[Federal Register Volume 87, Number 168 (Wednesday, August 31, 2022)]
[Notices]
[Pages 53477-53479]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-18834]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Request for Information: SAMHSA's Role in Possible Agency Actions 
Regarding Mental Health and Substance Use Wellbeing in the Context of 
Climate Change and Health Equity

AGENCY: Substance Abuse and Mental Health Services Administration 
(SAMHSA), Department of Health and Human Services (HHS).

ACTION: Notice of request for information.

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SUMMARY: SAMHSA seeks input from members of the public about how it can 
best address the behavioral health impacts of climate change and health 
equity considerations. Behavioral health includes mental health 
conditions and substance use disorders. SAMHSA specifically seeks input 
on suggested priorities, resources, partners and collaborating agencies 
and organizations.

DATES: Comments on this notice must be received by October 31, 2022.

ADDRESSES: Please submit all responses via email to 
[email protected] as a Word document, Portable Document 
Format (PDF) or in the body of an email. Please include ``Request for 
Information: SAMHSA's Role in Climate Change'' in the subject line of 
the message.

FOR FURTHER INFORMATION CONTACT: Mitchell Berger, Public Health 
Advisor, Telephone: 240-276-1757, Email: 
[email protected], or Maggie Jarry, Emergency Management 
Specialist, Email: [email protected].

SUPPLEMENTARY INFORMATION: In January 2021, President Biden signed 
Executive Order 14008, Tackling the Climate Crisis at Home and Abroad. 
Recognizing that ``we face a climate crisis that threatens our people 
and communities, public health and economy, and, starkly, our ability 
to live on planet Earth,'' the Order called for a ``government-wide 
approach'' to climate change and development of agency action plans to 
``bolster adaptation and increase resilience to the impacts of climate 
change.'' \1\
    President Biden also in January 2021 signed Executive Order 13985, 
Advancing Racial Equity and Support for Underserved Communities Through 
the Federal Government, which called upon Agencies to take steps to 
enhance

[[Page 53478]]

