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"If the proof of the
pudding is in the eating,
the ultimate utility of
science is in its applica-
tion for improving the
human condition. There-
fore, the translation and
adaptation of scientific
findings into practical
application are the

ultimate touchstones of
progress in human

services."

This is the philosophy
underlying the Prevention
Enhancement Protocols
System (PEPS) Program
of SAMHSA's Center for
Substance Abuse Preven-
tion (CSAP), according to
PEPS Program Director
Prakash L. Grover, Ph.D.,
M.P.H.

PEPS was created to
distill and disseminate the
latest science-based

information about preven-

tion into practical tools that may be used to
improve substance abuse prevention
policy, practice, and future research in this
field.

SAMHSA has just released the first
guideline in this series of tools, Reducing
Tobacco Use Among Youth: Community-
Based Approaches. This publication
coincides with SAMHSA's first report to
Congress on the progress of the Synar
Regulation (Public Law 103-321), which
mandates the reduction of tobacco sales to
minors and calls on States to enforce the
law and measure its results. The law is
part of a larger Presidential initiative to
reduce youth tobacco access and use.

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This new publication can assist States,
communities, organizations, and individu-
als to achieve this goal.

Each PEPS guideline is based on
information carefully gathered and
analyzed by a panel of non-Federal
experts. The guidelines offer the reader a
systematic assessment of the effectiveness
of each prevention practice and identify a
concise set of "lessons learned."

Recognizing that there are many target
populations, practitioner backgrounds, and
service settings, CSAP offers the PEPS
guidelines as a resource for practitioners
to use in selecting and adapting the

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service Substance Abuse and Mental Health Services Administration
• Center for Mental Health Services

• Center for Substance Abuse Prevention

approaches that best suit
their needs.

Six
Approaches

The panel examined the
following six approaches to
determine what works best
in preventing tobacco use
among youth:

1. Economic

interventions;

2. Counteradvertising;
3. Retailer-directed

interventions;

4. Multicomponent,

school-linked,

community
approaches;

5. Tobacco-free

environment
policies; and

6. Restriction of
advertising and
promotion.

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• Center for Substance Abuse Treatment

SAMHSA Measures Performance and Outcomes of Managed Care Treatment

Measuring the success of treatment for mental and addictive disorders-often called behavioral health care- -is a problem that has confounded provision of services for these disorders for more than half a century. The history of behavioral health care has been marked by confusion, misunderstanding, and stigmatization concerning the causes of these disorders, as well as disagreements over appropriate treatment and definitions of recovery. The rapid growth of managed care as a means to control costs and improve the quality of services has escalated the need for accurate and widely accepted ways to measure both the performance of service

delivery and the treatment

outcomes resulting from services provided.

Managed care has had an

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impact on all stakeholders: consumers of services and their families who may be faced with a change in provider or in services offered; service providers who may find their clinical decisions modified based on financial considerations; and health care payers such as private companies and State agencies that are called upon to be active purchasers by comparing and assessing competing plans.

In response to this need for standardized measures, SAMHSA has initiated several significant activities to try to assist the field. In the vanguard of these efforts is the MHSIP Consumer-Oriented Mental Health Report Card, released by SAMHSA's Center for Mental Health Services (CMHS) in 1996.

The Report Card grew out of the work of a special task force convened by the CMHS Mental Health Statistics Improvement Program (MHSIP). MHSIP is a voluntary network of providers, advisory groups, associations, State agencies, and consumers that assists CMHS in collecting

Center for Mental Health Services

MHSIP Consumer-Oriented Report Card

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HAWAII

LEGEND:

Highlighted States are using the MHSIP Report
Card and/or the Consumer/Family Surveys.

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PUERTO RICO

Card goes beyond this. According to Ronald W. Manderscheid, Ph.D., who coordinated the development of the Report Card and serves as Chief of the Survey and Analysis Branch within the CMHS Division of State and Community Systems Development, "A primary challenge is to move the managed health care field from competition based on price to competition based on quality."

If behavioral health care services are to be viable in the long run, he says, independent measures of value must be developed. If key stakeholders have access to a valid assessment of quality of service and measures of positive outcomes, they can justify the financial investment that needs to be made in behavioral health care services. Payers will be more willing to cover the costs of mental health services when concrete outcomes are measured and reported.

"Unless we are successful in these endeavors," says Dr. Manderscheid, "the field runs the risk that progressively

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