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A New Executive Order and Homelessness and Mental Illness

This brief examines data on homelessness and mental illness against the backdrop of President Trump’s executive order aimed at removing unhoused people from the streets and enabling more involuntary civil commitments for psychiatric institutional care. This approach could reverse a decades-long shift in treatment approaches for people with serious mental illnesses that moved people away from long-term psychiatric institutions toward community-based treatment settings.

Also: Five Key Facts About People Experiencing Homelessness

At the Three-Year Mark, Demand for the 988 Suicide & Crisis Lifeline Continues to Grow

How Might Changes to the ACA Marketplace Impact Enrollees with Mental Health Conditions?

The Impact of Gun Violence on Children and Adolescents

Mental Health and Substance Use State Fact Sheets

Access and coverage

  • Mental Health Parity at a Crossroads

    More than 25 years after the first federal mental health parity protections were put in place, adequate coverage for behavioral health care remains elusive. This brief explains the federal behavioral health parity requirements and sets out key policy issues.

  • Section 1115 Waiver Watch: Contingency Management

    Of the 800,000 Medicaid enrollees aged 12 to 64 with a diagnosed stimulant use disorder in 2019, about 20% were in states that now have approved 1115 Medicaid waivers for contingency management services.

  • The Landscape of School-Based Mental Health Services

    In the 2024-2025 school year, 18% of students utilized school-based mental health services. This issue brief explores the landscape of mental health services, including services offered, utilization, barriers, and funding, as well as recent federal actions.

  • 5 Key Facts about Medicaid Coverage for Adults with Mental Illness

    Nationwide, an estimated 52 million nonelderly adults live with mental illness, and Medicaid covers nearly one in three (29%) of them, or about 15 million adults.

  • What Federal Medicaid Cuts Could Mean for the Opioid Epidemic

    Medicaid covers 47% of all nonelderly adults with OUD and is the primary coverage source among those receiving treatment services. This brief offers a look at what federal Medicaid spending cuts could mean for this population.

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  • The Mental Health Crisis Within the Mental Health Crisis

    From Drew Altman

    In his new column, KFF CEO Drew Altman discusses how America’s mental health crisis affects families. The number of families experiencing a serious mental health-related event is large enough to constitute a crisis within the larger mental health crisis.

  • Examining New Medicaid Resources to Expand School-Based Behavioral Health Services

    Issue Brief

    In light of worsening mental health among youth, strategies have been implemented to improve access to behavioral health services in recent years, including expanding school-based care for students. Leveraging Medicaid to improve and address gaps in school-based behavioral health services has been a key strategy in recent years as youth mental health concerns have grown. Provisions from the Safer Communities Act of 2022 utilize Medicaid to expand both school-based health care and other mechanisms of youth behavioral health care. This issue brief explores the implementation of these provisions from the Safer Communities Act thus far, with a focus on the guidance issued from CMS.

  • SUD Treatment in Medicaid: Variation by Service Type, Demographics, States and Spending

    Issue Brief

    Substance use disorders contribute to a growing number of deaths, yet they often go undiagnosed and untreated. While nearly three-quarters of Medicaid enrollees with a diagnosed substance use disorder utilized some type of treatment service in 2020, medication treatment rates varied widely, being much lower for alcohol use disorder than opioid use disorder, and lower among Black enrollees and youth compared to their counterparts. Treatment rates varied considerably across states and average Medicaid spending for people with a diagnosed substance use disorder is over twice as high compared to those without a substance use disorder.

  • Recent Trends in Mental Health and Substance Use Concerns Among Adolescents

    Issue Brief

    About 1 in 5 adolescents report symptoms of anxiety or depression, according to a KFF analysis of a new federal survey of teen health. The data comes at a time of heightened concern about adolescent mental health and substance use, particularly in light of gun violence and rising drug overdose deaths among young people. This brief explores the state of adolescent mental health in recent years.

  • A Look at Substance Use and Mental Health Treatment Facilities Across the U.S.

    Issue Brief

    This brief uses 2022 data from the National Substance Use and Mental Health Services Survey (N-SUMHSS), an annual survey sent to all substance use and mental health treatment facilities to assess the supply and characteristics of these facilities at a national and state level. Despite the escalation of mental health needs and the increasing and evolving opioid epidemic, accessing treatment continues to be difficult--as indicated by consumer surveys and national data. Factors like the decline in psychiatric beds, financing barriers, difficulty accessing outpatient treatment, and the growing workforce shortages have led to more reports of unmet need and psychiatric boarding in emergency departments. Overall, there are approximately 14,700 facilities providing substance use treatment services and about 9,500 facilities that offer mental health services. More than eight in ten substance use treatment facilities and mental health facilities provide outpatient services; smaller shares offers more intensive inpatient services. Substance use treatment and mental health bed availability varies across states. Most substance use and mental health treatment facilities are non-profit; however, for-profit ownership is more common among substance use treatment facilities, whereas public ownership is more common among mental health facilities. Most facilities report high participation with private insurance and Medicaid, but lower for Medicare and there is variation across states. Reported Medicaid participation by substance use treatment facilities varies across states.

  • A Look at State Take-Up of ARPA Mobile Crisis Services in Medicaid

    Issue Brief

    Rising concerns about mental health and substance use disorder have led to new policy initiatives and funding to improve access and quality of services to address mental health crisis. While crisis call centers are accessible nationwide, the availability and characteristics of other components of the crisis continuum--mobile crisis units and stabilization centers--vary across and within states, as does the financing of these systems. The American Rescue Plan Act (ARPA), passed in 2021, had several Medicaid-focused provisions to improve and expand access to crisis systems in Medicaid. Medicaid programs can access the 85% enhanced federal match for ARPA mobile crisis services for eligible Medicaid enrollees. As of November 2023, 13 states obtained CMS approval for state plans amendments to cover ARPA community-based mobile crisis intervention services, making them eligible for enhanced federal matching funds under the American Rescue Plan Act (ARPA) option. Beyond the ARPA incentives, recent Department of Justice (DOJ) investigations into police handling of mental health calls could spur expansion of mobile crisis.