It's been about a year since the official end of the COVID public health emergency - which has led to a significant drop in Medicaid enrollments and a rise in uninsured individuals in Colorado.
This poses challenges for community mental health centers, like the Jefferson Center for Mental Health, where the rate of Medicaid enrollee decline has surpassed earlier predictions. It has remained below pre-pandemic levels since January.
Dr. Kiara Kuenzler, president and CEO of the Jefferson Center for Mental Health, said it's now facing a daunting $6 million shortfall.
"The people that we're serving are just in extreme stress, struggling to deal with regaining health-care benefits. That impacts not only their access to behavioral health care, but all of their health-care needs," she said.
The nonprofit KFF recognizes the need for behavioral health at an all-time high in its 2023 Colorado fact sheet - identifying more people than ever reporting mental health and substance use challenges.
Kara Johnson-Hufford, Colorado Behavioral Health Care Council CEO, emphasized the urgent need for support for these clinics. She noted a projected shortfall of $24 million to $29 million for these centers overall could mean a risk of reduced services, longer wait times and compromised care.
She added many individuals who have lost Medicaid coverage and now have private insurance are also seeking treatment less frequently - or discontinuing it altogether - due to co-pays and deductibles.
"More people than ever are now going without insurance. No longer qualifying for Medicaid, but cannot afford private insurance - or they may be giving up on Medicaid altogether because of the emotional toll of the enrollment process just being too great," she continued.
Johnson-Hufford predicted if reimbursement mechanisms don't keep pace with the need, programs will close. Despite efforts to address the issue, such as helplines and complaint processes, she said the gap in funding remains a critical concern.
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Tennessee advocates are gathering at the state Capitol Wednesday to urge lawmakers to prioritize mental health funding and policies to strengthen families, communities and youth.
According to state records, 937,000 adults in the state have a mental health condition.
Katrina Gay, executive director of the National Alliance on Mental Illness-Tennessee, said her grassroots group is backing Gov. Bill Lee's budget with more investments in mental health and advocating for PTSD treatment for first responders. She explained the legislation they are opposing.
"We're also going to advocate to make sure that only qualified medical professionals have prescribing privileges for people with mental health conditions," Gay explained. "There's a bill in the House and Senate that would grant medication prescriptive authority to psychologists, and we are strongly opposed to that."
Gay added over the years, they have pushed for key legislation, starting with Tennessee's first mental health parity bill in the late '90s, and continue advocating for funding for services and support of the 988 Suicide and Crisis Lifeline and more.
One in six Tennesseans aged 6 through 17 experiences a mental health disorder each year. Gay noted they advocate year-round with community engagement, which includes the Young Adult Advisory Group and NAMI on Campus clubs, webinars for college students who are emerging advocates. She added an in-person training session for advocates is Wednesday at 9 a.m. at the Cordell Hull Building.
"We have more than 50 leaders coming from across the state in person to meet with members of the General Assembly that are in the districts in which they live," Gay pointed out. "They can educate lawmakers, reinforce their experiences and forge stronger relationships."
Gay stressed there is plenty of legislation on mass violence, and while her group is not addressing specific bills, they urged lawmakers to consider the effect on youth, especially those with disabilities. This summer, they will promote approaches supporting positive youth-adult relationships, better educator training and student empowerment to create safer schools without fear or trauma.
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As Mississippi grapples with a growing mental health crisis, state and local leaders are being urged to prioritize diversion programs and crisis care systems to prevent the unnecessary incarceration of people with mental illness.
It is estimated 2 million people with serious mental illness are booked into jails across the U.S. each year.
Shannon Scully, director of justice policy and initiatives for the National Alliance on Mental Illness, said in Mississippi, where mental health resources are often scarce and the incarceration rate is among the highest in the nation, it means more than 19,000 people in state custody.
"The criminal justice system disproportionately impacts people with mental illness," Scully explained. "They are overrepresented in those spaces, and that's mostly because historically, our communities have underfunded and under-resourced behavioral health."
The Bureau of Justice Statistics reports 44% of people in jails and 43% in state and federal prisons have a mental illness. The Magnolia State has made some progress in recent years, leveraging federal funding to expand mental health services. However, advocates warned proposed budget cuts could jeopardize the gains.
Mississippi's prison system has long been under scrutiny for overcrowding and poor conditions, and a lack of mental health services exacerbates the problem. Scully pointed to "nuisance laws" criminalizing behaviors associated with untreated mental illness, such as public disturbances or sleeping in public, as key drivers of incarceration.
"Instead of implementing policies that may connect these folks to crisis services or to supportive housing, they are charged with a crime or they are ticketed," Scully emphasized. "They become involved with the criminal justice system."
As March marks Criminal Justice Awareness Month, she urged Mississippians to learn more about how mental health intersects with the justice system and to push for reforms. Scully promotes the importance of community engagement, pointing to resources like reimaginecrisis.org, where people can track legislation and advocacy efforts for mental health diversion and crisis care in their state.
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Researchers at the University of Michigan have found that Black students attending Historically Black Colleges and Universities and Predominantly Black Institutions experience better mental-health outcomes compared with their peers at other institutions, but challenges remain.
The Healthy Minds Network, based at U of M, partnered with UCLA, Wayne State, and Boston University, to conduct the study in collaboration with the UNCF Institute for Capacity Building and the Steve Fund. Akilah Patterson, a doctoral candidate at the University of Michigan's School of Public Health, led the research and said the study involved 16 HBCUs and two PBIs, with more than 2,500 students participating.
"About 45% of them are flourishing mentally," she said. "Most notably, we saw that 83% of HBCU and PBI students reported having a sense of belonging in their campus community, compared to about 73% nationally."
However, the data also reveals significant challenges. More than half of the students report that their financial situation is "always" or "often" stressful, and 78% of those facing financial hardships are also dealing with mental-health issues.
In light of these challenges, the study recommends that colleges and universities address unmet mental-health needs, alleviate financial stress, expand on-campus mental-health resources and strengthen student-faculty connections.
Patterson said she hopes the report also underscores the importance of fostering a strong sense of belonging on campus and the crucial role HBCUs play in students' lives.
"HBCUs have a very long tradition of being centers of excellence and academic achievement," she said, "but this work also highlights that there are some mental-health challenges that do need to be addressed on those campuses so students can very much thrive academically."
As of 2023, HBCUs enrolled approximately 293,000 students. While originally established to serve Black students, as of 2015, non-Black students constitute about 22% of enrollment, up from 15% in 1976.
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