The nation’s progress toward reforming public mental healthcare systems again has been given a “D” grade by the National Alliance on Mental Illness. NAMI first issued the Grading the States report in 2006 and released the 2009 update today, and it says those states that have worked the hardest to transform their systems could have gains wiped out as state governments face dwindling resources in the economic downturn.

NAMI says Oklahoma improved the most, with its grade rising from a D in 2006 to a B this year, and 13 other states also improved their scores. South Carolina had the greatest decline, falling from a B to a D, and 11 other states also slipped in NAMI’s rankings. Twenty-three had no change from 2006 to 2009. NAMI determines the grades based on 65 criteria. To see how your state scored, click here.

Among some of the findings in the latest report:

• SAMHSA has failed to promote uniform standards for collecting data at the state, county, and local levels;
• states are not focusing on wellness services for people with serious mental illnesses (SMI);
• states lack plans for developing and maintaining their mental healthcare workforces;
• consumers and families do not have adequate input in monitoring mental healthcare systems’ performance; and
• states are not considering the long-term housing needs of people with SMI.

The report also includes many recommendations to improve mental healthcare systems, such as implementing modest tax increases, co-locating primary care physicians and psychiatrists in clinics, and bolstering the mental healthcare workforce.