$400 Million Boost In Budget for Mental Health

The House and Senate passed and the President signed the $1.1 trillion 2016 budget bill (HR 2029) late last Friday, Dec. 18. The great news is this budget bill includes important new investments in mental illness research and services including:

• $85.4 million boost for research at the National Institute of Mental Health (NIMH)
• $50 million more for services at the Substance Abuse and Mental Health Services Administration (SAMHSA)
• $255 million increase for veterans mental health treatment

Read on to see more about how the 2016 budget impacts people with mental illness.

Mental Illness Research Funding

The 2016 budget bill includes the largest increase to mental illness research at NIMH since 2012. Overall, the National Institutes of Health (NIH) received a $2 billion increase, boosting funding to $32.1 billion. For 2016 the NIMH budget will be set at $1.548 billion–an $85.4 million increase above the 2015 level.

The budget bill also gives $150 million for the President’s BRAIN Initiative (Brain Research through Application of Innovative Neurotechnologies), an $85 million increase over the 2015 level and $15 million more than the President requested. This increase shows the strong bipartisan support that funding for the NIH has achieved in Congress.

Mental Health Services Funding

SAMHSA will receive a $160 million increase over 2015 levels, for a total budget of $3.8 billion. This is the largest single year increase for SAMHSA in the agency’s 20-year history. It shows the rise of both mental health and substance abuse treatment as national priorities.

The Mental Health Block Grant program received a $50 million increase–boosting funding to $532.57 million. Most importantly, the bill adds a series of new requirements on the Block Grant program to ensure that this increase is focused on evidence-based programs targeted to serious mental illness. The bill also doubles  the current 5% “set aside” for first episode psychosis (FEP) programs to 10%. NAMI, in partnership with the National Institute of Mental Health (NIMH), held a Congressional briefing in October to focus attention on the promise of First Episode Psychosis (FEP) programs such as those established through the NIMH Recovery After an Initial Schizophrenia Episode (RAISE) initiative and to ask Congress for this increase in funding.

The bill also provides $15 million for a new Assisted Outpatient Treatment (AOT) pilot program through SAMHSA. NAMI will be encouraging SAMHSA to focus on funding projects modeled after San Francisco's new AOT program that include a significant outreach and engagement component prior to AOT or if an AOT order is necessary, to assist and empower people under AOT orders to realize their personal goals and achieve better outcomes.

Most other programs at SAMHSA’s Center for Mental Health Services (CMHS) were level funded at their 2015 levels including:

• $64.6 million for the PATH program – a state grant program to the states for outreach and engagement services for homeless individuals with serious mental illness.
• $117 million for the Children’s Mental Health program–$300,000 below the current level.
• $36.1 million for the Protection and Advocacy for Individuals with Mental Illness (PAIMI) program.

Most programs under the CMHS Programs of Regional and National Significance (PRNS) are continued at current levels. Among these items are:

• $49.8 million for the Primary-Behavioral Health Care Integration (PBHCI) program, which supports the co-location of services in behavioral health and primary care settings.
• $54.9 million for suicide prevention activities, including the Garrett Lee Smith state and campus grant programs.
• $49.9 million for new Project AWARE (Advancing Wellness and Resilience in Education) grants—a $10 million increase.
• $14.9 million for Mental Health First Aid training.
• $30.7 million for homelessness prevention programs.

Supportive Housing Funding

While the budget bill includes an increase of $1.6 billion for the U.S. Department of Housing and Urban Development (HUD), most of that increase will go toward renewing rent and operating subsidies for existing units across HUD’s programs. For supportive housing programs, the bill does not include increases put forward in President Obama’s 2016 budget proposal.

In February, the President proposed $301 million in additional funding for development of new permanent supportive housing (PSH) under the McKinney-Vento Homeless Assistance Act. These new funds were projected to help end chronic homelessness by 2017. The President’s budget also called for a $25 million increase for the HUD Section 811 Project-Based Rental Assistance (PRA) program. These housing units are made available to states through a competitive process tied to efforts to promote community integration as an alternative to restrictive settings such as board and care homes serving people with severe disabilities (including serious mental illness).

The budget does not include either of these requests and instead provides only enough funding to renew the operating subsidies associated with existing PSH units in both programs. Funding includes:

• $2.25 billion for McKinney-Vento, which is $115 million above the 2015 level, but $230 million below the President’s request.
• $250 million to the Emergency Solutions Grant (ESG) program under McKinney-Vento. ESG grants go towards:
  • Engaging homeless individuals and families living on the street.
  • Improving the number and quality of emergency shelters for homeless individuals and families.
  • Rapidly re-housing homeless individuals and families.
• $1.918 billion for the Continuum of Care (CoC) competition. It is projected that only $27 million would be available within the CoC competition for new PSH units. The CoC Program is designed to:
  • Promote a community-wide commitment to the goal of ending homelessness.
  • Quickly re-house homeless individuals and families while minimizing trauma.

For the HUD Section 811 program, the bill contains $150 million, an amount projected to fund renewal of all existing Project-Based Rental Assistance Contracts (PRACs)–roughly 30,000 housing units–with no funding for new units. The bill does include an additional $60 million in funding for new rental vouchers for supportive housing for veterans experiencing homelessness under the VASH program.

The budget bill also contains funding to renew all existing tenant-based and project based vouchers – $17.68 billion for tenant-based and $10.4 billion for project-based. It also boosts funding for the HOME program by $50 million, up to $950 million. Finally, the bill rejects a previous proposal in the House bill that would have redirected funds from the National Housing Trust Fund.

Veterans Funding

The funding bill provides an additional $2.369 billion in forward funding for the U.S. Department of Veterans Affairs (VA) Medical Care for 2017. This is $1.5 billion more than the 2015 bill. The VA operates on a two-year forward funding budget cycle in order to manage long-term planning for the largest health system in the nation. For Veterans mental health, the bill specifies $7.455 billion for 2016 and $7.715 billion in forward funding for 2017. This is a $255 million increase for the current year. Finally, the budget bill gives $630.7 billion for Medical and Prosthetics Research at the VA for 2016, a $41.8 million increase over current levels.

Criminal Justice Funding

The 2016 budget bill contains an increase of $1.5 million for Criminal Justice/Mental Health Collaboration grants funded through the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) program administered by the U.S. Department of Justice. This program, whose total funding will be $10 million in fiscal year 2016, provides vital grants to states and communities to support:

• Jail diversion
• Mental health courts
• Law enforcement training
• Community reentry programs for people with mental illness and co-occurring substance use disorders involved with criminal justice systems