Cuts in Mental-Health Funding Pose Risks for States

by Joye Barksdale  |  February 08, 2013

The recent spotlight on the intersection between mental-health disease and gun violence makes the case that we should put more support – not less – into mental-health care, Alyx Beckwith, a licensed outpatient therapist, wrote in The Washington Post. Yet Medicaid reimbursement rates have actually declined steadily since 2008, and 2013 will see another round of cuts.

Beckwith, based in Raleigh, N.C., works mostly with disadvantaged children and teenagers. One of his patients, a 14-year-old boy he calls “Trevor,” threatened to “light his house on fire and stab everyone in the family” the day before the Sandy Hook school shooting.

Trevor is a schizophrenic whose medical coverage provides for mental health care. But because most psychiatrists in Trevor’s area don’t accept Medicaid due to low reimbursement rates, there is a two- to three-month wait until he can get the help he needs.

North Carolina is not unique. Throughout the nation, states have cut more than $4 billion in funding for mental health from 2009 through 2012, according to the National Association of State Mental Health Program Directors. The trend is expected to continue for several years. Yet, the number of people who received services from state mental health community-based systems increased by 10 percent from 2007 to 2010.

“States are responsible for a larger portion of mental health services than they are for physical services, which means mental health is hit hard by state budget negotiations,” Beckwith wrote. “In my professional opinion, Trevor needs to be admitted to an inpatient facility for evaluation and monitoring. That’s not an option for the poor in our fractured system.

“Gallup polling last month found that more than 80 percent of Americans support increased spending for youth mental health programs,” Beckwith concluded. “In practice, our states are moving in the opposite direction. That cannot continue.”

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