After months of delay, Congress has completed action on spending legislation for mental illness research and services for fiscal year 2002. The massive $123.8 billion FY 2002 Labor-HHS-Education Appropriations bill (HR 3061) includes important increases for mental illness research and services programs, including the National Institute of Mental Health (NIMH) and the Center for Mental Health Services (CMHS). Despite the fact that FY 2002 actually began back on October 1, funding levels for the remaining nine months of the fiscal year have now been set. President Bush is expected to sign HR 3061 by the end of the week.
It is important to note that the Labor-HHS-Education Appropriations bill was the legislative vehicle for the Domenici-Wellstone mental illness parity amendment that House conferees rejected on December 18 (see NAMI E-News, Vol. 02-39 for further details). Differences between the House and Senate over mental illness parity, as well as President Bush's education bill, held up final action on HR 3061 for weeks. While the Domenici-Wellstone amendment was not included in the final version of HR 3061 (a major disappointment for NAMI), House and Senate conferees did extend the 1996 limited federal parity law (parity only for annual and lifetime dollar limits).
In addition, the final bill adds the following advisory language: "The conferees recognize the devastating impact of mental illnesses on Americans from every walk of life and the widespread bipartisan support of mental health parity legislation in both houses of Congress. The conferees strongly urge the committees of jurisdiction in the House and the Senate to convene early hearings and undertake swift consideration of legislation to extend and improve mental health parity protections during the second session of the 107th Congress" (i.e. in 2002). While this language is not legally binding on Congress, it is an important step forward in forcing action on the part of key House leaders who blocked the Domenici-Wellstone amendment in recent weeks.
The final House-Senate agreement on the Labor-HHS-Education Appropriations bill for FY 2002 contains an overall increase for NIH of $3 billion, up to $23.28 billion. This level is well above the $2.5 billion increase recommended by the House and the Bush Administration increase of $2.5 billion (up to $23.2 billion). This represents nearly a 15% increase - maintaining the bipartisan goal of doubling the federal commitment to biomedical research by 2004 - a goal that NAMI enthusiastically supports. For NIMH, the final Labor-HHS-Education bill for FY 2002 includes $1.249 billion, more than a $131 million increase over the FY 2001 level of $1.118 billion. This 13% increase represents a major victory for NIMH, although the agency's increase is slightly below the average for the 13 research institutes at NIH. This allocation for NIMH represents a splitting of the difference between the House recommended level ($1.228.8 billion) and the higher Senate recommended level ($1.279.4 billion).
NIMH is the principal federal agency responsible for scientific research on mental illness. NAMI strongly supports NIMH's scientific mission to advance research on severe mental illness. Given that severe mental illnesses are among the most costly in terms of disease burden to society and have historically been under-researched, NAMI believes a strong case can be made for Congress to keep NIMH's increase on par with all other institutes. NAMI is grateful to the leadership of key members of the House and Senate Appropriations Committees and the Bush Administration for the overall funding increases at both NIMH and NIH. NAMI also encourages Congress and the Bush Administration in 2003 and beyond to revisit the relative increases for institutes within NIH to better reflect the true costs of severe mental illnesses to society and the promise of brain research to have greater emphasis on basic scientific and clinical research on diseases such as schizophrenia, bipolar disorder and major depression.
While increases for mental illness service programs at the Center for Mental Health Services (CMHS) - part of the Substance Abuse and Mental Health Services Administration (SAMHSA) - were far below those for NIH and NIMH, Congress was able to increase spending for many of the agency's programs. Overall, SAMHSA's FY 2002 budget will be $3.138 billion - more than half of which is allocated to the states through formula grant programs. Below is a summary of funding levels for selected programs of concern to children and adults with severe mental illnesses and their families.
Other specific amounts set aside in the CMHS PRNS account for specific national initiatives are $20 million for children with PTSD who experience or witness trauma, $3 million for model suicide prevention programs, $2.5 million for counseling for public safety workers and $5 million for outreach services for senior citizens.