State mental health agencies (SMHAs) provide direct services to between 15 to 60 percent of people living with serious mental illnesses in their states, according to state-by-state figures reported today by the National Alliance on Mental Illness (NAMI).
State mental health services are being cut dramatically, however, even as need has increased due to the nations economic crisis. Medicaid is the other major funding source of mental health care for people with serious mental illness, but also has been subject to cuts (see table below).
State mental health agencies cannot do it alone, said NAMI Executive Director Michael J. Fitzpatrick. They serve only a fraction of those who need helpand they struggle to do so with shrinking budgets.
Even without budget cuts, low percentages of people with serious mental illness served by SMHAs may point to weakness in the reach of a states overall system of care. Congress has some responsibility to help strengthen state mental health care systems. Federal mental health block grants have been reduced or frozen over the past 10 years. The impact of cuts in Medicaid-funded state programs also has been softened only through use of federal stimulus funds.
The state figures are offered as part of NAMIs fourth alert in an Election 2010 series reminding editors, reporters and others to ask all candidates what they intend to do about the nation's mental health crisis. Protecting and strengthening state mental health care must be part of the Election 2010 dialogue. In editorial board meetings and community forums, please ask candidates what they will do to help, Fitzpatrick said.
Every issue in the election involves mental health carefrom unemployment to troops returning from war. For example, unemployed workers are four times more likely to report symptoms of mental illness and veterans are twice as likely as civilians to die from suicide.
The National Association of State Mental Health Program Directors (NASMHPD) Research Institute reported in Feb. 2010:
Total SMHA budget reductions from FY2009 to FY2011 were about $ 2 billion.
Approximately 90 percent of SMHAs were experiencing budget cuts in FY2010. Almost 75 percent had experienced cuts in FY2009 and the same level proportion expected cuts in FY2011.
Over 50 percent have responded by cutting community mental health services and reducing the number of people served. At the same time, SMHAs experienced increased demand for community services, including crisis services, emergency rooms and hospital acute care.
Weak state mental health care systems end up costing communities morethrough lost jobs and careers, broken families, more homelessness, higher insurance costs, more welfare and much more expensive costs for hospital emergency rooms, nursing homes, schools, police and courts, jails and prisons, Fitzpatrick said.
Below is a list of states that have adults with serious mental illness (SMI), rounded to 1,000, and the percent served by State Mental Health Agency (SMHA).
Source:Grading the States 2009: A Report on America's Health Care System for Adults with Serious Mental Illness
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