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State mental health cuts are even worse than NAMI thinks

March 10, 2011
by Terry L. Stawar, Ed.D.
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On March 9, 2011, the National Alliance on Mental Illness (NAMI) released a report entitled “State Mental Health Cuts: A National Crisis." Nationally state general revenues fund about 40 % of community mental health services, while the federal-state Medicaid program makes up another 46%. The report documents that since 2009, 32 states and the District of Columbia have cut their non-Medicaid mental health funding by over 1.8 billion dollars. Kentucky cut 47.5 % of their budget Alaska 35 %, South Carolina 22.7%, Arizona 22.7, and Wisconsin, 22.4. to round out the top five.

NAMI does its usual terrific job showing how all this will negatively impact individuals and families. It also demonstrated how these cut will decrease the quality of life in our communities, making them less humane and ultimately more dangerous. 

But it’s even worse than NAMI reports. My state is not even shown as a state that received cuts in this report because state mental health funding to most centers has been essentially flat lined for the past decade. All expansion and growth came through the Medicaid Rehabilitation Option (MRO) Program. The state and centers used most of the existing general revenue allocation as match to leverage more MRO funding, without increasing state spending on Medicaid. However in July the state drastically reduced access to Medicaid funds through a state plan amendment that redefined how services were to be delivered. Also in the last year, the state withheld FMAP MRO dollars from the centers that earned them. All together the defacto reduction would be close to 30%, placing my state third or fourth nationally in terms of overall percentage reduction. We all have to equally share the burden of such a terrible economy but with corporate bailouts, tax breaks to the wealthiest among us, and reductions in service to many of our most vulnerable citizens, it's like George Orwell said, some of us are more equal than others.


It may no longer be sufficient to just write one's congress person or express our opinions online. It may be time to unite across discipline, across economic strata to say enough is enough.

4.3M Texans have a diagnosable MH disorder, (1.2M children). Texas ranks 49th in per capita MH funding at $34.57, well below the NA of $103.53. Studies show that nearly 8 times more Texans w/SMI are in jails and prisons than in hospitals. Proposed budgets call for significant cuts to the Texas Dept. of State Health Services - reducing Children's MH services by 20% and the adult MH services by 20%. In other words, we (Texas) is the cheapest lemonade stand on the block and you intend on reducing/squeezing more out of the lemon.

Other draconian cuts such as the crisis services ($8.9 Million, 5%), State hospitals ($32.1M, 4%, and CMH hospitals ($1.8M, 3%) will not lead to cost savings. These patients will end up in the "revolving doors" of crisis (ER's and Jails).

Please help Texas re-consider their plan....please help put this vulnerable population first. Perhaps we can look at other ways to cuts (unrelated to Mental Health Services/Healthcare) to balance out the Texas Budget deficits.

Many thanks for your time.

Phil Hickmon

Terry Stawar

President/CEO (LifeSpring, Inc.)

Terry Stawar


Terry L. Stawar, EdD, is President and CEO of LifeSpring Health Systems, a community behavioral...

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