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Ronald W. Manderscheid, Ph.D. – Career Overview

Dr. Manderscheid has served in numerous leadership roles at the National Institute of Mental Health (NIMH) and at the Substance Abuse and Mental Health Services Administration (SAMHSA)--both components of the U.S. Department of Health and Human Services (HHS); he served for several years on the faculty of the University of Maryland; and he currently serves as the Executive Director of the National Association of County Behavioral Health and Developmental Disability Directors and as an Adjunct Professor in the Department of Mental Health at the Johns Hopkins University Bloomberg School of Public Health.

Career Experiences

While at NIMH, Dr. Manderscheid served as a researcher in the Biopsychosocial Research Program, where he had the opportunity to collaborate with Dr. Julius Axelrod, a prominent Nobel Laureate in brain chemistry. He also served as chief of evaluation research and as a founding chief of the mental health services grant and intramural research program. At SAMHSA, Dr. Manderscheid led the national mental health statistics and informatics programs as well as efforts to integrate mental health and substance use care services with primary care, and to develop a national training agenda for the mental health field. He also served on the Clinton Health Care Reform Taskforce, and as a Senior Policy Advisor on Health Care Reform in the Office of the U.S. Assistant Secretary for Health. At a young age, Dr. Manderscheid was President of the Washington Academy of Sciences. Later, he also served as Chairperson of the Mental Health Section of the American Public Health Association.

National Leadership in Mental Health

Dr. Manderscheid’s life-long interests in mental health encompass policy, research, and services. He is known both nationally and internationally throughout the mental health field as a leader who works with all groups to advance mental health research, care, and the wellbeing of mental health consumers in the community.

In 2003, while serving as a SAMHSA lead on mental health and primary care, Dr. Manderscheid took the initiative to develop the principal concepts and the federal and private-sector funding for the acclaimed IOM project on Improving the Quality of Health Care for Mental and Substance Use Conditions. He also served as the Federal Project Officer. This is a landmark study for several reasons. First, it is the only IOM study that specifically addresses both mental and substance use conditions. Second, it provides a detailed blueprint for action rather than just a series of recommendations. Third, the study has been endorsed by both the mental health and substance use care fields, and efforts are currently underway in the field and in the Congress to implement the blueprint. Several of the key concepts being applied in this work--i.e., community mental health collaboratives and public health advocates - were pioneered by Dr. Manderscheid.

Also while at SAMHSA, Dr. Manderscheid led efforts within that organization and in the mental health and substance use care fields to develop a national training strategy for both fields. This detailed strategy (available at www.samhsa.gov) involved input from more than 5,000 consumers, family members, care providers, and policy makers. Dr. Manderscheid continues to passionately support implementation of the strategy to ensure the future success of mental health and substance use care organizations and to address concerns that the mental health and substance use care leadership is aging out; replacements are not being trained; current providers do not know how to implement evidence-based practices; and new clinical trainees are not being taught how to perform in a quality improvement environment. To further this initiative, in his own time, Dr. Manderscheid has served as an academic mentor, an HHS mentor, and a mentor in transformative leadership.

Viewed by Dr. Manderscheid as the most important work of his career, in1982, he led the effort to open participation in federal workgroups and committees to mental health and substance use care consumers and their family members. Previously, the care, livelihood, and lives of these individuals were discussed and decided without their voices being at the table. Dr. Manderscheid invited them to participate in federal workgroups; he encouraged them to apply to serve on federal advisory groups; and he encouraged them to form national consumer and family coalitions. These efforts have borne fruit, and each of these forms of participation is now standard practice in the industry.

Today, Dr. Manderscheid continues to be an advocate for mental health and substance use care consumers and is leading efforts to reform mental health and substance use care benefits in Medicare, Medicaid, and private insurance. For 10 years, he directed a research project to investigate how these programs are used by mental health and substance use care consumers. Recently, he provided testimony to the U.S. House of Representatives Ways and Means Subcommittee on Health on reform of Medicare, and he organized a process to determine the positions of the 2008 presidential candidates and the state universal insurance coverage initiatives on mental health and substance use care benefits.

