CONCORD, N.H. — The New Hampshire state Senate is expected to pass a bill on Thursday to implement an ambitious, 10-year mental-health plan.
Among other things, Senate Bill 292 recommends increasing jobs in the mental-health sector. Lynn Stanley, executive director of the New Hampshire chapter of the National Association of Social Workers, said NASW supports this bill and the plan. She said she appreciates that the plan includes loan assistance for mental-health workers.
"One of the ways to encourage people to enter the field is to look at loan-repayment programs, loan forgiveness, scholarships,” Stanley said, “because students are coming out of graduate programs with a tremendous amount of debt."
The bill, mostly sponsored by Democrats, asks the state to implement the plan within two years of its passing and finalization. If it becomes law, the expected cost will be more than $12 million dollars in 2020.
Another New Hampshire bill aims to ease licensing requirements for mental-health and drug-abuse professionals to encourage more people to enter these fields. Republican state Rep. Jack Flanagan of Hillsborough is the primary sponsor of House Bill 239. Flanagan got the idea for the bill after talking to people who found it hard to complete their supervision hours for licensure.
"They had a master's in social work, they worked in the local school district, and they were complaining how difficult it was to get the hours and a supervisor willing to work hours,” Flanagan said. “The other fact was that we're dealing with this opioid situation in the state of New Hampshire."
The bill recently was amended to not include a significant reduction in supervision hours, as was first proposed. Now, it just makes the location for supervision meetings more convenient.
Stanley said she’s glad the reduction in supervision hours no longer is part of HB 239.
"Licensure for mental-health professionals, including social workers, is to protect clients,” she said. “It's not about what's easier for social workers and other clinicians. It's about protecting clients."
She thinks the licensing requirements are necessary to ensure mental-health and drug-abuse professionals treat their patients responsibly. A vote on HB 239 has not yet been scheduled.
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Nebraska mental health professionals worry the Trump administration's proposed $880 billion in Medicaid funding cuts would threaten progress the state has made in providing help to those who need it.
The reductions could have a dramatic impact on the 345,000 Nebraskans who rely on Medicaid as their only source of health insurance.
Aileen Brady, president and CEO of Omaha-based Community Alliance, said Nebraska has had recent success in getting higher Medicaid reimbursement rates for providers, and has expanded services.
She added that cuts would hurt people who need help the most - those struggling with mental health problems, people with disabilities, and kids.
"Nearly half of Medicaid enrollees in Nebraska are under the age of 20," said Brady, "and I think people need to understand that impact it'll have on our children in Nebraska - and that means our future in Nebraska."
A recent survey by the Centers for Disease Control and Prevention says at least 50% of American adults will need treatment for a mental health issue during their lifetime.
Brady said such steep cuts at the federal level would require dramatic cuts in services to Nebraskans, especially when considering the degree to which the state relies on the federal money.
"Fifty-eight percent of every dollar is a federal dollar, 42% of those dollars are state dollars," said Brady. "If those cuts would come into play, that $880 billion over a period of time, that's going to create a fundamental shift in how services are delivered - the shift of cost to the states - or it's going to result in a significant cut."
The Trump administration is following through on a campaign promise to cut federal spending across the board.
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Diagnoses of mental health conditions in children and teens are on the rise, including in Indiana. But getting kids the help they need can be a challenge.
About one-third of Indiana high school students reported "experiencing poor mental health, most of the time" in a 2023 survey.
But Jeff Reiter - a psychologist with Whole Team, a group that provides technical assistance to primary care clinics - said many parents have trouble accessing both medication and talk therapy for their kids.
He said he thinks what is most needed is more support for primary care providers - which is where mental health problems often are first identified.
"So they're getting those medications from a primary care provider," said Reiter, "a pediatrician, a family medicine, family doctor or something like that. And these are providers who don't have a lot of time in their visits, maybe 15 minutes. They're not specialists - they don't get a ton of training in how to work with psychiatric issues in kids."
Reiter advocated for placing mental health professionals in primary care clinics, to make them more easily accessible to patients and their parents.
He said he also supports what's known as parent management training as a non-medication option for youth with mental health concerns.
Advancements in mental health treatment programs and medications have been helpful. However, these services can be out of reach for a patient with limited or no insurance coverage.
Reiter said he agrees the traditional psychotherapy treatment model can be costly - a factor he said he sees as part of the access problem. But he maintained there's a more relevant issue.
"The point is, there are much more flexible and accessible ways that mental health professionals can practice," said Reiter, "and that's really what we need to be encouraging if we're going to have any chance of reaching more kids."
A study published in 2023 found in Indiana, in one recent year, untreated mental illness was associated with more than $4 billion a year in costs to society.
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The U.S. had more than 500 mass shootings last year, and a new program launched in Denver hopes to prevent targeted violence before it happens.
AllHealth Network is a nonprofit behavioral health center that serves all patients regardless of their ability to pay. Its Chief Clinical Officer Jen Bock said her team can intervene the moment that direct threats of violence, or violent behaviors are witnessed and reported.
"We can step in and work with community providers to identify and decrease that risk," said Bock. "The goal is to get people support, so we can increase overall community safety."
Just 5% of mass shootings are related to severe mental illness, according to researchers at Columbia University.
Other factors play a bigger role, such as a history of financial and legal problems, challenges coping with anger and stress, nihilism, and a desire for notoriety especially among young men.
Those wishing to request a targeted violence prevention training can send an email to tvp@allhealthnetwork.org.
AllHealth's Rebecca Rickard was certified as a targeted violence and prevention co-responder through the Department of Homeland Security's National Threat, Evaluation and Reporting Program Office.
She said people closest to individuals often don't believe they could harm others, and overlook threats. But she said it's important to take signs of potential violence seriously.
"If you see a sudden change in how your child is dressing that might seem really unusual for them, ask them what's going on," said Rickard. "What's fueled the change? And basically just getting as much detail as possible."
Bock said she believes education is key to reducing targeted violence.
She pointed to the success achieved by national and state campaigns that helped raise awareness about the signs and symptoms of potential suicide.
"This training helps with signs and symptoms of possible violence," said Bock, "and so, getting the word out can really help overall for early intervention and increasing community safety."
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