Two days after the school shooting in Newtown, the number of Google searches for mental health peaked to a 12 month high. The country is finally talking about mental health care. Connected and unconnected to Newtown, leaders exclaim that we must do something. Yet with some notable exceptions, the discussion is mostly lip service. We must translate that talk and the good intentions into real action.
A $10 billion national commitment to effective mental health services would save millions of American lives, and bring hope of a happier, productive future to millions more.
If we're serious about giving more than lip service to truly helping people, we have to do what works and be prepared to fund it. According to the National Association of State Mental Health Program Directors, states have collectively cut more than four billion dollars in public mental health spending since 2009. While the Affordable Care Act provides enormous potential, millions of Americans will still face barriers to full mental health treatment.
In meetings last month in Washington D.C. with Congress, representatives of the Biden Commission and mental health services advocates, I offered a framework for a $10 billion federal investment in mental health services and programs focusing on three key areas: prevention and early intervention ($1.2 billion), school-based health centers ($800 million), and comprehensive mental health treatment with a "whatever it takes" approach for the most severely ill ($8 billion).
This proposal is modeled on California's Proposition 63, the Mental Health Services Act. Even with severe cutbacks to California's base mental health budget, Proposition 63 has transformed our state's mental health system. Of the one billion dollars generated annually, 25 percent is devoted to prevention and early intervention in California's 58 counties. Most of the remaining 75 percent is spent on recovery for people with the most severe and persistent mental illnesses.
California has 421 innovative prevention and early intervention programs. In Sacramento County for example, a nationally recognized program identifies, screens and treats teens and young adults who are at high risk or already experiencing the initial onset of psychosis, especially schizophrenia. At University of California campuses, faculty and staff receive training to recognize and respond to signs of student distress. UC also reaches out to students through online stress and depression questionnaires. Campus psychologists respond within 24 to 48 hours, offering counseling and services. The American Foundation for Suicide Prevention says students engaged in such screening are three times more likely to enter treatment.
While mental health treatment is among the services provided at close to 2,000 school-based health centers nationwide, most lack the resources to help students needing more intensified care. A federal investment can expand such centers, to help children and youth overcome mental and behavioral disorders in the early stages.
California's Full Service Partnerships have provided a "whatever it takes" approach for 60,000 people needing the most intensive care. They may be older adults with frequent, avoidable emergency room and hospital admissions; veterans suffering Post Traumatic Stress Disorders; adults whose severe mental disorders lead them to a life on the streets or life in and out of jail; older teens or young adults aging out of foster care, exiting the juvenile justice system or experiencing their first episode of major mental illness; individuals battling with substance use as they self-medicate for their disorders; or people whose culture so stigmatizes mental illness that their disorder has become severely debilitating.
These Full Services Partnerships take a "whole person" approach that not only provides treatment, but can include safe housing, a job, help in school and physical health care. For these clients, a recent UCLA study shows dramatic reduction in psychiatric hospitalization, emergency room visits, incarceration and chronic homelessness.
We know what works. Congresswoman Doris Matsui's Excellence in Mental Health Act to enhance Medicaid funding for community-based mental health treatment and supports, and Congresswoman Grace Napolitano's bill to support more new mental health services in schools, would go a long way toward that end.
Whatever the approach, we must be prepared to fund it. We need a $10 billion federal investment that can save untold numbers of lives, and help untold numbers of people in every neighborhood, in every state across the nation. The time is now.