Montana's mental health advocates said state lawmakers addressed many of the state's pressing needs in the just-completed legislative session, but more work remains to be done.

The Montana Legislature addressed increasing funding for youth suicide prevention, adding beds at crisis care centers, improving Medicaid reimbursement rates for community behavioral health providers, increasing the number of community behavioral health centers and reworking conditional-release programs for offenders with serious mental health conditions.

Matt Kuntz, executive director of the National Alliance on Mental Illness-Montana, said it is exactly how lawmakers should address the state's critical mental health needs.

"There was a big, bipartisan push for mental health," Kuntz acknowledged. "There's a lot of things our country doesn't agree about right now. There's a lot of things our state doesn't agree about right now. But to see bipartisan agreement on mental health is really positive."

Kuntz pointed out while lawmakers did a lot to support mental health issues in the state, he and other advocates are already thinking about how to make more progress in the next legislative session.

While Medicaid reimbursement rates are slightly higher than they have been, Kuntz explained because reimbursement rates are still below where they should be, caregiver wages stay low, making it hard to attract providers to the profession.

"It's going to be a challenge to keep moving forward with increasing the number of care providers, both clinicians and technical staff," Kuntz cautioned. "Getting those bodies to serve and care for the people and make mental health their career is a long-term challenge, especially coming out of COVID."

Kuntz added he and other advocates are already planning to ask for higher Medicaid reimbursement rates moving forward.

The growing crisis in Ohio's child welfare system is drawing attention, particularly for its impact on children's mental health.

Across the state, children with complex behavioral needs are struggling as placement options shrink and demand for specialized care reaches an all-time high.

Lindsay Sparks, protective services administrator for the South Central Ohio Job and Family Services, Children's Division & Adult Protective Services, noted that despite efforts with mental-health providers, many agencies lack the resources to handle severe cases.

"We have had a young child, under the age of 10, who we have about 45 denials across the state, they feel that they cannot meet that child's needs," she said. "Children have had to spend the night at our agency. That is not ideal for our children, for our staff, for anyone - but it has happened."

In some cases, Sparks added, agencies are forced to seek out-of-state placements - which can further complicate care for children already facing significant challenges. Recruitment efforts for foster families are ongoing, but the gap remains wide.

The crisis extends beyond placement shortages to escalating mental health concerns. Jody Walker, executive director of South Central Ohio Job and Family Services, highlighted how these issues have worsened over the past decade.

"The types of children that we're seeing coming into care, that have more severe behavioral mental health issues, and our system really hasn't been able to keep up with types of placements that benefit these kids the most," he said. "The cost for those placements went up, at the tune of 300% in the last 10 years."

As Ohio faces rising costs and limited resources, the County Commissioners Association has made child welfare a top priority in the upcoming biennial budget. The association is applauding Governor Mike DeWine's commitment to children, and stresses that counties play a vital role in protecting them.

As mental health challenges continue to rise among young people, advocates across North Carolina are pushing for increased access to mental health services in schools.

They are watching the upcoming election for North Carolina Superintendent of Public Instruction closely.

Kathleen Daughety, vice president of campaigns and engagement for the mental health advocacy organization Inseparable, said the outcome could significantly help fill gaps in access to mental health services for children across the state.

"Increasing access to mental health care is our focus because half of people in the US who need mental health care are not getting it today," Daughety pointed out. "That number is even worse for children; 70% of children who need mental health care aren't able to access it."

A recent poll by Inseparable showed it is an issue resonating with voters. About 88% believe expanding mental health care access should be a top priority for elected officials.

Graham Palmer, director of systems innovation and policy for the nonprofit Rural Opportunity Institute, explained barriers like broadband and workforce shortages and limited funding make it difficult to provide the necessary services, especially in rural areas. He believes schools can make a life-changing difference for kids.

"Sometimes schools are the only access point that systems of care can get to for kids, because there's transportation challenges," Palmer explained. "There may be time challenges, if the student has a job or they just don't have extra time to be driving an hour to see a therapist."

The Superintendent of Public Instruction would play a key role in shaping school policies, funding, and resources directly affecting whether schools can provide mental health services. The Democratic candidate, Maurice "Mo" Green recently signed Inseparable's "Mental Health Now" statement of support. He worked as the superintendent of North Carolina's third-largest school district and pointed out addressing the workforce is going to be crucial to giving students the support they need.

"The school psychologist's major association would recommend a ratio of about one school psychologist," Green noted. "For every 500 students, in North Carolina that ratio is almost 1 to 1,800."

Green is facing off against Republican nominee Michelle Morrow, who is a nurse and homeschool educator in Wake County. Her campaign website shows she supports school choice and increasing school resource officers.

Advocates are also calling for state policymakers to invest in expanded school-based mental health programs and improve crisis response efforts.


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Mental health is a top issue for voters, and candidates running for office across Colorado are pledging to make it a priority if elected.

Kathleen Daughety, vice president of campaigns and civic engagement with Inseparable, said if people can get treatment, they can thrive. But if they can't, the situation can get much, much worse.

She pointed to a recent survey showing that half of all Americans who need mental health care aren't able to get it, and said one of the biggest barriers is that health insurance companies aren't doing their part.

"People are buying insurance policies expecting to get care when they need it. And then when they are sick, insurance companies are denying the care that their doctors are prescribing," she explained.

Nearly nine in ten voters say expanding access to mental health care should be a priority, ranking it just as high as lowering the cost of living. So far, 80 Colorado candidates have signed a Mental Health Now statement of support, more than any other state. The statement calls for policies that increase access to mental health care, improve crisis response, and expand youth mental health services, especially in schools.

Colorado is one of many states that lack facilities to place people experiencing severe mental illness. In 1955, there were nearly 6,000 psychiatric beds in the state. In 2023 the number dropped to 482.

Dusty Johnson, R-Fort Morgan, is running unopposed for House District 63 and signed the Mental Health Now statement of support.

"We shouldn't be using jail as a place to get mental health resources. But when you have nowhere to take them, they end up in our prisons, or back on the street, and then they go and hurt themselves worse, or hurt somebody else. It would be nice if we had places that would take them on the spot," Johnson said.

Since 2015, one out of five people killed by police were experiencing a mental health emergency. Daughety said the goal for politicians should be to make law enforcement involvement in crises the exception, not the rule.

"If someone is having a mental health emergency, they need a mental health specific response, they don't need a law enforcement response. Law enforcement says these calls are really stressful. They're not trained for them," Daughety contended.