By Robert Bartolotta, Ph.D.
The President of the United States proclaimed May 2016 “National Mental Health Awareness Month.” This proclamation recognizes the prevalence of mental health needs within our society, the need to reduce the stigma of having a mental illness (particularly among those pursuing treatment and support), and the expanding opportunities for treatment gained through the Affordable Care Act, as well as other Federal health initiatives. These opportunities have provided expansions in community health services, parity of service requirements for health insurance providers and clauses limiting discrimination against insurance seekers with pre-existing conditions, including mental illness.
According to the National Alliance on Mental Illness (NAMI), citing findings from the National Institutes of Health, National Institute of Mental Health, 25 percent of American adults, 20 percent of youth ages 13 to 18, and 13 percent of youth ages 8 to 13 experience mental illness each year. To provide context around these percentages, the Centers for Disease Control and Prevention (CDC) report 9 percent of the population have diabetes and 8 percent have asthma. Possessing a chronic mental illness, such as major depression, bipolar disorder, or schizophrenia, is less common with one-in-17, or nearly six percent of American adults living with a condition. This statistic is nearly identical to the percentage of the population who have ever been told they have an ulcer.
Though incredibly common, mental illness, particularly when untreated, has a significant impact on families, communities, and American society at large.
- Adults with significant mental illnesses have shorter life expectancies, living 25 fewer years, on average, than the general population. This discrepancy is largely attributable to treatable medical conditions.[i]
- In 2005, the Bureau of Justice Statistics reported that 56% of state prisoner, 45% of Federal prisoners, and 64% of jail inmates possessed a mental illness. [ii]
- The National Coalition for the Homeless, citing findings from the National Institute of Mental Health, reports that 20-25% of the homeless possess significant mental illnesses.[iii]
- In 2008, researchers funded by the National Institutes of Health, National Institute of Mental Health estimated $193 billion in lost earnings attributable to significant mental illnesses annually.[iv]
- According to the Social Security Administration, approximately a third of Social Security Disability Insurance (SSDI) payments are provided to recipients diagnosed with a mental disorder.[v]
- The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that Medicaid payments for mental health services more than tripled from 1990 to 2009, reaching an estimated expenditure of $41,158,000.[vi]
The Money Follows the Person (MFP) demonstration project is designed to reduce Medicaid expenditures on services for people with chronic conditions and disabilities through a shift from institution-based care to home and community-based services. As of December 2014, over 51,000 individuals have transitioned from institutional care back into the community through MFP programs in forty-three states and the District of Columbia.[vii] According to the Kessler Family Foundation, the percentage of MFP participants with mental illness is steadily increasing. In 2010, only 1.4 percent of the MFP participants transitioning into the community possessed a mental illness. This percentage grew to 6 percent in 2015, with several states, including Ohio, Illinois, and Washington, interested in growing it further.[viii]
Research conducted in the 1990s has shown that community and home based mental health services can be as effective, on average, as systems who use more hospitalizations, but at lower cost.[ix] Additional research has shown that mental health follow-up care post incarceration for inmates with bipolar disorder or schizophrenia has contributed to lower recidivism rates and lower costs. Those who received treatment during the study period cost the government approximately $68,000, while those who did not receive treatment and were rearrested cost $95,000.[x]
New Editions aids state and federal efforts to provide support to people with disabilities, including those with mental illness, through its contracts with the U.S. Department of Health and Human Services; in particular, through its Technical Assistance for Money Follows the Person (MFP) Demonstration) and Technical Assistance for Self-Directed and Home and Community Based Services (HCBS) projects. In each of these projects, New Editions provides technical assistance assisting state agencies in providing services within their communities that address local needs and strengthen the capacity of communities to better service individuals with disabilities, including those with mental illness, within them.
Robert Bartolotta, Ph.D. is a Project Manager at New Editions. He has worked in the disability community for more than 15 years as a teacher, researcher, and manager of programs focusing on transition, and the postsecondary education and employment of people with disabilities.