| Children's Mental Health |
| The State Legislative Role in the Regulation and Monitoring of Residential Treatment Facilities (February, 2008) |
This presentation, given at the Florida Mental Health Institute's 21st Annual Research Conference, highlights recent state legislative actions to address the problem of unregulated residential treatment programs for children and adolescents.
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| Screening and Entry Into Mental Health Treatment Balancing Help For the Individual and the Community (July 2007) |
In response to the shooting tragedy at Virginia Tech, this brief addresses the issue of mental health conditions in young adults. The brief highlights federal recommendations to prevent further tragedies, and an overview of screening programs, voluntary and involuntary treatment, state initiatives to improve mental health on campus, and the federal framework within which states must work in crafting legislation for mental health reform. A list of resources is also included for further information on the issue. |
| Unlicensed/Unregulated Residential Treatment Facilities for Minors (April 2006) |
There is a growing number of reports from youth, families and the public media regarding exploitation, poor care and abuse in unregulated, private residential treatment programs. These specialty boarding schools often promote themselves to parents as the only solution for reforming teenagers’ out-of-control behavioral and substance abuse problems, and promise to rein in uncontrollable youth. Several hundred such schools operate in the United States and abroad. Although several of these schools are therapeutic and beneficial to minors who have severe behavioral health problems, many of these institutions are not accountable to any governing body. Some, but not all, states require licensure or approval to operate a mental health facility with or without an educational program. Some states do not regulate private schools. In other states, the schools escape monitoring because they fit into a “grey” area. |
| Child Psychiatrist Shortage Looms (December 2005) |
Almost one in five children in the United States has a diagnosable mental disorder, but only about 20 percent to 25 percent of these children receive treatment. One reason for this treatment gap is a shortage of child and adolescent psychiatrists. |
| First National Survey of School Mental Health Services (November 2005) |
The Substance Abuse and Mental Health Services Administration (SAMHSA) national survey found that one-fifth of students receive some type of school-supported mental health services during the school year. Topics examined include types of mental health problems encountered in school settings; types of mental health services that schools are delivering; numbers and qualifications of school staff providing mental health services; types of arrangements for delivering mental health services in schools; and major sources of funding for school mental health services. |
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State Health Lawmakers' Digest: Teen Suicide Prevention (Fall 2005)
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The State Health Lawmakers' Digest focuses on a different health policy topic each quarter. The Digest provides a brief, focused analysis of the core issue alongside useful, timely summaries of research published by state, national and private sources.
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| Mental Illness Engenders Burden Early in Life: A study of prevalence, severity and level of impairment of specific mental health disorders (June 2005) |
The study describes the prevalence and age of onset of mental disorders; failure to receive and delay in initial treatment contact; severity, comorbidity and burden of mental illness; and use of mental health services. Although the study discovered some promising news—such as a higher proportion of people who reported seeking mental health services than 10 years ago—there were other troubling findings. They found that there is a median 10-year delay across disorders to seek treatment and that an untreated mental disorder can lead to more severe and difficult-to-treat illnesses and to the development of co-occurring mental illnesses.
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Balancing Budgets and Health Services: Children's Mental Health Care in an Era of Budget Cuts (June 2005)
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This paper provides an overview of how state budget cuts affected children’s mental health care, and reviews implications for the current system and potential trade-offs for policymakers to use as they make decisions about services for children.
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| Children’s Mental Health: An Overview and Key Considerations for Key System Stakeholders (May 2005) |
Children’s Mental Health: An Overview and Key Considerations for Key System Stakeholders provides a summary of current issues in children’s mental health policy. The report offers background information about barriers to care, strategies for improving the system, and new research about and emerging solutions to persistent challenges for policymakers, providers, state program administrators and health plans. |
| Children’s Mental Health: New Developments in Policy and Programs (May 2005) |
NIHCM also published proceedings from their Forum on children’s mental health, which was held in Washington, D.C. in May 2004. The Forum, Children’s Mental Health: New Developments in Policy and Programs, featured a thought-provoking agenda about programs and policy in children’s mental health at the federal and state levels. Presentation topics included an overview of the President’s New Freedom Commission on Mental Health, integration and coordination of behavioral and physical health, prevention and intervention for children’s mental health in schools, and programs and strategies for prevention and treatment. |
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Violent Acts of Sadness: The Tragedy of Youth Suicide (May 2002)
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This article appeared in the May 2002 issue of NCSL's magazine, State Legislatures. To order copies or to subscribe, contact the marketing department at (303) 830-2200.
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Nobody's Children: Improving Services and Outcomes for Seriously Troubled Youth (December 2000)
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Summary of Assembly on State Issues (ASI) Children, Families and Health Committee meeting in Washington, D.C.
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| Criminal and Juvenile Justice |
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Health Acts 2000: Summary on Mental Health Courts (February 2001)
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This summary is an information service provided by NCSL's Assembly on Federal Issues' Health Committee, relating to federal issues.
