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.

Colorado has made significant improvements in connecting young people with the mental health care they need, according to the mental health advocacy organization Inseparable's latest School Mental Health Report Card.

Many of those gains could be erased if the Trump administration signs off on cuts to Medicaid.

Sen. Dafna Michaelson Jenet, D-Commerce City, said Colorado relies on Medicaid dollars to reach students where they spend most of their time - in school.

"We use Medicaid to cover a lot of school-based health center care," Michaelson Jenet pointed out. "We could lose that completely, and then how do we fund our school based health centers?"

Since the last report card in 2022, Colorado has improved the ratio of mental health professionals to students by adding 43% more psychologists and 70% more social workers. Colorado also got good marks for creating school environments embracing mental health, for example by allowing excused mental health absences and not disciplining students through exclusion.

The state also instituted annual mental health screenings but the future of the program is in question after Colorado's Joint Budget Committee, facing a $2 billion budget deficit, recently cut its funding.

Caitlin Hochul, vice president of public policy for Inseparable, said when you catch a condition early on, students are more likely to be more engaged in school, have academic success and perform better in the workforce later on.

"We really emphasize providing annual screenings to students so you can catch some of those symptoms or flags early on," Hochul explained. "Then connecting them with some of the care that they need."

Under Colorado's Taxpayer Bill of Rights, voters would have to approve any new revenues to pay for screenings and other initiatives not making the cut. Michaelson Jenet emphasized she is working to keep effective programs to protect children in place.

"One of the things that I'm grateful that the budget protected this year is the I Matter program, offering free therapy for any school-age youth who wants it," Michaelson Jenet noted. "From the beginning of I Matter, we have seen our suicide rate go down."

Nebraska lawmakers are considering a bill to ensure managed health care companies cannot limit the state reimbursement rate for mental health service providers.

Advocates for the bill want to make sure in the future, the companies could not negotiate a lower rate. Right now, there's no requirement they use the posted rates, it has just been the practice. Legislative Bill 380 would keep "guardrails" in place.

Annette Dubas, executive director of the Nebraska Association of Behavioral Health Organizations, said providers have worked for 20 years just to get the reimbursement rates to meet the minimum state standards.

"Nebraska's rates were, two decades ago, towards the bottom," Dubas pointed out. "We've worked hard over those last two decades to get rates built up. It comes down to the ability to build capacity, so that people who are in need of mental health care can access that mental health care."

Dubas noted the bill was introduced after Nebraska autism care providers had to fight an effort to reduce their reimbursement rates last year. It awaits action in committee. Dubas emphasized her group opposes an amendment to remove the minimum pay "guardrails."

Dubas explained low wages and often challenging working conditions already make it difficult to find mental health care professionals, and lower reimbursement rates mean even lower wages and less stable employment. She added protecting the rates already in place is critical to ensuring the ability to recruit and retain workers.

"If rates do not stay up where they need to be, it just puts that much more pressure on these providers to be able not only bring in new workforce, but to retain the workforce that they have," Dubas explained. "Burnout is a huge issue."

Dubas added any rate adjustment legislation could also complicate a reimbursement process she described as already confusing and complex in Nebraska.

A national report card finds that even with a $150 million budget threat last year, Michigan still made solid progress in staffing up its school mental health system.

The report released by Inseparable - a mental health policy organization, as part of the Hopeful Futures Campaign - shows the state reached 36% of recommended psychologists, nearly 60% of counselors, and just over 40% of social workers.

However, Inseparable's Vice President of Public Policy Caitlin Hochul said some gaps remain, including in staff training and essential early mental health screenings.

"When you catch a condition early," said Hochul, "and you get treatment that you need early, you have better outcomes. You're more likely to be more engaged in school and have academic success and perform better in the workforce later on."

The report also finds that while Michigan is making progress, it has failed to enact other key policies, including excused mental health absences and school-linked mental health services program.

According to Inseparable, there's been significant improvement in Michigan's social worker-to-student ration - going from one per 2,300 students to one per 600.

Lynn Maye, a licensed social worker with over 20 years in Detroit schools, credited proper training as key to the state's success.

"There is an organization called the Michigan Association of School Social Workers," said Maye, "who make sure that those types of trainings and educational classes are made available for professional growth and development, for our mental health professionals in the schools."

Polls reveal that mental health is a priority for Americans, regardless of party, with 90% of voters saying expanding mental health care should be a priority for elected officials.