10 Problems in behavioral health funding:
And peer advocate organizations simply don’t have enough time between the grant announcement and the due date to build relationships with every single entity that should be listening to us. Why aren’t these lead applicant building relationships with US? Why are funders not requiring it?
10. Basically, just doing stuff the way it’s always been done. Stuck systems are unable to implement reforms.
How to fix this? 10 solutions for behavioral health funders:
1. Share letters of intent. Ask for a letter of intent. When peer organizations ask, “Who is applying in my region for this grant?” At least give us the names of the people who sent in the letter of intents so we aren’t hunting people down like a needle in a haystack.
2. Have small grants for all the big grants you put out. For every million dollar grant, have a $40,000 grant available, too. Say that the smaller grant can be for a peer organization to find the lead entity and build relationships. SAMHSA told me that aren’t currently doing this because, “a minimum amount for inclusion is often becomes a ceiling, or a maximum amount.” Ie, the grant that might have spent $100,000 on peers might only spend that $40,000 now. But right now we aren’t getting included at all. It takes time to build relationships and right now all the “relationship building,” is unpaid work and gambling that may or may not even pay off. Usually it doesn’t pay, really, as very few of these lead applicants understand peer inclusion principles.
3. Score the lead entity a LOT more on peer input. (like 20% of the grant score) for how well they include peer and recovery organizations. This could include scoring for budgeting the peer organizations in, so it would raise the ceiling quite a bit.
4. Require that the lead entity budgets in a “placeholder” for peer activities. Just in case they can find the peers later, once they are awarded the grant. Or that the lead entity puts out a RFP specifically to find and fund peers later.
5. Put a cap on the % of money that can go to service providers or academic groups. The rest needs to go to community organizations. If you think recovery is in the community, start funding community.
6. Include us in the review panel. If you are funding behavioral health, make sure your funding review committee inlcudes people from mental health organizations. Check the links page at the National Empowerment Center for a whole list of good organizations. If you have never heard of any of these organizations and you are funding mental health, it’s time to get a clue!
7. Use less reliance on evidence based practices. Since many EVP are based on concepts that actually harm people.
8. Outreach. Have you done some marketing of the RFP to get more diverse grants in? A lot of “community mental health” grants just end up being “psychologists in social service agencies.” This is a low value intervention, as relationships do 85% of the benefit of therapy and relationships can be built with significantly lower cost and lower stigma.
9. Give Advocates visibility. Do you have advocates speaking at the pre-proposal conference? That’s a good way to indicate the value of peer and stakeholder engagement.
10. Most important – emphasize prevention and community resilience (80% of health care outcomes) vs. treatment (20% of health care outcomes). If you you are working on a culture of health or social determinants of health, it’s time to include the peer organizations who have asked for this stuff for 30 years. We’re the ones who can actually solve the issue.