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State Health Lawmakers' Digest: Mental Health and Juvenile Justice (Spring 2004)
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The State Health Lawmakers' Digest focuses on a different health policy topic each quarter. The Digest provides a brief, focused analysis of the core issue alongside useful, timely summaries of research published by state, national and private sources.
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| Mental Health Funding |
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Balancing Budgets and Health Services: Children's Mental Health Care in an Era of Budget Cuts (June 2005)
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This paper provides an overview of how state budget cuts affected children’s mental health care, and reviews implications for the current system and potential trade-offs for policymakers to use as they make decisions about services for children.
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| National Expenditures for Mental Health Services and Substance Abuse Treatment (April 2005) |
The Substance Abuse and Mental Health Services Administration just released updated figures on national expenditures for Mental Health Services and Substance Abuse Treatment from 1991 to 2001. Among several key findings, the report found that costs for the treatment of MHSA disorders were $104 billion in 2001, up from $60 billion in 1991, an average annual growth of 5.6 percent. Mental health spending totaled $85 billion in 2001, which was 6.2 percent of all health care spending. At $18 billion in 2001, substance abuse spending comprised 1.3 percent of all health care spending. Both mental health and substance abuse programs experienced large increases in the amount of public spending from 1991 to 2001—from 57 to 63 percent and 62 to 76 percent, respectively. The role of Medicaid—an already crucial public payer—grew in significance for both systems.
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| Public Costs of Systems of Care for Children and Adolescents (March 2005) |
A new study in Psychiatric Services found that the costs of children’s mental health services may be offset by savings in other agencies. Children and adolescents who receive public mental health services are often involved with other child-serving agencies, such as the child welfare, juvenile justice and special education systems. This study examined whether a systems-of-care community approach for youth, which provided coordinated services from several agencies and community groups, saved money in other sectors.
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| Mental Health Parity and Insurance |
| Evaluation of Mental Health Parity in the Federal Employee Health Benefits (FEHB) Program (July 2005) |
An evaluation of the Federal Employee Health Benefits (FEHB) Program demonstrated that mental health/substance abuse parity—a policy in which mental health substance abuse benefits are equal to benefits for general medical services—could be implemented with some increases in access to services but with little or no increase in total mental health/substance abuse spending.
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Mental Health Benefits in Non-Medicaid SCHIP Plans (April 2001)
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This chart focuses on the State Children's Health Insurance Programs.
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State Laws Mandating or Regulating Mental Health Benefits (February 2009)
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A summary and chart on state mental health parity laws. It also includes information on how these services may be used in response to individuals' mental health needs related to the September 11 terrorist attacks.
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| Suicide Prevention |
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State Health Lawmakers' Digest: Teen Suicide Prevention (Fall 2005)
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The State Health Lawmakers' Digest focuses on a different health policy topic each quarter. The Digest provides a brief, focused analysis of the core issue alongside useful, timely summaries of research published by state, national and private sources.
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| Violent Acts of Sadness: The Tragedy of Youth Suicide (May 2002) |
This article appeared in the May 2002 issue of NCSL's magazine, State Legislatures. To order copies or to subscribe, contact the marketing department at (303) 830-2200.
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| System Change |
| New National Alliance on Mental Illness (NAMI) Report Calls for Substantial Improvement of National Mental Health System (March 2006) |
The National Alliance on Mental Illness (NAMI) released the first state-by-state evaluation of mental health care in 15 years, Grading the States 2006: A Report on America’s Health Care System for Serious Mental Illness. The report card slapped state mental health care systems nationwide with a “D” average. NAMI used 39 different criteria to grade each state’s mental health system, including indicators that assessed the mental health care infrastructure, information accessibility, services and recovery support. Interested individuals can look up state-specific results and system descriptions, compare results between states, and learn about state best practices, innovations and common barriers to system quality improvement. The report also provides a list of standards that states should achieve for a high-quality mental health system and recommendations on how to improve their systems to meet them. Five states received “B” and 17 states “C” grades, while 10 states earned the average “D” grade and eight states failed. |
| Broad Strategy Needed to Improve the Quality of Health Care for Mental Health and Alcohol and Drug Problems (January 2006) |
The Institute of Medicine (IOM) of the National Academies of Sciences published Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. The report urges governments, clinicians, health care organizations, purchasers and other stakeholders to develop a comprehensive approach to improve the quality of mental health and substance abuse care in this country. In a previous landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, IOM presented recommendations for improving health care overall. The authors of the mental health and substance abuse report conclude that the health care quality framework, with some modifications, can be applied to mental health and substance abuse care. |
| Treatment |
| Screening and Entry Into Mental Health Treatment Balancing Help For the Individual and the Community (July 2007) |
In response to the shooting tragedy at Virginia Tech, this brief addresses the issue of mental health conditions in young adults. The brief highlights federal recommendations to prevent further tragedies, and an overview of screening programs, voluntary and involuntary treatment, state initiatives to improve mental health on campus, and the federal framework within which states must work in crafting legislation for mental health reform. A list of resources is also included for further information on the issue. |