Nelba Chavez  MSW '71  SAMHSA Administrator     Almost 30 years of advocacy for the mentally ill and addicted have taught Nelba Chavez, MSW '71, the importance of ensuring that those who are affected the most by government policies have a voice in their creation.  Yet the ongoing devolution of government services from the federal to the state and local level has added a troubling new twist to that task.  "We tell the people, you need to be sitting at the table where those policy decisions are made, but many of us, even the large service providers that I come into contact with, don't know where the table is," said Chavez, administrator of the federal Substance Abuse and Mental Health Services Administration (SAMHSA).  Created in 1992 as a public health agency on the same level as the Food and Drug Administration or the National Institutes of Health, SAMSHA and its $2.3 billion budget are dedicated to improving the availability and quality of services to all Americans struggling with mental illness or addiction.  That formidable task -- one of every four Americans will need mental health or substance abuse services during their lifetime -- is made even more difficult by ignorance and stigmas, Chavez said.  "We deal with the kinds of things people don't want to hear about," she said. "But these problems are very real, and in my view we cannot claim to have any kind of public health system in this country unless we look at mental health as a cornerstone of that system and are cognizant of the addictions that exist and of their impact on all other health care problems."  Born and raised in the Tucson barrio, Chavez majored in sociology and psychology as an undergraduate and went to work as a juvenile probation officer in her hometown. She quickly realized that she needed more education to really make a difference.  "I think the MSW is one of the most useful degrees, because it gives you the knowledge you need to be able to practice in a community, an institution, or one-on-one. Not many degrees prepare you for those kinds of opportunities," she said.  Armed with her master's and a doctorate from the University of Denver, she spent 17 years at La Frontera Center in Tucson, where as executive director she transformed the storefront clinic into a comprehensive community-based mental health center hailed as a national model.  It is that long experience in the Tucson community, as well as a stint as director of juvenile probation services for the city and county of San Francisco that informs her work at SAMHSA.  Convinced of the vital importance of early intervention, Chavez and SAMSHA have launched a unique public/private collaboration with the Seattle-based Casey Family Program. The new Starting Early Starting Smart program has funded pilot programs around the country that seek to address the needs of young children, from birth to age seven, who are at risk for developing substance abuse or mental-health related problems.  When I was in San Francisco, what I saw over and over was that we were recycling generations," Chavez said. "This new program is an effort to break that cycle."

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