June 1, 2017

Florida Must Increase Its Support for Mental Health Services

Sound mental health is fundamental to quality of life, and there is a strong correlation between mental health, productivity and healthy maturation. Florida, ranking 50th in the nation for per capita mental health funding, has an uncommon opportunity to address the mental health needs of the state.

Why is Mental Health So Important?

Good mental health is vital for the well-being of children and families. It is as fundamental as physical health in helping individuals reach their full potential and become contributing and productive members of their community. Unmet mental health needs hamper the success of children and families, affecting their long-term economic mobility and quality of life. It also affects parents’ productivity at work and their ability to care for their children.

Additionally, untreated mental illness has significant fiscal consequences for state and local governments and exacts a high toll on the nation’s economy.[1]  Serious mental illness can trap individuals in a lifetime of poverty, dependency and homelessness.[2] It can also lead to costly and frequent hospitalization, institutionalization and recurrent involvement in the criminal justice system.[3]

What is at Stake in Florida?

The latest report from Mental Health America reveals that Florida has an estimated 594,000 uninsured individuals with mental health issues.[4]

Florida ranked a disappointing 50th in the nation in its per capita mental health support for Fiscal Year 2014 (the most recent year for which data is available). Florida invested $36.05 per capita, versus the U.S. average of $125.90.

The state should increase investment in mental health and substance abuse services to address growing needs at prison facilities and universities/colleges and tackle the growing opioid crisis, which has been declared a public health emergency.  Opioids alone were responsible for the death of nearly 3,900 Floridians in 2015.[5] The number of inmates with mental illness or substance use disorder increased from 8,000 in 2000 to 17,000 in 2010, and is projected to reach 35,000 by 2020.[6]

What Steps Must be Taken to Address This Issue?

First, state lawmakers can take a common-sense approach to tackling the state’s pervasive mental health and substance abuse problems by expanding Medicaid. Using expanded Medicaid funding, the state could increase mental health services without significantly increasing state expenditure.  Expanding Medicaid would provide the state with additional resources to cover behavioral services for adults who were previously excluded from the program.[7] Ten Medicaid expansion states reduced uninsured mental hospital stays by an average of 44 percent in 2014, a decline that has not been replicated in non-expansion states such as Florida.[8]  Medicaid can play a pivotal role in underwriting vital services and supports for low-income individuals with serious mental illnesses.[9]

Medicaid is the single largest source of funding for public mental health services in the country and underwrites the costs of health care, primarily for low-income persons and individuals with disabilities, including adults with severe mental illnesses in community treatment programs.[10] Further, Medicaid has offered a broader array of mental health services than those available through other kinds of coverage, including crisis response, prescription medication, psychosocial rehabilitation and a range of recovery support.[11]

Although Florida currently provides mental health services to its low-income families under Medicaid, expanding the program would increase access to care and help meet the chronic mental health needs of poor and low-income families who do not qualify under current eligibility requirements.[12] The federal government covers at least 90 percent of Medicaid expansion costs, which would allow the state to ensure access to quality and affordable mental health services for its residents.

Additionally, on the federal level, the U.S. Senate must reject the American Health Care Act (AHCA) as a replacement for the current Affordable Care Act. The AHCA would cut Medicaid funding by $839 billion over the next decade and fundamentally alter its financing structure. This reduction would limit the state’s ability to care for people with behavioral health conditions.[13]

It’s imperative that state lawmakers and Florida’s congressional delegation address the mental health needs of residents.


[1] Smith, Gary and et al. 2005. Using Medicaid to Support Working Age Adults with Serious Mental Illnesses in the Community: A handbook. p. 1. Retrieved from: https://aspe.hhs.gov/legacy-page/using-medicaid-support-working-age-adults-serious-mental-illnesses-community-handbook-142751#intro

[2] Ibid

[3] Ibid

[4] Mental Health America. 2017. The State of Mental Health in America, 2017. p. 27. Retrieved from: http://www.mentalhealthamerica.net/sites/default/files/2017 MH in America Full.pdf

[5] State of Florida. 2017. Office of the Governor, Executive Order Number 17-146 (Opioid Epidemic).: Retrieved from: http://www.flgov.com/wp-content/uploads/2017/05/17146.pdf

[6] Florida House of Representatives.2017. HB 1051 Forensic Hospital Diversion Pilot Program. p. 2  Retrieved from: https://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=h1051f.HHS.DOCX&DocumentType=Analysis&BillNumber=1051&Session=2017

[7] Kaiser Family Foundation. 2017.  Medicaid’s Role in Behavioral Health. Retrieved from: http://files.kff.org/attachment/Infographic-Medicaids-Role-in-Behavioral-Health

[8] Ibid

[9] Supra note at 1

[10] Ibid

[11] Ibid

[12] National Alliance on Mental Illness. 2011. State Mental Health Cuts: The Continuing Crisis. A Report by the National Alliance on Mental Illness. Retrieved from: http://www.nami.org/getattachment/About-NAMI/Publications/Reports/StateMentalHealthCuts2.pdf

[13] Supra note at 7

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