Major Contributions to Mental Health Statistics and Informatics

For 25 years, Dr. Manderscheid led the National Reporting Program on Mental Health Statistics and the Mental Health Statistics Improvement Program. Here, we present examples of his major accomplishments in those roles.

In1996, Dr. Manderscheid introduced a Mental Health Consumer-Oriented Report Card to assess consumers’ views on access to care, quality of care, and outcome of care. This report card has become the national standard in mental health. Particularly noteworthy is the consumer survey, which predates similar quality surveys in the health care field.

Dr. Manderscheid has served as the principal editor for nine editions of Mental Health, United States between 1987 and 2004. He evolved this publication from a traditional statistical document to one that serves as a national platform on mental health policy and current service issues in the field. This publication is recognized both in the U.S. and internationally as the definitive source on mental health epidemiology, services, and expenditures.

In 1998, Dr. Manderscheid transformed the national mental health statistical surveys from traditional paper-and-pencil surveys to online data collections, and he added major surveys of mental health services in criminal justice settings. Of particular note, he also added mental health content to the national and state health surveys, including the National Health Interview Survey, conducted by the National Center for Health Statistics, and the State Behavioral Risk Factor Surveillance System, operated by the Centers for Disease Control.

At the time the Health Insurance Portability and Accountability Act (HIPAA) was being implemented, Dr. Manderscheid pioneered a fully compatible set of data standards for mental health, Decision Support 2000+, and he built the first national web-based information system for field users to report, analyze, and apply statistical data for benchmarking and to conduct online surveys. Similar systems are currently being built for other fields.

Major Contributions to Mental Health Research

Dr. Manderscheid’s contributions to mental health research broadly span the field “from the bench to the trench”. Some key examples are cited below.

In the very early part of his career, Dr. Manderscheid was engaged in biopsychosocial research around brief group psychotherapy interventions for married couples and brief coping interventions for adolescents. In this work, as several key examples, Dr. Manderscheid examined the relationship between brain catecholamine activity, as measured through analyses of blood samples, and psychological stress; he modeled the dynamics of married couple interactions using multistage Markov chain analysis; and he examined the important role of placebo-effect control groups in brief psychotherapy.

In a later stage of his career, Dr. Manderscheid did considerable research on mental health epidemiology and services evaluation. He authored/co-authored three classic papers on mental health epidemiology published in the Archives of General Psychiatry in 1993, which were based on the Epidemiological Catchment Area Project. He also contributed to the more recent National Co-morbidity Survey and its replication. In addition, he published numerous articles on the evaluation of service programs for adults with serious mental illness. That work has led to more recent efforts to define and measure recovery and resiliency, and to specify community-based performance measures that reflect these factors. Of particular note, a “wellness model” developed by Dr. Manderscheid in 1981 is now beginning to be applied in the mental health field.

In more recent research work, Dr. Manderscheid has worked on the issue of premature death of public mental health clients. The finding that public mental health clients die, on average, 25 years younger than other Americans has mobilized the state and local mental health system. The National Association of State Mental Health Program Directors (NASMHPD) Medical Directors Group has produced an action plan to begin addressing the problem. The National Council on Community Behavioral Healthcare (NCCBH) devoted an entire issue of its community mental health center newsletter to this problem, as well as a signification portion of its 2007 national meeting.

Major Recognitions Received

Dr. Manderscheid has received many awards for his professional work including multiple distinguished service awards from the Secretaries of HHS and the Administrators of SAMHSA. He has also received lifetime achievement awards from the American College of Mental Health Administration, NASMHPD, and NCCBH, as well as public service awards from the Mental Health Section of the American Public Health Association; the Federal Executive Institute Alumni Association; his undergraduate institution, Loras College; and the American Association for Psychosocial Rehabilitation, among others. Dr. Manderscheid is a Life Fellow of the Washington Academy of Sciences and the International Academy of Art and Science.