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 About the Issue

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Budget Advocacy Overview

Budget cuts today are dismantling state mental health care systems at levels never faced before. In 2010, NAMI's top advocacy priority is to protect and strengthen state and local public mental health services.

Why NAMI Cares

One in four Americans experiences mental illness at some point in his or her life. Hundreds of thousands adults and children depend on public community services and state Medicaid payments for care.

Treatment works-if you can get it. State mental health services represent hope for recovery. Without them, more people will end up hospitalized, on the street, in jail or dead.

About the Issue

Overall, 46 states face revenue shortfalls in 2011. Even under the most optimistic forecasts, the economic forecast is bleak for the next few years as the nation recovers from the worst economic crisis since the 1930s.

Most states have already reduced administrative expenses in mental health agencies, imposed hiring freezes and implemented managed care restrictions. Current budget proposals threaten deeper cuts in services.

State Medicaid programs are especially a source of concern. Thirty-eight states have reduced provider payments. Thirty-three are aggressively imposing pharmacy restrictions. About 15 states have reduced benefits.

These cuts are coming while the need for services is increasing. Unemployment rates remain stubbornly higher than at any time in the last 26 years: approximately 10 percent.

Unemployed workers are four times more likely than those with jobs to report symptoms of severe mental illness. Four times as many report thoughts of harming themselves. The numbers of calls to suicide crisis centers have risen dramatically, even as funds for the centers are cut.

Over 45 million Americans lack health insurance. The new Affordable Care Act prevents plans from denying coverage to children with pre-existing conditions and permits young adults to remain on their parents’ plan up to age 26, but many young people continue to be uninsured even though three-quarters of all lifetime cases of mental illness occur by age 24.

The challenge in this environment is to protect and strengthen existing programs. States need to invest in proven, cost-effective kinds of treatment and supports for recovery. As part of budget debates, governors and legislators need to recognize the high cost of cutting mental health.

What You Can Do

Help NAMI lead. Speak out. Join the national mobilization. This Web site provides information and tools that can be used in months ahead; there will be more to come.

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