Mental Health
Coordinated State Leadership for Better Mental Health
Funded by The John D. and Catherine T. MacArthur Foundation
Think that mental health care can be handled simply by your state’s mental health agency or by your Legislature’s health committee? Maybe, maybe not.
Adults and children with mental health needs rarely contact their state’s mental health department for initial help. Instead, they are more likely to first come into contact with state services when they become involved with child welfare, criminal justice or educational agencies. But those departments are often unable to provide adequate mental health care, or to coordinate with those who can.
Consider these statistics: the Bureau of Justice Statistics reports that 56 percent of state prisoners, 45 percent of federal prisoners and 64 percent of local jail inmates have a mental illness. Of those with mental illness, only 1 in 3 state prisoners, 1 in 4 federal prisoners and 1 in 6 local jail inmates received mental health treatment while incarcerated.
Meanwhile, the Child Welfare League of America says that more than 80 percent of the 588,000 children in the foster care system have mental health issues, compared with about 10 percent of all U.S. children. The U.S. Department of Health and Human Services reports that 75 to 80 percent of all children requiring mental health services do not receive them.
Compounding that problem, state agencies rarely coordinate the programs used by people with mental health needs. As a result, these individuals may not be linked to the multiple services that they need.
Through a grant from The John D. and Catherine T. MacArthur Foundation, NCSL’s Forum for State Health Policy Leadership has launched a new initiative designed to improve collaboration between legislative committees and executive branch agencies in the mental health care arena. The new Coordinated State Leadership for Better Mental Health project will publish articles, hold seminars, provide technical assistance and carry out a range of other activities to help legislators find workable, innovative and efficient strategies to meet mental health needs across the spectrum of service settings.
Legislators are likely to find opportunities for leadership in a wide variety of jurisdictions—including child welfare, substance abuse, criminal justice, juvenile justice, education, Medicaid, aging, housing, veterans’ affairs, employment, disaster relief and budgets.
For more information or to receive regular notices about the Coordinated State Leadership for Better Mental Health project, please contact Robin Richardson in NCSL’s Washington, D.C. office at 202.624.3583 or robin.richardson@ncsl.org.
Mental health disorders affect a wide array of other issues, including those listed below.
Child Welfare
Up to 90 percent of children in the foster care system have some type of mental health disorder, but between 75 and 80 percent of those children do not receive treatment. In addition, the vast majority of parents of children in the child welfare system have a mental health and/or substance use disorder. If child welfare systems have the resources and training to help both children and adults with mental illness, and the ability to link foster care children to treatment after those children “age out” of the system, the foster care system will produce healthier, more socially integrated children, parents and families.
Chronic Illness
Chronic physical diseases—such as diabetes, hypertension and hepatitis C—are much more prevalent in people with mental illness than they are in people without mental illness. But mental health problems often go undetected in people with chronic illness. If doctors screen patients for mental health conditions during routine exams, people with co-occurring mental and chronic physical illnesses will be more likely to receive the treatment they need, greatly improving their prognosis.
Criminal Justice
Police officers often arrest people with mental illness who are exhibiting erratic behaviors because they want to protect the public and a local psychiatric crisis bed is not available. If more communities establish outreach services and crisis beds, then fewer jails and prisons will bear the burden of housing people with mental illness. Additionally, if jails and prisons are better equipped to treat those with mental illness, they could reduce recidivism. Ex-offenders could receive discharge planning and be connected to appropriate community treatment.
Education
After the home, children typically spend most of their time at school. But teachers and students may not be aware of the symptoms and signs of mental health disorders. Such disorders can damage self-esteem and lead to poor academic performance, compromised relationships, bullying, school violence or suicide. If school employees and students are educated about mental health issues, they can help at-risk students get the help they need, enabling them to succeed in school and transition into being productive adults.
Substance Abuse
Approximately 50 percent of people with a serious mental illness have a co-occurring substance use disorder. On average, mental illness precedes a substance use disorder by six years. If people with mental illness are diagnosed and treated shortly after their symptoms present, they are much less likely to begin self-medicating with alcohol and illicit drugs. Integrated substance abuse and mental health treatment is much more effective than treating the two disorders separately; this dual approach to treatment can greatly increase the chances of recovery while reducing long-term costs.
|