Mental Health Reforms Have Slowed Since the Newtown Tragedy

Posted on December 9, 2014

ARLINGTON, Va., Dec. 9, 2014 -- Momentum for reform of the nation's mental health care system slowed in 2014 as a result of failure by Congress to enact comprehensive mental health care legislation and a decrease in the number of states strengthening investment in mental health services, according to a report released today by the National Alliance on Mental Illness (NAMI).

The report,  State Mental Health Legislation 2014 stands in contrast to one issued in 2013 which described a dramatic response by many states following the tragedy at Sandy Hook  Elementary School in Newtown, Conn. on Dec. 14, 2012.

From 2009 to 2012, states cut mental health budgets by $4.35 billion. Thirty-six states and the District of Columbia began to restore funding in 2013 in the wake of heightened public awareness of mental health needs.

This year only 29 states and the District of Columbia increased funding for mental health services. Progress was made in some states, but according to the report, "much of the legislation felt like tinkering at the edges."

Minnesota, Virginia and Wisconsin were leaders in enacting measures that might serve as models for other states in such areas as 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. "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."

"Public awareness of mental health concerns has not diminished. In 2014, the tragic death of Robin Williams was another dramatic reminder that no one is immune."

"Unfortunately, people sometimes forget that tragedies are happening every day. They include people living with mental illness who end up in emergency rooms, people who end up in jail or homeless on the street. They include deaths by suicide. They include young people whose symptoms too often aren't recognized early enough to avoid the worst outcomes."

Overall, the mental health care system still needs to recover lost ground from the state budget cuts of 2009-2012.  But reinvestment is unsteady.

Although 22 states and the District of Columbia increased mental health spending in 2013 and 2014 (See Appendix 1), six states cut it in both those years:

• Arkansas
• Alaska
• Louisiana
• Nebraska
• North Carolina
• Wyoming

Four states increased mental health spending in 2013, but then cut it in 2014:

• Hawaii
• Kentucky
• Michigan
• Rhode Island

Five states increased mental health spending in 2013, but stayed level in 2014:

• Illinois
• Massachusetts
• Mississippi
• Oregon
• Tennessee

Five states kept mental health spending level in 2013 and managed to increase it in 2014. Indiana stayed level in both years:

• Alabama
• Florida
• New Mexico
• New York
• West Virginia

Four state legislatures did not convene in 2014:

• Montana
• Nevada
• North Dakota
• Texas

NAMI's State Legislative Report surveyed mental health related laws enacted by states around the country, noting those that might serve as models elsewhere. Areas surveyed include:

• Health reform and Medicaid expansion
• Health insurance transparency and parity
• Crisis and inpatient care
• Prescription medications
• Mental health care delivery strategies
• Housing and employment
• Children, youth and young adults
• Mental health care standards
• Criminal justice
• NAMI's policy recommendations for states in 2015 fall within four basic areas:
• Strengthen public mental health funding
• Hold public and private insurers and providers accountable for appropriate, high-quality services with measurement of outcomes
• Expand Medicaid with adequate coverage for mental health
• Implement effective practices such as first episode psychosis (FEP), assertive community treatment (ACT) and crisis intervention team (CIT) programs

About NAMI

NAMI is the nation's largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.

Twitter.com/namicommunicate 
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www.nami.org/legreport2014