2006-2010 Statewide Comprehensive Plan for Mental Health Services
Chapter 2
Building on a Solid Foundation for Measuring Progress

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Major components of the Office of Mental Health (OMH) Strategic Plan Framework are described in this chapter to enhance understanding of the performance measurement system that has been adopted by OMH for promoting services consistent with its mission and values. In particular, the chapter provides an overview of the Framework in relation to the agency's strategic direction and it highlights the importance of measuring performance against the Framework to assess progress toward meeting established goals. Full descriptions of these components can be found in the 2004-2008 and 2005-2009 Statewide Comprehensive Plans for Mental Health Services.

The Strategic Planning Framework

The 2004-2008 Statewide Comprehensive Plan outlined OMH's Strategic Plan Framework to guide day-to-day operations and to support its ongoing commitment to quality. The foundation of the Strategic Plan Framework rests on the agency's mission, vision, values and enduring principles. Primary among the core principles, and consistent with the focus of the President's New Freedom Commission findings, is OMH's pledge to facilitate recovery from mental illness and enhance the resiliency and well-being of all New Yorkers. Over the past year, strategic planning has been expanded to clearly delineate a shared set of aims, goals and objectives in support of the agency's commitment to recovery-oriented services. The precise description of OMH's purpose, what it strives to be, and the inherent characteristics and qualities considered to be important to OMH are reflected in its mission, vision and values.

As indicated in Chapter 1, OMH has initiated its annual planning cycle for the past several years with an examination of its Strategic Plan Framework. This has been done in concert with major stakeholders of the public mental health system and findings from this year's examination of the Goals and Objectives are presented in depth in Chapters 4 and 5. Refinements to other parts of the Framework, most notably the agency vision statement and the ABC's of Mental Health Care, exemplify how stakeholders substantively influence planning design and implementation.

Stakeholders asked OMH to examine its vision statement and to determine whether it would benefit from a broadening in scope, making explicit the fundamental importance of achieving person-centered recovery goals in the agency's vision for the future. As a result of this feedback, OMH critically reviewed the national literature on recovery and resilience and determined that the President's New Freedom Commission on Mental Health clearly articulates what OMH envisions for the New York State public mental health system. OMH has adopted this vision as the vision it is working toward.

The statement, "The New York State Office of Mental Health will work toward a more effective public mental health system, which values recovery, hope, excellence, respect, and safety" has been replaced with a slightly modified version of the vision statement from Achieving the Promise: Transforming Mental Health Care in America. The new vision statement for OMH reads: The New York State Office of Mental Health envisions a future when everyone with a mental illness will recover, when all mental illnesses can be prevented or cured, when everyone with a mental illness at any stage of life has access to effective treatment and supports - essential for living, working, learning, and participating fully in the community.¹ The revised foundation of the Strategic Plan Framework appears in Figure 2.1.

Figure 2.1
The Foundation of the OMH Strategic Planning Framework

Mission
The mission of the New York State Office of Mental Health is to promote the mental health of all New Yorkers, with a particular focus on providing hope and recovery for adults with serious mental illness and children with serious emotional disturbances.

Vision
The New York State Office of Mental Health envisions a future when everyone with a mental illness will recover, when all mental illnesses can be prevented or cured, when everyone with a mental illness at any stage of life has access to effective treatment and supports – essential for living, working, learning, and participating fully in the community.

Values

• Recovery is the process of gaining control over one’s life in the context of the personal, social and economic losses that may result from the experience of psychiatric disability. It is a continuing, non-linear, highly individual process that is based on hope and leads to healing and growth.
• Hope is the belief that one has both the ability and the opportunity to engage in the recovery process.
• Excellence is the state of possessing superior merit in the design, delivery and evaluation of mental health services.
• Respect is esteem for the worth of a person including recognition of dignity, diversity and cultural differences.
• Safety is an environment free from hurt, injury or danger.

Another example of enhancements to this year's Strategic Plan Framework deals with accountability, best practices and coordination of care, which have been known as the ABC's of Mental Health Care. These three components serve as the underpinnings of OMH's mission and vision. Stakeholders acknowledged the importance of these principles and recommended the addition of a "D" to represent, "disparities elimination and cultural competence," to make known OMH's commitment to diversity and inclusiveness in assessing, planning, implementing and evaluating mental health treatment and supports. In adopting this new principle, OMH is emphasizing its determination to assure culturally and linguistically competent care at all levels of the service system, from adapting service environments, practices and delivery to match the individuals and families served to partnering with community leaders, cultural brokers and natural networks to facilitate the design of and improved access to services, to implementing a series of measures to recruit, train and retain a workforce that embraces and values diversity and incorporates its philosophy into its ongoing work.

Now known as the "ABCD's of Mental Health Care," these fundamental concepts include:

• Accountability for Results, whereby a clearly defined entity or individual is responsible for the effectiveness of services delivered. Services are designed and delivered to achieve specific outcomes, which are measured by performance indicators.
• Best Practices, whereby service design and delivery are based on the best research and evidence available and best practice guidelines are incorporated into treatment practices. Adherence to these guidelines is measured as part of the accountability process.
• Coordination of Care, whereby coordinated, comprehensive networks of providers deliver a balanced array of medical, self-help, social, supportive and rehabilitative services and programs. These services are focused on rehabilitation and recovery, and individualized service plans are designed around the needs and desires of the individual.
• Disparities Elimination and Cultural Competence, whereby all service components are held accountable to address disparities in access to and participation in services, differences are managed skillfully, cultural knowledge is absorbed organizationally, language assistance services are provided routinely, and service modifications are made to take into account the diversity of individuals, families and communities.

