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Matters of Fact - MASSACHUSETTS
April 2004

Access to Treatment for Mental Illness in Medicaid

  • Nearly 185 thousand of Massachusetts’ over six million residents have a severe mental illness. (U.S. Census 2000; U.S. Center for Mental Health Services)
  • In the year 2000, the estimated number of people age 18 or older with a serious mental disorder living in Massachusetts (excluding homeless people or people in institutions) was over 126,000; 37 percent, or over 46,000, of these citizens are eligible for Medicaid services through the state’s system of mental health care. (SAMHSA National Mental Health Information Center)
  • In the year 2000, the estimated number of children and adolescents with a serious mental disorder was 1,866,112, or over 58,000 children in Massachusetts. An estimated 17.6 percent of those affected live in poverty. (SAMHSA National Mental Health Information Center)
  • Sixty percent of emergency physicians report that the upsurge in people with mental illness seeking treatment in community emergency departments is negatively affecting patient care, causing longer wait times, and is affecting everyone’s access to lifesaving treatment. Two-thirds of responding physicians attribute the recent escalation to state health care budget cutbacks and the decreasing number of psychiatric beds for people living with mental illness who are in crisis. (American College of Emergency Physicians, national survey, April 2004)
  • More than 20,000 eligible, vulnerable individuals with mental illness, or nearly 50% of those eligible, are currently waiting on lists for services from the Massachusetts Department of Mental Health. (Department of Mental Health, Massachusetts, 2000)
  • In fiscal year 2001, the average value of increased business activity generated from Massachusetts’s $3.4 billion in Medicaid spending was $7.5 billion, or a rate of return per dollar invested in Medicaid of over $2.21. ("Medicaid: Good Medicine for State Economics", Families USA, January 2003)
  • The U.S. Supreme Court affirmed that—under the Americans with Disabilities Act (ADA)—it is a violation of an individual’s civil rights to deprive him or her of the opportunity to live in integrated community settings. As a result of this decision, states, including Massachusetts, must assume a leadership role in ensuring that people with mental illness have access to permanent and affordable housing of their choice. Currently, there is a severe housing crisis in Massachusetts. (U.S. Supreme Court, Olmstead v. L.C., 1999)
  • Unlike the rest of healthcare, Medications comprise only 3% of costs for mental illnesses—and some experts contend that they may be responsible for more than 50% of positive treatment outcomes. (M. Graham, "Restrictive Formularies," National Mental Health Association, Department of Healthcare Reform)

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