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The mental health community does not have time to mourn or rehash the death of the Mental Health Special Needs Plan (SNP) legislation on June 30. There isn't time. The challenge now is to work together to ensure that as much good and change as possible come from lessons learned through the SNP planning process.

While there were few consumers or provider agencies who embraced every aspect of the proposed SNP, most came to be very positive about the changes the SNP could bring. I believe that optimism is still warranted and that many of the positive features of the Plan may be retained in some fashion.

One aspect of the SNP planning process over which the community retains control is the maintenance of the coalition formed by non-profit agencies, consumers and advocates, and hospitals in order to have input into the SNP design. The unity that ensured the coalition's voice was heard then, can continue to have an impact in this post-SNP era.

As plans for a future system are developed, the primary focus of the SNP—the move to a recovery-based model—should be emphasized. The local community, the Department, and the State Office of Mental Health should examine whether Medicaid funding can become more flexible without a formal managed care plan. Such flexibility is likely necessary if we are to move from an historically hospital-based system to one that promotes recovery rather than accepting stability.

Another important component of the SNP well worth keeping is the move towards a less fragmented and more integrated and accountable system. The lessons being learned today about the development of a seamless continuum of services through the still-evolving Assisted Outpatient Treatment (AOT) program can one day be applied on behalf of all those with severe and persistent mental illness.

It is important to note that the Department, in partnership with community-based providers and the Health and Hospitals Corporation (HHC) already has developed holistic program models that address the range of overlapping problems faced by many consumers. The successful three-year-old Cumberland Program, offers mothers with mental health and substance abuse issues who are involved with the child welfare system one place to come for mental health and substance abuse treatment, job training, and primary health care.

This on-going and expanding move to more integrated services reflects the belief of Surgeon General David Satcher, which I strongly endorse, that mental illness should be seen as a public health issue. It should not be placed in a box and dealt with in isolation, separate and apart from the broader health care system. Reducing the high prevalence of suicide in today's society should be viewed as a public health priority on par with preventing tuberculosis, HIV, or sexually transmitted diseases, or any other preventable illness.

The SNP process unified the disparate components of our community in a way not seen since Reinvestment was passed in 1993. While the SNP proposal lies dormant, this sense of unity and common purpose it engendered continues. Let us take the best of what we've learned and make something significant happen in New York City.