Values Supporting the Strategic Direction

Recovery, hope, excellence, respect and safety reflect the values that govern behavior, foster responsible decision making, and are critical to the agency's strategic direction and success. They help to define the conduct by which OMH carries out its daily operations and enable a culture in which partnerships, trust and hope are valued and appreciated.

The importance of these values and their connection to strong partnerships that foster quality improvement are underscored by the groundbreaking document, Infusing Recovery-Based Principles into Mental Health Services: A White Paper by People who are New York State Consumers, Survivors, Patients, and Ex-Patients, commissioned by OMH in 2002 and published in 2004.² The rules for recovery-based mental health services espoused in the White Paper are consonant with the values embraced by OMH. Moreover, the White Paper calls for continuing collaborations with consumer, survivors and ex-patients for the purpose of developing recovery-focused outcomes and quality indicators. How OMH is measuring and being accountable for performance will be explored further in the remaining chapters.

Primary Functions of the Office of Mental Health

As the State mental health authority, OMH has two main functions: assuring access to services of the highest quality for children with serious emotional disturbance and adults with severe mental illness and promoting the mental health of all New Yorkers through a public health approach of education and advocacy. To effectively meet agency responsibilities, OMH organizes its operations along four administrative lines:

1. Regulating, Certifying and Overseeing New York's Public Mental Health System
   OMH regulates and licenses all mental health facilities and programs in the State, with the exception of private practices and Federal facilities. The agency oversees 58 Local governmental units, one of which covers New York City in its entirety. Within the five regions of the State, more than 2,500 mental health programs are operated by local governments and private agencies. The services offered by these programs include inpatient, outpatient, emergency, residential, and community support. While certain policy, funding, regulatory, and management functions are centrally administered, actual program administration takes place on the Local government level. Each year approximately 588,000 individuals receive services in County-operated or non-profit mental health programs.

2. Providing State-operated Inpatient and Outpatient Mental Health Services
   OMH is a major provider of intermediate and long-term inpatient as well as outpatient treatment services. It operates 26 psychiatric centers, including six serving children with serious emotional disturbance and 17 serving adults with serious mental illness, and three serving adults with mental illness involved with the criminal justice system.

   State-operated outpatient services are designed to serve children and adults who also use State-operated inpatient services. Additionally, OMH provides mental health services in 23 sites around the State to inmates incarcerated in Department of Correctional Services' facilities.

3. Conducting Mental Health Research to Advance Prevention, Treatment, and Recovery
   Research conducted by OMH is an important effort to identify practices based upon scientific inquiry that are effective in improving the outcomes of services and integrating these practices into the public mental health system. Basic research aimed at better understanding the molecular, biochemical, neurological and genetic mechanisms underlying mental illness is conducted primarily at the Nathan S. Kline Institute (NKI) in Orangeburg, New York, and the New York State Psychiatric Institute (NYSPI) in New York City. In addition to conducting clinical trials to develop and evaluate new treatments and services, researchers at both institutes participate in consortia and other scientific collaborations that lead to the development of new medications to treat schizophrenia, bipolar disorder, depression, anxiety disorder, and Alzheimer's disease. OMH research and evaluation staff also examine the outcomes of services and conduct data-driven analyses of critical mental health issues, such as suicide prevention,^3,4,5 to develop sound recommendations and approaches for improving access to, and the quality of, mental health services for the general public, with a special emphasis on children with serious emotional disturbance and adults with serious mental illness.

4. Promoting Mental Health through Public Education
   OMH promotes mental health through education and advocacy for all New Yorkers. Mental health promotion activities are targeted toward expanding the general public's awareness and knowledge of mental health, including persons at risk for or living with mental health problems. Specifically, mental health promotion focuses on enhancing individual resiliency, making communities stronger, and diminishing structural barriers such as promoting access to housing and gainful employment.⁶ Through OMH mental health promotion activities, as many New Yorkers as possible are being provided with information on the nature and impact of mental health and mental illness, effective treatments and services, preventive and coping strategies, and how to get help when it is needed.

Chapter 3 provides an overview of the balanced scorecard approach, while Chapters 4 and 5 offer details of how OMH's strategic planning efforts are being focused and refined.

Notes:

1. New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final report. DHHS Pub. No. SMA-03-3832. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Rockville, MD.
2. New York State Office of Mental Health. (2004, September). Infusing recovery-based principles into mental health services: A white paper by people who are New York State consumers, survivors, patients, and ex-patients. Albany, NY: Author.
3. New York State Office of Mental Health. (2005, May). Saving lives in New York: Suicide prevention and public health. Volume1: Challenge, strategy and policy recommendations. Albany, NY: Author and the New York State Suicide Prevention Council.
4. New York State Office of Mental Health. (2005, November). Saving lives in New York: Suicide prevention and public health. Volume 2: Approaches and special populations. Albany, NY: Author and the New York State Suicide Prevention Council.
5. New York State Office of Mental Health. (2005, November). Saving lives in New York: Suicide prevention and public health. Volume 3: Data book. Albany, NY: Author and the New York State Suicide Prevention Council.
6. Sainsbury Centre for Mental Health. (2003). How does mental health promotion work? London: Author. Available online at http://www.mentality.org.uk/

Comments or questions about the information on this page can be directed to the Office of Planning.