiences and their own story of recovery. They’re often able to connect people to services and support sometimes, you know, in instances where they haven’t connected before. And so I think there’s real space for certainly we’re interested in I’m interested and SAMHSA is interested in learning more about, you know, some of those pockets of innovation we may not be aware of, we may not be aware of we see recovery coaches now working in emergency departments, in all different healthcare settings across the country.

Tom Temin: We’re speaking with Miriam Delphin-Rittmon. She’s administrator of the Substance Abuse and Mental Health Services Administration, and HHS assistant secretary. And so does the challenge seek to look at better delivery mechanisms? Or are you also thinking and maybe there’s whole new medical approaches out there or all of the above?

Miriam Delphin-Rittmon: So we are looking for new approaches, you know, not necessarily medical approaches. Often peer recovery approaches are about individuals with lived experience or meeting people where they’re at and developing innovative programming and strategies and approaches to connect people with care and services, or people individuals in recovery will say sometimes it’s also just about walking alongside the person walking alongside them and asking them, you know, how can I help you and your recovery today? And what comes up is what they focus on. So it’s not necessarily a medical model. But nevertheless, it’s a model where we’re seeing significant impacts and significant outcomes in terms of people connecting to care, and people being able to move into long term recovery.

Tom Temin: And what types of organizations should apply for these challenge grant prizes? And what will you be looking for? How will this all be judged?

Miriam Delphin-Rittmon: Yes. So you know, it’s open in terms of applicants, I mean, certainly, peer run peer led organizations are invited to apply. But we also know there are other community based organizations that have significant peer recovery programs and initiatives led by individuals in recovery. So it’s pretty wide open. And then in terms of how we’re judging the challenge we’re looking for, you know, how people operationalize SAMHSA’s this definition of recovery, will certainly we’ll be looking at how the program or initiative has helped people to overcome sort of challenges incorporating recovery into their behavioral health systems. So certainly, if we have programs that are well incorporated into behavioral health systems, or they have addressed those challenges, and innovative ways, we’re looking for that. And then, you know, we’re definitely looking for the challenge to directly engage with more larger and more diverse organizations, to the extent that individuals and programs are doing that, you know, connecting and partnering and collaborating with other groups. You know, that’s always wonderful to see as well.

Tom Temin: And they get a challenge prize grant, what can happen in the long term, you know, often challenge grants can lead to production orders in other federal agency contexts, and therefore commercialization, what is the benefit for someone winning this challenge?

Miriam Delphin-Rittmon: Yeah. You know, certainly the benefit of winning is, you know, certainly there are some, you know, resources attached to it. But also, I think it’s an opportunity to continue to, you know, to share with us and with the field, what their practice and what their approach and strategy is it creates opportunity for scale up. I mean, that’s one thing I’m really excited about, you know, if we see programs and initiatives that are making an impact. There’s there’s all types of, you know, potential opportunities from there. I’m always really interested in evaluation. So, so that be interested in knowing like, is there an evaluation component and grantees that win can certainly apply for other grants as well.So certainly a range of other possibilities in terms of next steps.

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Tom Temin: Briefly, what are the timelines deadlines? When will this all be concluded?

Miriam Delphin-Rittmon: So the the challenge, ends I believe July 15, is the last day but but if folks are interested, they can go to challenge.gov. You know, challenge.gov, and they can see more information about the recovery challenge there, including deadlines and any other criteria related to it as well.

Tom Temin: Evidence has melted in the last year about the effects of social media on mental health. Now, the Substance Abuse and Mental Health Services Administration, part of Health and Human Services, has established a center of excellence on social media and mental wellness. Joining us once again with what the center will do. SAMHSA Administrator Dr. Miriam Delphin-Rittmon.

Dr. Delphin-Rittman, good to have you back.

Miriam Delphin-Rittmon: Thank you, thank you so much and appreciate being able to talk with you.

Tom Temin: Now, at $2 million, this is not very big in terms of federal programs, but a center of excellence on mental health and social media. What are you getting at here?

Miriam Delphin-Rittmon: Yeah, so you know, we’re excited about this, this is a newer initiative for us. And sometimes we’ll do this with a smaller, you know, initiative we’ll, or a newer initiative will start a bit smaller, and then sort of scale up from there. But the goal of this, so again, it’s we’re looking to award a center of excellence on social media and mental health, the goal is that it will be focused on children and youth. And we’re interested in disseminating information, guidance, training, the impact, to include both risks and benefits that social media has on children and youth, especially as it relates to you know, their mental health. And so ultimately, the center of excellence, it will examine both social and clinical interventions that can be used to mitigate risks. So we’re excited about that. Because there are, you know, certainly some risks that have a negative impact on on adolescents and youth.

Tom Temin: And I guess, at some point, last year, there were some pretty lurid revelations coming before Congress and in the press, about the effects of Facebook and Instagram, and some of these platforms, teenage girls, for example, were seen as being induced into believing they had a horrible body image and all of this, and some pretty bad outcomes. Is this what prompted this? Or is there a larger body of evidence, say, from academia, looking at this, that maybe didn’t make the headlines?

