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States in Crisis:
The Grassroots Response

In states across the country, a battle is being waged by NAMI family and consumer advocates. As state and local government budget shortfalls become an overwhelming reality, legislators, governors, and administrators are faced with significant financial pressures. Many governors and legislatures are debating proposed cuts to their mental health systems. Already fragmented, fragile, and under funded systems of care are at risk of spinning out of control. The nature and funding of the safety of those persons who are most at risk is under attack.

Many governors have proposed targeted and/or across the board cuts to existing mental health services. NAMI advocates are organizing across the country in coalitions to press our case that cuts to the existing system of care are unacceptable and will have devastating consequences for consumers and their families.

Medicaid currently funds upwards of 50% of existing state mental health systems. It makes up nearly 20% of state budgets. Medicaid is, after education, generally the largest cost item in state budgets. Medicaid costs are rising sharply throughout the country. Pharmacy costs in Medicaid are rising particularly fast. All states are seeking to rein in these costs. They are doing so through legislation, changes in regulations, and by seeking federal waivers from to the Center for Medicaid and Medicare Services (CMS). Services to persons with mental illness are at risk. Most of these changes will occur out of the spotlight. This factor, linked with the short legislative sessions and the 2002 election year, makes this a tenuous time for NAMI family and consumer advocates.

In 2002, the NAMI Web site will periodically spotlight a NAMI state affiliate's grassroots efforts to deal with this crisis. By sharing this information we can all learn and share our experiences as we work to build coalitions in our communities that will in the end create systems that truly improve the quality of life of persons with mental illness.

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