Arlingotn, Va. — According to a report released by the National Alliance on Mental Illness (NAMI), two-thirds of states have cut mental health care in the last three years—even though need has increased because of the nation's economic distress and troops returning home from war.
Seventeen states managed to increase mental health budgets during the same three years. For 10 of them, the increases totaled four percent or less.
"State mental health cuts are a national crisis," said NAMI Executive Director Michael J. Fitzpatrick. "Some states are trying to hold the line or make progress, but most are cutting deep. This stands in contrast to the intense national concern about the mental health care system following the Arizona tragedy two months ago."
In all states, the budget squeeze is getting worse in part because of the expiration of enhanced federal Medicaid support in June 2011. Oregon, for example, which increased mental health by $57.4 million over three years, will lose $156 million because of the expiration.
The report focuses primarily on non-Medicaid mental health services, which are financed with state general funds and provided through state mental health agencies. It is the part of the mental health system that state legislatures have the most control over.
"Cutting mental health means that costs only get shifted to emergency rooms, schools, police, local courts, jails and prisons," Fitzpatrick said. "The taxpayer still pays the bill.
"Mental health cuts mean that clinics, crisis centers and hospitals close. Admissions are frozen. Emergency room visits increase. Where services remain, staff is cut, wait times for appointments are stretched and when people finally are seen, it's for shorter amounts of time.
"Cuts mean people don't get the right help in the right place at the right time. Communities suffer and families break under the strain. Some people end up living on the street or dead."
The report makes five priority recommendations:
- Protect state mental health funding and restore budget cuts, but tie funding to performance.
- Maintain adequate numbers of inpatient beds for psychiatric treatment.
- Invest in research on early detection and intervention in the treatment of serious mental illness in youth and adults.
- Implement mental health screening and assessment programs.
- Support programs designed to educate families, peers and the public about serious mental illness and how to respond to people living with mental illness.
"Decisions need to be made carefully rather than simply cutting for cutting's sake. If done right, the state budget crisis can still be turned into opportunity," said Fitzpatrick.
The report can be downloaded at www.nami.org/budgetcuts. State-by-state tables appear in the appendices. A summary of decreases and increases appears below listing the total change in dollars, percentages and rank.
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