The 21st Century Cures Act: Ensuring Mental and Substance Use Disorders Prevention, Treatment and Recovery Programs Keep Pace with Science and Technology

Title VII of the of the 21^st Century Cures Act (the “Act”) underscores the importance of evidence-based programs and practices for diagnosing, preventing, treating and recovering from mental and substance use disorders. Title VII amends the Public Health Service Act to ensure that such programs reflect the increased knowledge obtained through the progress in science and technology.

Encouraging Innovation and Evidence-Based Programs

Section 7001 of Title VII establishes the National Mental Health and Substance Use Policy Laboratory (“Laboratory”) within the Substance Abuse and Mental Health Services Administration (“SAMHSA”). Beginning January 1, 2018, the Laboratory will have the following responsibilities:

Carrying out the activities that were in effect for the Office of Policy, Planning and Innovation;
Identifying, coordinating and facilitating the implementation of policy changes likely to have a significant effect on mental health, mental illness, recovery supports and the prevention and treatment of substance use disorders;
Working with the Center for Behavioral Health Statistics and Quality to collect information from grantees under SAMHSA programs in order to evaluate and disseminate information on evidence-based practices;
Providing leadership in identifying and coordinating policies and programs, including evidence-based programs, related to mental and substance use disorders; and
Periodically reviewing SAMHSA’s programs and activities relating to diagnosing, preventing, treating and recovering from mental and substance use disorders.

The Assistant Secretary of SAMHSA (“Assistant Secretary”), in coordination with the Laboratory, is authorized to award grants to states, local governments, Indian tribes and tribal organizations to promote developing evidence-based programs.

Promoting Access to Information on Evidence-Based Programs and Practices

Section 7002 of Title VII authorizes the Assistant Secretary to post reliable information on SAMHSA’s website gleaned from evidence-based programs and practices so that states, local communities, nonprofit entities and other stakeholders may use it. The Assistant Secretary may require applications for evidence-based programs and practices that would be posted publicly on SAMHSA’s website. Such applications would be rated using publicly available metrics.

Priority Mental Health Needs of Regional and National Significance

Section 7003 of Title VII amends Section 520A of the Public Health Service Act, allowing the Assistant Secretary to address regional and national priority mental health needs by providing or assisting with systems change grants, including statewide family network grants and client-oriented, consumer-run self-help activities. Technical assistance centers would be set up to help such self-help activities.

Substance Use Disorder Treatment Needs of Regional and National Significance

Section 7004 of Title VII amends Section 509 of the Public Health Service Act, allowing the Assistant Secretary to address treating substance use disorders of regional and national significance by providing or through assisting with targeted capacity response programs. Such programs would permit states, local governments, communities and Indian tribes and tribal organizations to focus on emerging trends in substance abuse and co-occurrence of substance use disorders with mental illness or other conditions.

Priority Substance Use Disorder Prevention Needs of Regional and National Significance

Section 7005 of Title VII amends Section 516 of the Public Health Service Act, directing the Assistant Secretary to address preventing substance use disorders of regional and national significance by providing or assisting with targeted capacity response programs, including those focused on emerging drug abuse issues. Further, the amendment changes references from “substance abuse” to “substance use disorder” throughout Section 516.

Practical Takeaways

Behavioral health providers should evaluate current programming to assess whether evidence-based treatment is being provided and how to incorporate science and technology into the treatment programs.
Incorporate evidence-based screening tools for adults and children to identify mental illnesses and substance use disorders early.
Ensure that your behavioral health generalists are trained to used evidenced-based strategies to promote behavior change across a broad range of populations and behavioral and physical health conditions.

If you would like further guidance regarding Title VII of the Act, please contact: