Can't Make the Grade: NMHA State Mental Health Assessment Project

In its October 2002 interim report to President George W.Bush, the President’s New Freedom Commission on Mental Health reported that the “public mental health system is in shambles.” Only one--third of adults in the United States,and even fewer children, receive the mental health treatment they need.1 Even states that appear to spend more than most on mental health still invest far less in communities than is needed.

As states confront the worst budget shortfalls since World War II, investment in mental health services is in great jeopardy. States have begun to do what should be unthinkable —cut services for people with mental health treatment needs. In 2002,nearly two-thirds of states cut funding for mental health services. And 2003 is proving even more challenging as state after state has moved to cut funding for mental health services, reduce Medicaid eligibility levels and restrict access to medications.

States must recognize that they will pay for the costs of mental illnesses, one way or another. They can choose either to invest in effective,community-based services or to pay a greater price through increased emergency room visits, homelessness and an overburdened criminal justice system.

The National Mental Health Association (NMHA) originally embarked on the State Mental Health Assessment Project to evaluate and grade the level of state policymakers ’ overall investment in mental health services. But in the course of conducting our research,we found we had to revise our goal. No state can earn passing marks for its mental health system,because all have failed to invest adequately in mental health services. And few states even track how mental health is funded across state agencies. In view of these facts,instead of grading the mental health system as a whole, NMHA has evaluated states based on the priority they have given to mental health in three policy areas. Because,when it comes to investing in mental health, states just can’t make the grade.

This project was made possible by the generous funding of the W. K. Kellogg Foundation in collaboration with the Community Voices: Healthcare for the Underserved initiative (www.communityvoices.org).

1.U.S.Department of Health and Human Services.Mental Health: A Report of the Surgeon General. (Rockville,MD:U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration,Center for Mental Health Services, National Institutes for Health,National Institute of Mental Health,1999).

National Mental Health Association
2000 N. Beauregard Street, 6th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA
TTY Line 800/433-5959