Mental health conditions do not resolve on their own and many people face barriers to accessing care.
Recent legislation expanding funding through Medicaid has increased mental health coverage.
States have utilized these and other funds for integrated community mental health services.
Severe mental health conditions are often chronic, requiring long-term care access and management (Park, 2008). Treatment time can vary by illness — some disorders like depression can improve after 3-4 months of therapy, while post-traumatic stress disorder treatment can last over 18 months (Boerema, 2016; APA, 2017).
Since 2010, the Affordable Care Act allowed states to expand the eligibilities for Medicaid and various services (MO DSS, 2022). Missouri expanded Medicaid through MO HealthNet in 2020, requiring a percentage of state funding for a larger share of federal funds; in 2023, Medicaid will match spending in MO at a rate of 2.5x, or 72% of all costs. (KFF 2023; 2021)
State mental health services can be funded by a combination of expanded Medicaid support, fee-for-service models, federal and state grants, case rates, contracts with discounted providers, or private insurance reimbursement (HHS, 2019).
Mobile Crisis Units (MCUs) provide ‘first-response' services to individuals experiencing a mental health crisis, and can be dispatched alongside or independent of law enforcement.
Crisis Hotlines: The federal National Suicide Designation Act established 988, the National Suicide Prevention Lifeline, expanding the number of trained counselors in each state.
Certified Community-Behavioral Health Clinics (CCBHCs) and/or Healthcare Homes integrate physical and behavioral care on-site, with state or federal funding from Medicaid or the Substance Abuse & Mental Health Services Administration (SAMHSA) (NCSL, 2022).
Community Health Workers and Peer Specialists (PSs) are trained frontline public health workers at health facilities, agencies, and non-profits that have been shown to aid patients to access health services, increase knowledge of health maintenance, aid in behavioral changes, and address the social determinants of a patient’s illness (Weaver, 2018; Swider, 2002). PSs themselves have recovered from mental illness and navigated healthcare (NASHP, 2021).
Comprehensive School Mental Health Systems (CSMHS) are collaborations between schools and community mental health providers, giving specialized care (screening, referrals, long-term care and monitoring) with support from local, state, and federal funding (Hoover, 2021).