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1.25MB
2022 Profiles SMHA The BH Crisis Continuum April 2023
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Through our State Profiling System, NRI tracks State Mental Health Agency initiatives in prevention and treatment of mental disorders. Dating back to 1996, our State Profiling System database provides detailed descriptions about each State Mental Health Agency’s:
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Description: This report focuses on the number of MCTs in a state (and plans to open additional MCTs,), the number of clients served, what organizations operate them, how they are funded, workforce issues, and outcomes measured.
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Description: This report focuses on how much SMHAs spend on crisis services (over $1 billion in FY 2022), and what the major funding sources are for each of the Crisis Now components.
Description: This report focuses on the use of software/data dashboards to monitor Crisis Services and key Outcomes being reported to SMHAs.
Description: This report looks at workforce shortages by professional discipline at State Hospitals, residential settings, community mental health providers, and crisis providers and at state initiatives to address workforce shortages.
Description: This report focuses on SMHAs use of technology to enhance their BH workforce, including telehealth, using technology for training, and Learning management systems.
Description: This report addresses what groups are responsible for transporting individuals in crisis and the development of alternatives to Law Enforcement in mental health service transportation.
Tagged: 04. SMHA Crisis Services
Description: This report focuses on State behavioral health initiatives to address the diversity and cultural competence of BH workforce.
Description: This report focuses on how states are working with Peer Specialist, including information about peer recruitment, training, credentialing, working in crisis services, reimbursement and initiatives to increase rates.
Description: This report focuses on workforce shortages (by professional discipline and Crisis System component) and initiatives of states to address workforce shortages.
Description: Developed in coordination with NASMHPD’s Housing Task Force, this report reviews the roles of SMHAs in supporting housing services for individuals with mental illness, the types of housing services and supports supplied, and major funding sources used for housing.
Description: Every state has a State Mental Health Agency (SMHA), but states vary widely in where the SMHA sits within state government, the services it is responsible for, and how it organizes and funds these services. This report describes the organization and structure of the SMHA within state government. The report details where the SMHA sits within state government, how the SMHA Director/Commissioner relates to the Governor, what other disability responsibilities are combined with the SMHA (including Substance Abuse services and Intellectual/Developmental Disability services), specific mental health client groups and service settings the SMHA is responsible for, and how the SMHA organizes and funds community mental health services in each state.
Tagged: 01. SMHA Organization and Structure
Description: Every State operates psychiatric inpatient beds, but how many psychiatric beds and state hospitals each state has varies widely. This report reviews the number of state psychiatric hospitals in each state, the number of patients served in them, and some of the major policy issues regarding how states use their psychiatric beds.
Tagged: 02. Use of State Psychiatric Hospitals
Description: Every state mental health agency is responsible for assuring the provision of community mental health services. Some states provide community MH services using state employees, other states fund county/city governments, and other states contract with local providers. This report discusses the various ways states organize and fund community mental health services. The report also discusses community service utilization rates and financing.
Tagged: 03. Organization of Community MH Services
Description: Implementing a comprehensive continuum of services to meet the needs of individuals with a behavioral health crisis is a high priority of states. This report reviews the behavioral health crisis services being supported by SMHAs in 2020-2021, the year before the launch of the new national 988 sucicide/crisis line. THe report reviews the use of behavioral health call centers, mobile crisis teams, crisis receiving centers, short term residential crisis services, and other initiatives.
Tagged: 04. SMHA Crisis Services
Description: This report highlights the experiences of 43 state Mental Health Agencies in working with state funded Behavioral Health Crisis Call Centers as they prepare for the implementation of 988—the three-digit-number for the National Suicide Prevention Lifeline that must be live by July 16, 2022. States supplied information during the summer/fall of 2021 in a report NRI conducted in collaboration with the National Association of State Mental Health Program Directors (NASMHPD), a group of Transformation Transfer Initiative (TTI) grantee states, and with input from Vibrant Emotional Health. The report focuses on state sponsored behavioral health crisis hotlines and warmlines, 988, and experiences working with 911. The purpose of the survey was to help states learn from each other on how they are working to implement 988 within the context of existing and emerging behavioral health crisis continuum. The survey found that in most states, the SMHA is the lead agency responsible for crisis call centers. The survey also identified that there are more than twice as many behavioral health crisis call centers than Lifeline call centers, and while many local centers may join the 988 system, in some states, many of the local call centers will continue as an important part of the behavioral health crisis continuum after the implementation of 988. The report also identifies efforts of states to work with 911 call centers to identify and refer behavioral health crisis calls to Lifeline and other behavioral health call centers.
