White House Appoints 'Mental Health Czar'

By Paul Gaita 08/21/17

The announcement of Dr. Elinore McCance-Katz as "Mental Health Czar" has been met with a mix of support and criticism from federal officials.

Mental Health Czar Elinore McCance-Katz
Mental Health Czar Elinore McCance-Katz Photo via YouTube

Members of the medical and mental health community are praising the appointment of a psychiatrist to serve as assistant secretary for mental health and substance abuse in the U.S. Department of Health and Human Services (HHS).

President Donald Trump selected Elinore McCance-Katz, MD, PhD, to fill the newly created position, which will oversee the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) and coordinate mental health service efforts at other federal agencies. However, McCance-Katz's appointment is not without controversy—which concerns her criticism of the federal government's strategy for treating mental illness, as well as perceived failures within SAMHSA during her tenure as chief medical director from 2013 to 2015.

Organizations such as the National Alliance on Mental Illness (NAMI), the American Psychiatric Association (APA) and American Society of Addiction Medicine (ASAM) were all effusive in their approval of McCance-Katz's appointment as "mental health czar," as the position has been dubbed.

"We've not had a physician-psychiatrist in this sort of position since 1988 to 1992," said Dr. Saul Levin, CEO and medical director of the APA. "I think it's a really good choice on behalf of HHS Secretary Tom Price and the president [and] we look forward to working with her."

Levin also noted that McCance-Katz is the right match for other White House entities like Surgeon General Jerome Adams, MD, who has stated that the opioid epidemic will be a top priority in his new role.

"Her core training was as a psychiatrist, but then she's super specialized in addiction," said Levin. "So we've got a double gift with her being appointed. She's lived and breathed [the opioid epidemic] for many of her professional years. I think this is a timely appointment for her and for the nation."

But the outpouring of support for McCance-Katz's selection was also tempered by opposition—surprisingly, from within Trump's own party.

Republican Senator Tim Murphy issued a statement in which he said he was "stunned" by her nomination after conducting an investigation into practices at SAMHSA while under her administration. "The old regime at SAMHSA was incapable and unwilling to work with me and my colleagues in Congress to deliver the transformative changes needed at the agency and throughout the federal government to serve families in crisis," wrote Murphy, who authored the Helping Families in Mental Health Crisis Act, which was signed into law December 2016. 

"Dr. McCance-Katz served as Chief Medical Officer at the very same time SAMHSA was under investigation for multiple failed practices and wasteful spending. She was the key medical leader when the agency actively lobbied against any change or accountability…and while she was serving at SAMHSA, there were questionable hiring practices, no accountability for federal grants, an anti-medical approach to serious mental illness and substance abuse treatment and most importantly, the continued upward rise of suicide and substance abuse deaths."

Murphy also pointed to an article written by McCance-Katz after her departure from SAMHSA in which she appeared to criticize the agency for lacking the resources or focusing in developing real medical care for mental health issues.

"Nowhere in SAMHSA's strategic initiatives is psychiatric treatment of mental illness a priority," she wrote. "The occasional vague reference to treatment is no substitute for the urgent need for programs that address these issues."

But those in favor of McCance-Katz have suggested that her previous experience with the agency—as well as turns as medical director for alcohol and drug programs in California and Rhode Island, collaborations with the World Health Organization and tenure as president of the American Academy of Addiction Psychiatry—will only advance the agency, not hinder it.

Please read our comment policy. - The Fix

Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, Amazon.com and The Los Angeles Beat, among many other publications and websites.