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State Healthcare Reforms for Uninsured Fail to Address High Percentage of Mental Illness and Substance Use Disorders

June 16, 2008

Washington, DC—-New data indicates that more than one in four adult Americans without medical insurance have a mental illness or substance use disorder, or both.

But many state healthcare initiatives intended to cover the uninsured are neglecting these conditions, according to a report by the National Alliance on Mental Illness (NAMI) and the National Council for Community Behavioral Healthcare (National Council).

The report is available at www.HealthcareforUninsured.org. It is supported by a grant from the Robert Wood Johnson Foundation.

“Many states are trying to cover the uninsured but need to do more in  these critical areas that affect one in four Americans,” said NAMI executive director Michael J. Fitzpatrick.

Mental illness is the leading cause, and substance use is the second leading cause, of disability among adults. Approximately one-third of these groups, living below the federal poverty line, do not have insurance.

“We can effectively treat substance use disorders and mental illnesses—and people that suffer from these debilitating conditions deserve treatment,” said Linda Rosenberg, President and CEO of the National Council. “It is distressing that there are insurance plans and healthcare reform initiatives that continue to discriminate.”

The report reveals that benefits for mental illness and substance use treatment vary greatly across states.  Among the report’s findings:

  • Based on a study of 18 states, approximately 60% have equal coverage for mental illnesses in initiatives for the uninsured, but only 28% include substance abuse.
  • Basic parity is not enough. More states need to address problems with scope of benefits, co-payments, prior approvals, and shortages of mental health professionals.
  • Few states are including mental illness and substance use disorders in wellness and chronic disease management programs.


The National Alliance on Mental Illness is the largest grassroots mental health organization dedicated to improving the lives of individuals and families affected by mental illness. NAMI has over 1,100 state and local affiliates nationwide who engage in research, education, support and advocacy.

The National Council for Community Behavioral Healthcare is a not-for-profit, 501(c)(3) association of 1,400 behavioral healthcare organizations. Member organizations provide treatment and rehabilitation services for mental illnesses and addictions disorders to nearly six million adults, children and families in communities across the country.

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