programs for underserved communities.\2\
    In August 2021, HHS established the Office of Climate Change and 
Health Equity (OCCHE) as part of the Office of the Assistant Secretary 
for Health. OCCHE priorities include supporting efforts to reduce 
greenhouse gas emissions, partnering with other government agencies and 
the nonprofit and private sectors and supporting efforts to address 
health disparities.
    Consistent with Administration priorities, HHS in 2021 developed a 
Climate Action Plan emphasizing the Department's proactive response to 
climate change.\3\
    SAMHSA leads public health efforts to advance the behavioral health 
of the nation. SAMHSA's mission is to reduce the impact of substance 
abuse and mental illness on America's communities. SAMHSA accomplishes 
this mission by working closely with other federal partners, state, 
local, tribal, and territorial governments, health care providers, 
academic institutions, persons with lived experience and family members 
and caregivers to promote mental health, prevent substance misuse, and 
provide treatments and supports to foster recovery. SAMHSA works 
closely with such partners as the Administration for Strategic for 
Preparedness and Response, Health Resources and Services 
Administration, Centers for Medicare & Medicaid Services, Centers for 
Disease Control and Prevention and other agencies to expand access to 
behavioral health services, ensure compliance with the Mental Health 
Parity and Addiction Equity Act, and provide services to vulnerable 
populations.
    SAMHSA also supports such programs as the Substance Abuse and 
Mental Health Block Grants, Disaster Technical Assistance Center, 
Projects for Assistance in Transition from Homelessness emphasizing 
services for vulnerable populations. Through these and other grants and 
activities supported by SAMHSA's Office of Behavioral Health Equity and 
Office of Tribal Affairs and Policy, SAMHSA, consistent with the 
Administration's January 2021 Executive Orders, works to ensure 
disadvantaged and underserved communities and individuals experiencing 
behavioral health conditions are supported.
    Increasingly, climate change is impacting, directly and indirectly, 
clients, providers, caregivers, and communities, and in particular, 
persons with behavioral health conditions. For instance, climate change 
may increase the likelihood of extreme weather events, such as 
heatwaves, that adversely impact persons with psychiatric 
conditions.\4\ Hurricanes may disrupt access to and participation in 
behavioral health treatment and recovery supports for people with 
substance use and/or mental disorders. For instance, hurricanes may 
disrupt access to medications or increase anxiety, depression, and 
substance use.5 6 Hurricanes may also disrupt access to the 
SAMHSA identified four major dimensions of recovery--health, home, 
purpose, and community. In addition, growing numbers of youth and 
others are experiencing heightened anxiety related to current and 
potential impacts of climate change. Climate emergencies, such as 
droughts, also may lead to loss of community cohesion, depopulation, 
loss of natural resources, and loss of economic opportunities.\7\ 
Under-resourced populations are among those most impacted by climate 
change because of their inadequate access to healthy foods, lack of 
stable housing and healthcare barriers.\8\
    SAMHSA programs, along with those of other HHS and federal 
agencies, are working to address these impacts. For instance, SAMHSA 
participates in the National Integrated Heat Health Information System, 
which works to mitigate the health impacts of extreme heat and supports 
the recently launched website, Heat.gov. In collaboration with the 
Federal Emergency Management Agency, SAMHSA also supports the Crisis 
Counseling Assistance and Training Program, which provides outreach and 
psychosocial support following disasters.
    Consistent with its mission and the Administration's focus on 
climate change and health equity, SAMHSA seeks input on how its 
programs, technical assistance and training, and other resources can 
support clients, providers, family members and communities in 
confronting the impacts of climate change. Specifically, SAMHSA seeks 
input on the following questions:
    A. What should SAMHSA's top priorities be with respect to climate 
change and behavioral health? What are current strengths or gaps in 
SAMHSA's work in this area?
    B. What should SAMHSA's top priorities be to ensure behavioral 
health equity with respect to climate change?
    C. Which population(s) are most vulnerable to the behavioral health 
impact(s) of climate change? How can SAMHSA communicate with such 
population(s) and others to support their preparedness for the 
behavioral health impact(s) of climate change?
    D. In thinking about behavioral health, what are the top lessons 
learned from past climate-related emergencies and natural disasters, 
such as recent or past hurricanes, heat waves, wildfires, or other 
events?
    E. What peer-reviewed articles, papers, toolkits, listservs or 
other resources related to climate change should SAMHSA highlight in 
its work with states, local, tribal and territorial health authorities, 
behavioral health providers, grant recipients, national and local 
stakeholder organizations, and the general public?
    F. Should SAMHSA programs highlight the importance of climate 
change to its grant recipients? If so, how?
    G. What barriers exist in SAMHSA's programs or regulations that 
make it difficult to prepare for, mitigate, respond to or recover from 
the impacts of climate change on mental health or substance use 
disorders?
    H. What steps should SAMHSA take to help states, local, tribal and 
territorial health authorities, grant recipients and stakeholders, 
behavioral health providers, national and local stakeholder 
organizations, and the general public address the impacts of climate 
change and the needs of underserved populations?
    I. Can SAMHSA promote behavioral health equity by addressing 
intergenerational trauma resulting from climate change? If so, how?
    J. How can SAMHSA support access to behavioral health and climate 
change resources and supports for future generations?
    K. How can SAMHSA effectively collaborate with governmental and 
non-governmental partners to facilitate adaption to current and future 
climate change impacts?
    L. What research should be prioritized to build the evidence base 
on how climate change affects mental health and substance use disorder 
outcomes?

Endnotes

    \1\ 86 FR 7619 (2021).
    \2\ 86 FR 7009 (2021).
    \3\ HHS Climate Action Plan, Sept. 2021, https://www.hhs.gov/sites/default/files/hhs-climate-action-plan-9-28-2021.pdf.
    \4\ See e.g., Disaster Behavioral Health in an Era of Climate 
Change, Dialogue, 2022; 17(3), https://www.samhsa.gov/sites/default/files/dtac-dialogue-vol-17-issue-3.pdf; Mental Health and Our 
Changing Climate, 2021 Edition, https://ecoamerica.org/mental-health-and-our-changing-climate-2021-edition/; N. Obradovich and K. 
Minor, Identifying and Preparing for the Mental Health Burden of 
Climate Change, JAMA Psychiatry 2022 Apr 1;79(4):285-286. doi: 
10.1001/jamapsychiatry.2021.4280; R.

