As America waits for the U.S. Supreme Court to hear oral arguments in, and decide on, the constitutionality of the Patient Protection and Affordable Care Act of 2010 (PPACA) in March, state cuts in mental health funding continue unabated in many states throughout the country. As previously mentioned here, the PPACA review undertaken by the Court will not only focus on the constitutionality of the individual mandate but will also examine PPACA’s Medicaid expansion. By expanding Medicaid, PPACA will provide coverage to millions of those living with serious mental illness. PPACA also provides for increased community-based outreach, from changing the waiver laws to awarding grants for new programs, in order to further improve essential services for those living with mental illness.
While many fixate on late March, local governments continue a practice that started a few years ago: slashing funding for mental health services. Just last week, Chicago’s Department of Public Health announced they were closing half of their mental health clinics — disproportionately affecting the city’s African-American and Hispanic populations, according to advocates. Over the last fiscal year, New York has cut its mental health budget by $95 million, and California has by $177 million. According to a new NAMI study released late last year, from 2009 to 2012, four states have slashed their mental health expenditures by more than 30 percent; South Carolina, at the top of the list, has cut funding by nearly 40 percent. Alaska and Nevada — the two states with the highest suicide rates in the country — are both in the top five. In total, “general funds for mental health” are down $1.6 billion overall between 2009 and 2012.
Besides painful, the cuts are likely to be counterproductive: advocates argue that they will actually cost states more in the long run. Ronald Hornberg, director of legal and policy affairs at NAMI recently told ABC news that the cuts are resulting in those in need of services showing up in emergency rooms or prisons, where they are expensively boarded because there is nowhere else for them to go. Eric Lindquist, a clinical therapist at the Chicago Department of Public Health, called the mental health clinics that Chicago has decided to cut, when compared to hospitalizations or incarcerations, “one of the taxpayer’s best bargains.”
At the same time, headlines late last week brought news that 20 percent of Americans were diagnosed with mental illness in 2010 — nearly one in four women and about one in six men. Among other findings, nearly nine million Americans “thought seriously” about suicide in 2010, with over one million attempting to kill themselves. Almost two million teenagers “experienced a major depressive episode.” Those aged 18 to 25 had the highest incidence of illness: nearly 30 percent.
Obviously, the incidence of illness and prevalence of spending cuts nationwide does not bode well for the future of mental health care in this country. Those that depended on the services being cut are left to try and make it on their own, and those who worked for gutted agencies are looking for jobs. And this is why advocates look toward March. The Court’s decision later this year will shape the future of mental health services in this country for years to come — services that, right now, are increasingly endangered nationwide.