State Mental Health Budgets, Cut During Recession, Increase After Newtown Tragedy, Report Finds

State mental health budgets were gutted during the recession, according to a report issued by the National Alliance on Mental Health (NAMI), and are only now beginning to return to previous levels in most states, even as mental health needs are becoming better known and growing.

“With reductions totaling $4.35 billion from FY2009 to FY2012, public mental health systems struggled to meet rising demand with diminishing resourcesnami,” the report indicated. Then, the shooting at Sandy Hook Elementary School in Newtown on December 14, 2012 provided “a major impetus for lawmakers to propose legislation which would impact children and adults living with mental illness,” the 63-page report indicated.

Nearly 60 million Americans experience a mental health condition every year, according to the organization. Regardless of race, age, religion or economic status, mental illness impacts the lives of at least one in four adults and one in 10 children across the United States.

NAMI is the nation’s largest grassroots mental health organization.  NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need.

“Realizing the risks of failure to provide adequate public mental health services, governors and legislatures in many states began the process of restoring state mental health budgets,” according to the report, “Trends, Themes & Best Practices in State Mental Health Legislation.”

The report concludes that “Dramatic changes in American healthcare finance and delivery systems combine with an improving economy and a growing array of best practices to provide a window of opportunity in the next few years to transform the mental health system and integrate care across systems.”

In addition, NAMI recommends that “advocates and policy makers should continue the work of building the mental health system of the future, one in which mental illness is identified as it emerges and an array of proven, cost-effective services are available as needed to provide children, youth and adults with the mental health care they need to stabilize, recover and live healthy lives.”

Looking ahead to the 2014 state legislative sessions, NAMI issued a series of recommendations including: mental health budgets

  • Actively engage in outreach and enrollment
  • Increase integrated care
  • Increase the mental health workforce capacity
  • Identify mental illness and intervene early
  • Build the bridge from Medicaid to private health coverage
  • Increase access to supported employment services
  • Increase housing with supportive services
  • Increase justice system diversion strategies
  • Comply with mental health parity
  • Expand Medicaid

Most states either increased or maintained state mental health authority budgets at current levels during 2013 legislative sessions. Of special note, the report indicated, is Texas which allocated a $259 million increase over the previous biennial budget, the largest mental health budget improvement in the state’s history. South Carolina reversed previous cuts to its mental health budget while Illinois restored $32 million that had been cut in 2011 due to an administrative error. In California, an additional $143 million was allocated to create crisis and triage positions throughout the state.

The report stated that “A tipping point on the heels of several recent mass shootings, the Newtown tragedy shaped the debate about the lack of access to mental health services and the barriers that many families and individuals face in light of the nation’s fragmented and grossly inadequate mental health system.”

After the Newtown tragedy NAMI advocated for policies supporting early identification and intervention, training for school personnel, families and the public, mental health services in schools and increased access to care.

The report highlights actions by states in 2013 in areas including mental health system monitoring, early identification and mental health screening, services for transitional youth, school mental health training and services, mental health facilities and suicide prevention.  Also included are elements of state legislation in law enforcement areas such as juvenile justice, incarceration and the courts.  A final section looks at stigma reduction efforts in the states.

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.  Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD) and borderline personality disorder.

Connecticut resident Marilyn Ricci, a past president of NAMI Connecticut, serves on the national NAMI Board of Directors, and is on the board of NAMI Farmington Valley in Connecticut, which she helped found in 2004.  Kevin Sullivan, a former Connecticut Lieutenant Governor currently serving as Commissioner of Revenue Services, is a past Board member of the organization. The state legislative report was issued on October 28, 2013.

CT's Mental Health Services Ranking is Good, But "Citizens Deserve Better"

The National Alliance on Mental Illness (NAMI), in its ranking of states in 2009, placed Connecticut as among the top six states in the nation, along with Maine, Maryland, Massachusetts, New York and Oklahoma.  However, it described Connecticut as “a state of paradoxes” in mental health care and treatment, stressing that “Connecticut’s citizens deserve far better.” The state ranked 31st in the prevalence of mental illness, with 108,730 individuals, according to the organization, which pointed out that even in states with solid grades, “there is no doubt that many of their residents living with serious mental illnesses are not receiving the services and supports they need.”

Connecticut’s overall grade was “B,” according to the report, “Grading the States 2009.”  The Alliance graded states in four categories:  

  • Health Promotion and Measurement,
  • Financing & Core Treatment/Recovery Services,
  • Consumer & Family Empowerment, and
  • Community Integration and Social Inclusion.

Connecticut received a “C” in Community Integration and Social Inclusion, an “A” in Consumer and Family Empowerment – the only state in the nation to receive the top grade – and a “B” in the other two categories.

Three “urgent needs” were noted for Connecticut:  Increase community-based services, housing as an alternative to more restrictive placements, and ending nursing home warehousing.

In the days after the mass killings of 20 first-graders and six adults at the Sandy Hook Elementary School in Newtown, Connecticut, questions have been raised about the role of mental health services as part of a state and national response to the tragedy.

Overall, NAMI gave the United States a grade of “D.”  In the 2009 report, NAMI reviewed progress made since the organization’s previous state-by-state report in 2006, and found state mental health agencies “making valiant efforts to improve systems and promote recovery despite rising demand for services, serious workforce shortages, and inadequate resources.  Many states are adopting better policies and plans, promoting evidence-based practices, and encouraging more peer-run and peer-delivered services.”

However, NAMI reported that “these improvements are neither deep nor widespread enough to improve the national average. The grades for almost half the states (23) remain unchanged since 2006, and 12 states have fallen behind.”

Nearly 60 million Americans experience a mental health condition every year, according to data cited by NAMI, which  is the nation’s largest grassroots mental health organization dedicated to building better lives for Americans affected by mental illness.

The 2009 report concluded that “Without a significant commitment from our nation’s leaders—in Washington, among governors, and in state legislatures—state mental health agencies will continue to struggle to provide even minimally adequate services to people living with serious mental illnesses.”

Specifically, the report noted that as a nation, “We have too few psychiatric beds, treatment services, and community-based supports for those who need them; people with mental illnesses are neglected until they reach the point of crisis, and are then dumped onto other systems. Across the nation, people with mental illnesses are unnecessarily incarcerated, homeless, out of work, and unable to access needed medicines. On top of it all, we have an extremely limited capacity to monitor and measure our own efforts—the very foundation of effective reform.”

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