Role of government in public health regarding mental
health
Public health is concerned with disease
prevention and control at the population level, through organized
efforts and informed choices of society, organizations,
public and private communities, and individuals.
However, the role of government is crucial for
addressing these challenges and achieving health
equity.
The Federal And State Role In Mental Health
The Federal Role In Mental Health
The federal government works in partnership with the states to
address mental health. The federal role in mental health includes
regulating systems and providers, protecting the rights of
consumers, providing funding for services, and supporting research
and innovation. As a major funding source for mental health
services, the federal government establishes and enforces minimum
standards that states can then expand upon.
- Federal Legislation and Regulations. Federal
laws create changes and provide oversight across the states.
Legislation at this level may take a longer time but can have a
massive impact once passed. Regulations are rules issued by federal
agencies to help implement the laws. In terms of mental health,
regulations cover a variety of topics and apply to a number of
groups including schools, insurance companies, treatment providers,
and employers. These rules clarify just how major pieces of
legislation like the Americans with Disabilities Act (ADA), the
Rehabilitation Act, the Mental Health Parity and Addiction Equity
Act (MPHAEA), and the Affordable Care Act (ACA) should be
implemented. The agencies also issue additional guidance when
questions about compliance arise. The federal government invites
individuals and groups to submit comments on regulations. You might
see this or hear this referred to as a notice for proposed
rulemaking. For more information about how you can be heard, check
out www.regulations.gov.
- Federal Protections. The federal government
works to protect the rights of individuals with mental health
disorders in a variety of settings, including the workplace,
schools, and in treatment. It sets privacy standards, prohibits
abuse, and fights discrimination to promote civil liberties and
inclusion. It works to provide reasonable accommodations and
supports to those who need them. Mental Health America's history is
deeply rooted in protecting the rights of those with mental health
disorders, and this focus continues to guide our work. To learn
more from MHA about rights and protections, check out the Rights of
Persons with Mental Health and Substance Use Conditions, Community
Inclusion after Olmstead, and Privacy Rights.
- Federal Role in Funding Services. The federal
government is a major funding stream for mental health services. In
addition to funding mental health services that fall under Medicare
and the Department of Veterans Affairs (VA), it matches state
Medicaid and CHIP (Children's Health Insurance Program) spending
from between 50 to 70 percent, depending on the state. While these
programs do not focus exclusively on mental health, Medicaid is the
single largest funder of mental health services in the country,
which makes this support especially valuable. The federal
government also provides Mental Health Block Grants (MHBG) that
support states in building out their community mental health
services. MHA supports the continued role of the federal government
in funding services and advocates for expanded and sustained
funding for mental health services.
- Federal Role in Research. Federal funding of
mental health research creates opportunities to study the causes
of, treatments for, and recovery from mental health disorders that
might not otherwise be available. Government agencies, like the
National Institute of Mental Health (NIMH) or the Substance Abuse
and Mental Health Services Administration (SAMHSA), lead research,
administer grants and educate the public about findings. This
information contributes to our overall understanding of mental
health disorders and services and can improve treatment and future
research.
The States' Role In Mental Health
States have significant power in making decisions about their
mental health systems so mental health regulations and available
services can look very different from state to state and even from
county to county. State mental health systems must meet certain
standards set by the federal government, but they are free to
expand beyond what exists at the federal level and improve
services, access, and protections for consumers. This freedom to
experiment with new or innovative services and delivery models
allows states to create improvements that can ultimately be
translated across the country.
- State Legislation and Regulations. State laws
create changes and provide oversight within the state. Regulations
are rules issued by state agencies to help carry outlaws. In terms
of mental health, state regulations can address a variety of issues
including treatment facilities, medical records, and standards for
involuntary treatment. These rules help states to implement their
mental health plans and provide guidance as to what is and is not
allowed under the law.
- State Protections. States follow the
protections established by the federal government with many states
increasing protections even further. From the workplace to schools
to treatment facilities, states have the power to increase
standards for protecting privacy, fighting abuse, and eliminating
barriers and discrimination to promote civil liberties and
inclusion. This ranges from discretion over civil commitment
standards to determining duty-to-warn laws to supporting access to
the least restrictive services that keep people in the community.
Mental Health America's history is deeply rooted in protecting the
rights of those with mental health disorders, and this focus
continues to guide our work. To learn more from MHA about rights
and protections, check out the Rights of Persons with Mental Health
and Substance Use Conditions, Community Inclusion after Olmstead,
and Privacy Rights.
- States' Roles in Funding Services. A state's
role in funding mental health services varies greatly across the
U.S. While all states receive federal support via Mental Health
Block Grants and partial funding of services provided through
Medicaid and CHIP (Children's Health Insurance Program), each has
freedom in designing and funding its mental health system. In
addition to funding state hospitals, state funding is typically
funneled to county and local levels where services are offered.
Depending on the state's political and economic climate, states
will play a more or less substantial role in funding comprehensive
mental health services.
- States' Roles in Research. Because they vary
in their services and delivery of services, state reporting of
outcomes provides important insight into what may or may not work
and can translate into improvements both within a state and across
other states. States often use models or areas that have been
successful and filter programs upwards, expanding them in size or
to other regions. This flexibility can create examples of new or
improved programs that can then be implemented around the country.
State-funded academic institutions also play an important role in
fostering research.