Miriam Delphin-Rittmon: I would say all of the above, there certainly is a body of evidence from and research and literature, within academia, that’s been studying the impacts of social media on youth, but also on adults as well. There is a growing body of literature there. I mean, some of the studies, recent studies have shown that we know adolescents, for example, they spend more than three hours per day on social media, that they may be at heightened risk for mental health problems, particularly internalizing, you know, internalizing mental health problems. So there is some research coming out of academia that suggests negative impacts.

Tom Temin: And from the SAMHSA standpoint, are there known ways to mitigate the effects of social media on young minds?

Miriam Delphin-Rittmon: No, and that is some of what this center of excellence on social media mental wellness, it’s some of what we’ll get will be geared towards, you know, we’re interested in learning more about what some of those impacts will be are. In addition, the some of the priorities will be sort of, for example, education, and resources around risks and benefits of social media for children and youth. In addition, culturally, and linguistically appropriate techniques, focusing on active learning consultation, to support and assist children as well as families in sort of managing and navigating the digital world. And then we’re looking for, you know, best practices and research updates, in terms of what is the most current literature saying, and what are the best practices in terms of mitigating risks, and benefiting from some of the benefits of social media as well.

Tom Temin: We’re speaking with Miriam Delphin-Rittman, administrator of the Substance Abuse and Mental Health Services Administration and an HHS assistant secretary, and is your sense that the mitigation techniques and best practices might be enabling young people to deal with social media at the level they are, only handle it better, and understand when well, you can ignore that bully or whatever the case might be, or some form of taking the phone away some intervention to reduce exposure to it. You see what I mean? The difference?

Miriam Delphin-Rittmon: Yeah, big difference, big difference in so some of what, you know, I anticipate and again, we’re still waiting for the different applications to come in, and we’ll score them and we’ll award you know, the center but some of what we’re anticipating is that we’ll be looking to provide strategies for people around coping with and managing social media in a healthy way.

Tom Temin: And what activities do you expect the center to perform on behalf of SAMHSA. Collecting literature? I mean, there must be so much probably every other professor in the country has something to say about this.

Miriam Delphin-Rittmon: Yeah. Yeah. So you know, collecting literature certainly is a part of it. But then, you know, turning that literature around and developing training and education and resource packages for, and approaches for communities, whether it be schools or community centers, or health centers, or practitioners, you know, ultimately it will be a training and technical assistance center, you know, around this particular topic area. So it’s pretty broad, you know, in terms of what they can offer, but largely, it’s often training and education and resource development. And, you know, along those lines related to sort of social media and mental wellness for children in youth.

Tom Temin: It sounds like there’s an opportunity for collaboration with the Dducation Department, which has exposure to those types of organizations also?

Miriam Delphin-Rittmon: Absolutely, absolutely. I mean, it’s certainly the, you know, Department of Education. You know, there, there are opportunities there, you know, once the once the grant is awarded, and so we think that this will bring real value to the space, we know that there are challenges in terms of what young people and communities and families are experiencing. But that also that there are benefits, you know, there are wonderful apps that are emerging and coming onto the scene that help young people with tracking their emotions, and, and learning how to manage stress and learning how to name and identify emotions. So so we do want a balanced approach sort of approaches to get at some of the risks, but also approaches and information and training that gets that you know, lifting up some of the benefits as well.

Tom Temin: And what about the industry that offers these platforms? They’re very good at running, advertising, showing earnest people, and how hard they’re approaching the issues connected with what we all know, is the problem with their platforms. But that’s advertising, can they participate perhaps in the center of excellence in a way that is appropriate? In a way that’s objective? Based on the data they actually do have?

Miriam Delphin-Rittmon: Yeah, you know, I think all opportunities, you know, it’s important for all opportunities and possibilities to remain on the table. I think this is an area that will require, you know, all all entities that sort of touch us in any way to come together and think creatively about how to produce the best health outcomes for children and youth. And, and adults as well.

Tom Temin: When do you expect to make this award?

Miriam Delphin-Rittmon: And so this award, I believe, will be made early end of the summer, early, early fall, but within the next few months. It is it is out there now and so we are looking to award this soon.

Tom Temin: And who is eligible? Academic institutions or nonprofits, nongovernmental organizations?

Miriam Delphin-Rittmon: All of the above, all the above. And so if folks are interested in this, and certainly they can go to the SAMHSA website, and we have an area or notice of funding opportunities, and there’s additional information about this there as well.

Tom Temin: Dr. Miriam Delphin-Rittmon is administrator of the Substance Abuse and Mental Health Services Administration and an HHS Assistant Secretary, thanks so much for joining me.

Miriam Delphin-Rittmon: Oh, you’re welcome. You’re welcome. Thank you for having me.

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