One in five adults in the U.S. experiences a mental health condition, but less than half receive treatment. This alone speaks to the need for major changes in mental health policy to ensure people get the help they need, when they need it. Fortunately, advancements in mental health policy are happening, and nowhere is this more true than within state legislatures.

Recognizing the crucial role of the states in directing mental health services and supports, NAMI has reviewed and analyzed standout state mental health legislation in 2019 to identify key trends in mental health policymaking. NAMI’s State Legislation Report: Trends in State Mental Health Policy (2019) offers policymakers and mental health advocates examples of policy options they can advance to improve the lives of individuals affected by mental health conditions.

The report also highlights lessons from NAMI State Organization leaders who played an important role in shaping some of these policies.

While this report’s analysis is limited to 2019 legislation, the solutions contained within can be used at any time. We hope this report can serve as a roadmap for state policymakers interested in addressing urgent mental health challenges as well as finding innovative solutions.

The report’s analysis is framed around the three pillars of NAMI 2020–2025 Strategic Plan: that people should get help early, get the best possible care and get diverted from justice system involvement. The report further breaks up legislation within “areas of focus” that represent issues of critical importance to NAMI’s mission and that also saw significant legislative action in 2019.

Areas of focus covered in the report include:

  • Early Intervention
  • Continuum of Mental Health Services
  • Mental Health Education
  • Mental Health Workforce
  • Suicide Prevention
  • Inclusive and Culturally Competent Care
  • Medicaid and State-Regulated Health Insurance Coverage
  • Crisis Response
  • Mental Health and Substance Use Parity
  • Diversion
  • Medication Access
  • Rehabilitation and Reentry

Due to the breadth of issues impacting mental health, this report is not comprehensive of all possible issue areas and related legislation.

Mental health policymaking spans many issues and varies widely state-to-state. Nonetheless, our research uncovered several clear areas of progress in 2019, including:

  • Incorporating mental health and suicide prevention into formal education curriculums
  • Defending against threats to Medicaid coverage and funding for mental health services
  • Reforming parts of the commercial insurance market by mandating more active and transparent enforcement of the federal parity law
  • Requiring alternatives to law enforcement response to crises, such as mobile crises teams and crisis stabilization

NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).