[[Page 53479]]

Thompson et. al., Associations between high ambient temperatures and 
heat waves with mental health outcomes: a systematic review. Public 
Health. 2018 Aug;161:171-191. doi: 10.1016/j.puhe.2018.06.008. Epub 
2018 Jul 12. PMID: 30007545; D. Dodgen et. al., 2016: Ch. 8: Mental 
Health and Well-Being. The Impacts of Climate Change on Human Health 
in the United States: A Scientific Assessment. U.S. Global Change 
Research Program, Washington, DC, 217-246. http://dx.doi.org/10.7930/J0TX3C9H.
    \5\ K. Bevilacqua et. al. Understanding Associations Between 
Hurricane Harvey Exposure and Mental Health Symptoms Among Greater 
Houston-Area Residents. Disaster Med Public Health Prep. 2020 
Feb;14(1):103-110. doi: 10.1017/dmp.2019.141. PMID: 32019618; JM 
Shultz and S. Galea, Mitigating the Mental and Physical Health 
Consequences of Hurricane Harvey. JAMA. 2017;318(15):1437-1438. 
doi:10.1001/jama.2017.14618; E.A. Storch et. al., Psychiatric 
Diagnoses and Medications for Hurricane Harvey Sheltered Evacuees, 
Community Mental Health Journal, 2019; 55 (7): 1099-1102. doi: 
10.1007/s10597-019-00378-9.
    \6\ See e.g., L. Elliott et al., Disaster preparedness among 
opioid treatment programs: Policy recommendations from state opioid 
treatment authorities. International Journal of Disaster Risk 
Reduction, 2017; 23: 152-159. doi.org/10.1016/j.ijdrr.2017.05.001; 
A.R. Griffin, et. al., A Crisis Within a Crisis: The Extended 
Closure of an Opioid Treatment Program After Hurricane Sandy. 
Journal of Drug Issues, 2018; 48(4), 536-545. doi.org/10.1177/0022042618779541; H. Matusow et al., Challenges to Opioid Treatment 
Programs After Hurricane Sandy: Patient and Provider Perspectives on 
Preparation, Impact, and Recovery. Substance Use & Misuse, 2018; 
53(2), 206-219. https://doi.org/10.1080/10826084.2016.1267225; PJ 
Joudrey et. al., Assessment of Community-Level Vulnerability and 
Access to Medications for Opioid Use Disorder, JAMA Network Open. 
2022;5(4):e227028. doi:10.1001/jamanetworkopen.2022.7028.
    \7\ H. Vins et. al. The mental health outcomes of drought: a 
systematic review and causal process diagram. Int J Environ Res 
Public Health. 2015;12(10):13251-13275. doi: 10.3390/
ijerph121013251. LA Palinkas and M. Wong, M. Global climate change 
and mental health. Current Opinion in Psychology, 2020; 32, 12-16. 
https://doi.org/10.1016/j.copsyc.2019.06.023.
    \8\ See e.g., Behavioral Health Equity. https://www.samhsa.gov/behavioral-health-equity.

How To Submit a Response

    Responses will be accepted through October 31, 2022. Responses must 
be emailed to [email protected]. Please include ``Request 
for Information: SAMHSA's Role in Climate Change'' in the subject line.
    Responders are free to address any or all the questions listed 
above. Please identify the question or question(s) to which you are 
responding. Responses also may address concerns or issues not 
identified above.
    The submitted information will be reviewed by SAMHSA and HHS staff. 
However, individual comments may not be acknowledged by SAMHSA due to 
the volume of comments received.
    Responses to this RFI are entirely voluntary and may be submitted 
anonymously. Please do not include any personally identifiable 
information or any information that you do not wish to make public. 
Proprietary, classified, confidential, or sensitive information should 
not be included in your response.
    SAMHSA will use the information submitted in response to this RFI 
at its discretion. SAMHSA reserves the right to use any submitted 
information on public websites, in reports, in summaries of the state 
of the science, in any possible resultant solicitation(s), grant(s), 
contract(s) or cooperative agreement(s), or in the development of 
future funding opportunity announcements.
    This RFI is for informational and planning purposes only and is not 
a solicitation for applications or an obligation on the part of the 
Government to provide support for any ideas identified in response to 
it. Please note that the Government will not pay for the preparation of 
any information submitted or for use of that information.

Carlos Graham,
Reports Clearance Officer.
[FR Doc. 2022-18834 Filed 8-30-22; 8:45 am]
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