On December 14, it will be two years since a young man with multiple mental-health diagnoses and no sustained treatment killed 20 children and six adults in Newtown, Conn. According to the National Alliance on Mental Illness (NAMI), the health policy momentum that emerged in the wake of the tragedy has already slowed.
From 2009 to 2012, states had cut mental health budgets by $4.35 billion. However, 36 states and the District of Columbia began to restore funding in 2013 as a result of heightened public awareness of mental health needs.
In this year’s NAMI report, State Mental Health Legislation 2014, the District of Columbia and 29 states increased funding for mental health services. Progress was made, but according to the report, "much of the legislation felt like tinkering at the edges."
For example, Florida appropriated a 4.3 percent increase to community mental health, which restored $15.2 million worth of funding cuts made since 2012. With Florida ranking 49th per capita in mental health spending in 2010, NAMI says lawmakers still have a long way to go. Overall, NAMI says access to services for individuals with mental health needs has been decimated.
Among the positive notes, Minnesota, Virginia and Wisconsin were leaders in enacting measures that might serve as models for other states in workforce shortages, children and youth, school-based mental health, employment and criminal justice.
"What a difference a year makes," said NAMI Executive Director Mary Giliberti, in a press release. "Last year, as the first anniversary of the Newtown tragedy approached, Americans could see progress flowing from both the White House Conference on Mental Health and state legislation. This year, as the second anniversary approaches, progress has slowed and with the exception of a few members, Congress has been missing in action."
NAMI notes that psychiatric boarding continues to be a concern with Virginia being the only standout—clearly because of the efforts of Senator Craigh Deeds, who is a mental health advocate. His son was unable to receive psychiatric treatment and ultimately committed suicide after attacking Deeds at their family home in November 2013.
One of the policy moves the organization recommends is more adoption of telehealth to help reach patients in areas where there are too few providers. While general telehealth legislation is moving forward in many states, only a few have passed legislation harnessing telehealth technology to address the mental health workforce shortage. For example, Wisconsin passed AB 458 that would permit children to receive mental health consultation and treatment in-home via telehealth providers. Ohio passed HB 123 that requires the state Medicaid authority to establish standards to bill Medicaid for telehealth and HB 83, which requires the state board of psychology to adopt rules governing the use of telepsychology for the purpose of protecting people who receive telepsychology services.
The report also lists current state legislation and resources in detail.