NAMI report tracks investment in mental health
The tragic Newtown, Conn. shootings in 2013 turned the spotlight on mental health issues and prompted attempts to rebuild the system with additional funding and initiatives. But that upsurge did not continue in 2014, according to a report by the National Alliance on Mental Illness (NAMI).
The report, entitled, “State Mental Health Legislation 2014,” showed that 29 states and the District of Columbia increased funding for services last year but all states are still struggling to recover from budget cuts from 2009-2012.
Lead author Sita Diehl, MSSW, NAMI’s state policy and advocacy director, said that the gains made surrounding certain policy issues appeared to be “small and tinker around the edges,” while the system remains “under resourced and fragmented.”
“People trying to get the services they need face an uphill climb,” Diehl said. While she cited Wisconsin and Minnesota as states that “continue to be innovative and move forward,” she is still dismayed, although not surprised, that increased investment in mental health is not happening.
“We’re used to being forsaken,” Diehl said.
The report indicates that the northeast part of the country provided better funding and gave more attention to health and human service issues.
“Northeast states stand out as better than most but I can’t say it is good,” she added.
Vermont, New Hampshire, Connecticut and Maine demonstrated increases in investment while Massachusetts stayed the same and Rhode Island showed a decrease.
Dania Douglas, J.D., NAMI’s state advocacy manager, noted that with the passage of the consent decree, New Hampshire’s Department of Justice will provide funding for community services and take steps such as developing a crisis system operating 24/7, making mobile crisis teams available and adopting assertive community treatments designed to address housing, transitional planning and other issues for people with mental illnesses.
New Hampshire’s Medicaid program effectively uses a work incentive program as well, Diehl said.
Diehl said that although Rhode Island has expanded its Medicaid services, it’s relying on that program to cover mental health services for the uninsured. The transfer of funding from mental health authorities to Medicaid leaves some services uncovered and some people going without.
Although its investment is level, Diehl feels Massachusetts does a good job as a result of being an early adopter of the system. In addition, the Rosie D. lawsuit ruling resulted in the requirement for early screening in children.
In the wake of the report, NAMI issued a series of recommendations including expanding Medicaid while ensuring that alternative plans mirror coverage in terms of better rates and the like; holding insurers and providers accountable for high quality services with measurement of outcomes; implementing effective practices such as First Episode Psychosis, Assertive Community Training and Crisis Intervention Team Program; and strengthening public health funding.
Diehl wants to see more support of an array of community services to alleviate problems including the overuse of emergency rooms and jails to board people with mental illnesses.