Tagged: 05. Behavioral Health Call Centers, 988 and 911
Description: This report highlights the experiences of SMHAs during the Spring/Summer of 2020 in addressing the impact of COVID-19 on public mental health services. The report details the impacts of COVID on state psychiatric hospitals and community mental health services, as well as the use of Telemedicine to help provide services remotely during the pandemic.
Tagged: 06. Impact of COVID 19
Description: Provision of Mental Health services and supports to Individuals with mental illness and criminal justice involvement are a major priority focus of State governments. States vary regarding which forensic responsibilities are vested in the State Mental Health Agency and the extent to which services are provided in state psychiatric hospitals and community settings.
Tagged: 07. SMHA Responsibilities for Forensic MH
Description: Providing Competency Restoration services to individuals found incompetent to stand trial are an increasing client population in many states. This report discusses locations states are conducting competency restoration and identifies states that are implementing community-based competency restoration services.
Tagged: 08. Competency Restoration
Description: Evaluation of Competency To Stand Trial for individuals awaiting trial are a growing population in many states. This report reviews different locations where states are conducting evaluations of competency to stand trial and experiences in moving evaluations to community or jail based settings.
Tagged: 09. Evaluation of Competency to Stand Trial
Description: This report address what types of initiatives states are supporting to divert individuals with mental illness out of the criminal justice system into mental health treatment. The report reviews use of Mental Health Courts, Pre-Booking Diversion programs and Post-Booking Diversion programs.
Tagged: 10. CJ Diversion Programs
Description: This report reviews how states are using standardized instruments to assess dangerousness (risk of violence) of individuals sent to the state for treatment. The report reviews which specific instruments states are using and how the states are applying the results of these instruments.
Tagged: 11. Measurement of Dangerousness
Description: Medicaid has become the largest single funding source in many states supporting SMHA systems. This report highlights the different ways Medicaid is being used to finance mental health services, including the use of Medicaid Managed Care or fee-for-service reimbursement approaches, the role of the SMHA in setting Medicaid Rates for mental health services, and SMHA initiatives to link specialty MH data with Medicaid claims data.
Tagged: 01. SMHA Organization and Structure, Financing SMHA Services
Description: SMHAs have been working to incorporate evidence-based practices (EBPs)--services that have been demonstrated by extensive research to provide positive results--into their community-based mental health service systems. This report focuses on the provision of 7 adult focused EBPs and 5 Child/Adolescent EBPs. The report reviews their level of implementation by states, measurement of fidelity to the EBP model, initiatives by states to support the adoption of EBPs, including partnering with universities and others to support EBP implementation.
Tagged: 01. SMHA Organization and Structure, Community MH Services, Financing SMHA Services
Description: A decent, safe, and affordable place to live is essential for anyone to achieve full participation in community life. This report addresses states with housing plans and/or housing coordinators working to assure a range of housing options and supports for adults with serious mental illnesses and children with serious emotional disturbances. The report identifies types of housing and housing supports available across states and state housing expert assessments of the adequacy of the supply of each housing type. The report discusses barriers to housing and methods states are using to finance housing and housing supports.
Tagged: 01. SMHA Organization and Structure, Community MH Services
Description: This report highlights State mental health agency (SMHA) controlled expenditures and funding sources in FY 2019 and trends in expenditures and funding from FY 2001 to FY 2019. The report details trends in overall SMHA expenditures as well as expenditures for community-based mental health services and state psychiatric hospital expenditures.
Tagged: 01. SMHA Organization and Structure, Financing SMHA Services
The State Profiles System (SPS) components were developed with guidance from an advisory group comprised of State Mental Health Agency (SMHA) Commissioners, Planners, and program staff, as well as staff from NASMHPD and NRI.
For additional information about the State Profiles Project, please contact: [email protected]