WHERE WE STAND
NAMI is the National Alliance on Mental Illness, the nation’s largest grassroots organization dedicated to building better lives for the millions of Americans affected by mental illness.
We work to ensure that children, youth and adults living with mental illness receive the treatment and supports they need to lead full and satisfying lives as valued members of the community. Our action agenda identifies priority policy objectives that support this important goal.
PROTECT MENTAL HEALTH FUNDING
As the single largest payer of mental health services in the country, Medicaid provides critical treatment and supports for many children and adults who live with severe mental illness. Stable and adequate funding for Medicaid is an essential investment that helps individuals with mental illness when they need it most.
Public Mental Health Services
Public mental health programs provide important community-based mental health services, including crisis services, psychiatric hospitalization, intensive services and supports and longer-term care, for children and adults with serious mental health needs. Stable and adequate funding for public mental health programs is vital to make sure that children and adults get the help they need.
EXPAND ACCESS TO MENTAL HEALTH COVERAGE
Medicaid coverage is unavailable in most states to low-income adults who are not receiving federal disability benefits. Increased access to Medicaid will help low-income Americans get the mental health care they need to successfully manage their mental illness and live healthy lives.
Affordable Coverage with Parity
Well over 50 million Americans have no coverage for health and mental health care. Others find that their health plan does not cover mental health care in the same way it covers other medical care. Americans need access to affordable health insurance that includes parity, or fair and equal, coverage for mental health and substance use conditions.
ENSURE THAT EFFECTIVE MENTAL HEALTH SERVICES ARE AVAILABLE
Range of Services
The right treatment at the right time helps children and adults living with mental illness experience success and get on with their lives—and we all benefit. A range of proven mental health services, such as supported housing, crisis services, care coordination and case management, medications, intensive home and community-based services and peer support services, is indispensable to promoting health and recovery.
Many individuals with mental illness remain unnecessarily isolated in state hospitals and other facilities when they could succeed in the community with the right services and supports. Intensive services, such as Assertive Community Treatment, supported housing, crisis services and acute care hospital treatment, are integral to promoting community integration.
For many individuals living with mental illness, medications are an important part of successful treatment. Because individuals have varying symptoms and unique responses to mental health medications, people need more, not fewer, choices.
A significant shortage of mental health professionals keeps individuals and families from getting treatment. Active recruitment and training of health professionals skilled in effective and culturally competent treatment of children and adults with serious mental illness is an urgent need.
Reliable data is crucial for informed decision-making and improving the quality of mental health care. Standardized data collection, including meaningful performance, process and outcome measures, is important to require of health systems that serve children and adults who live with mental illness.
PROMOTE INTEGRATION OF MENTAL HEALTH, ADDICTIONS AND PRIMARY CARE
Integration of care
Individuals with serious mental illness frequently live with other medical and substance use conditions. Effective models of integrated mental health, addictions and primary health care, such as health homes, show promise in both improving health outcomes and in controlling health care costs.
IMPROVE THE MENTAL HEALTH OF CHILDREN, YOUTH AND YOUNG ADULTS
Early Identification and Intervention
Half of all chronic serious mental illness begins by age 14, three-quarters by age 24. Despite effective treatment, most youth go without. Screening, assessment and early intervention of mental health conditions for children and youth should be an integral part of health care delivery systems.
Home and Community-based Services
Without appropriate mental health treatment, many youth struggle with peer and family relationships, drop out of school, become entangled in juvenile justice systems - or most tragically - die by suicide. A comprehensive range of effective services is necessary to provide youth the opportunity to live successfully with mental health conditions.
Juvenile Justice Diversion
Research has found that 70 percent of youth in state and local juvenile justice systems have at least one mental disorder. Routine mental health screenings and opportunities for diversion to effective services and supports could keep our youth from falling into juvenile justice systems that are ill-equipped to serve their needs.
Transition-age mental health services
Too frequently, young adults fall through the gaps between child and adult mental health systems. Care coordination, continuous mental health treatment, peer support services and supports for education, employment and housing, can fill pressing needs and ensure better lives for young adults who live with serious mental illness.
MEET THE MENTAL HEALTH NEEDS OF SERVICE MEMBERS, VETERANS AND THEIR FAMILIES
Mental Health Service Collaboration
One in four of America’s service men and women returning from Iraq and Afghanistan have a mental illness. Collaboration between state-funded public mental health programs and state National Guard and Veterans Affairs entities is imperative to address the needs of those who have served our nation.
PROVIDE HOMES AND JOBS FOR PEOPLE LIVING WITH MENTAL ILLNESS
Permanent Supportive Housing
Lack of safe and affordable housing is one of the most significant barriers to living in the community for people with serious mental illness. Supportive housing models combine housing with support services to provide stability and reduce shelter use, hospitalizations and involvement with criminal justice systems.
Fewer than one in six adults with serious mental illness is employed even though most want to work. The loss of productivity and loss of human potential is costly and unnecessary. Supported employment models show that with effective supports, most adults with serious mental illness can work and achieve independence.
ELIMINATE DISPARITIES IN MENTAL HEALTH CARE
Cultural and Linguistic Competence
Individuals living in racially and ethnically diverse communities are less likely to receive needed mental health care and, when they do receive treatment, more likely to receive poor quality of care. With racial/ethnic minorities projected to be the majority of the population by 2040, cultural and linguistic competence should be an expectation of the mental health care delivery system.
END THE INAPPROPRIATE JAILING OF PEOPLE LIVING WITH MENTAL ILLNESS
Diversion from Incarceration
Disproportionate numbers of people with mental illness are in jails and prisons, often as a result of untreated illness. Jail diversion programs are needed to divert offenders with mental illness from incarceration to more appropriate—and cost-effective—community-based treatment and supervision.
Care in Custody
Jails and prisons frequently fail to provide effective treatment to individuals with serious mental illness. Worse, many individuals are housed in solitary confinement as a result of their symptoms. Improving treatment and reducing the use of solitary confinement for individuals with serious mental illness should be a top priority for criminal justice systems.
Connection to Benefits
Inmates with mental illness are frequently released without access to the mental health treatment and supports they need and end up cycling in and out of jail. Ensuring that people with mental illness are connected to benefits and treatment upon release promotes successful re-entry, safer communities and more efficient use of tax dollars.
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