Enhance Counties' Ability to Prevent and Treat Mental Illness and Substance Use Disorders
-
Policy BriefUrge your members of Congress to maintain consistent funding for substance use and mental health services provided through the Substance Abuse and Mental Health Services Administration (SAMHSA) and pass legislation that enhances counties’ ability to provide local systems of care. Future appropriations bills should meet or exceed FY 2022 funding levels, particularly for the Community Mental Health Services (MHBG) and Substance Abuse Prevention and Treatment (SAPT) block grants, which allow counties to direct resources to those with the most need.Enhance Counties' Ability to Prevent and Treat Mental Illness and Substance Use Disorders
-
Document
Enhance Counties' Ability to Prevent and Treat Mental Illness and Substance Use Disorders
ACTION NEEDED:
Urge your members of Congress to maintain consistent funding for substance use and mental health services provided through the Substance Abuse and Mental Health Services Administration (SAMHSA) and pass legislation that enhances counties’ ability to provide local systems of care. Future appropriations bills should meet or exceed FY 2022 funding levels, particularly for the Community Mental Health Services (MHBG) and Substance Abuse Prevention and Treatment (SAPT) block grants, which allow counties to direct resources to those with the most need.
BACKGROUND:
America’s 3,069 counties are integral to the nation’s behavioral health system. Counties annually invest more than $80 billion in community health systems, including behavioral health services, and county-based behavioral health services exist in 23 states that represent 75 percent of the U.S. population. Through 750 behavioral health authorities and community providers, county governments plan and operate community-based services for persons with mental illnesses and substance use conditions. Counties also help finance Medicaid, the largest source of funding for behavioral health services in the U.S., and serve as the local safety net, administering wrap-around human services supports.
SAMHSA, an agency of the U.S. Department of Health and Human Services (HHS), administers programs such as the Community Mental Health Services (MHBG) and Substance Abuse Prevention and Treatment (SAPT) block grants, which help counties provide direct behavioral services to those individuals in most need. Such services improve community well-being, reduce counties’ health care and justice system costs and provide savings to local taxpayers.
Mental and behavioral health disorders remain prevalent and largely untreated. One in five adults in the U.S. experience a mental health condition, with less than half receiving treatment. One in twenty experience a serious mental illness, with only two-thirds receiving treatment. In 2020, over 40 million Americans (15 percent) reported having a substance use disorder, with only 10 percent of people receiving treatment, and only 6% of those needing both mental health and substance use disorder treatment received both services.. As of 2021, nearly 37 percent of the U.S. population, or 122 million American lived in areas experiencing mental health professional shortages, with approximately two-thirds of these shortages in rural or partially rural areas.
The combined total of FY 2023 appropriations amounts to $385 million for the Certified Community Behavioral Health Centers (CCBHCs) program (a $70 million increase over FY 2022), $2 billion in SAPT funding (an increase of $100 million over FY 2022) and $1.01 billion in MHBG funding (an increase of $150 million over FY 2022).
KEY TALKING POINTS:
-
Congress should meet or exceed FY 2023 appropriation and supplemental levels for the Community and Mental Health Services (MHBG) Block Grant in future appropriations. The MHBG is the principal federal discretionary program supporting community-based mental health services for adults and children. Counties may use block grant dollars to provide a range of services for adults and children with serious mental illnesses, including employment and housing assistance, case management (including Assertive Community Treatment), school-based support services, family and parenting education and peer support. The MHBG received a total of $1.01 billion in the FY 2023 appropriations bill passed by Congress in December 2022 and 250 million in supplemental funding in June 2022 through the Bipartisan Safer Communities Act.
-
Congress should meet or exceed FY 2023 appropriation and supplemental levels for the Substance Abuse Prevention and Treatment (SAPT) Block Grant in future appropriations. County behavioral health authorities use the SAPT block grant to serve vulnerable, low-income populations, such as those with HIV/AIDS, pregnant and parenting women, youth and others by ensuring access to substance use disorder services. An independent 2009 study of the SAPT block grant found that the program produces positive outcomes, including increased abstinence from alcohol and other drugs, increased employment and decreased criminal justice involvement. SAPT received $2 billion in the FY 2023 appropriations bill enacted by Congress in December 2022.
Urge your members of Congress to maintain consistent funding for substance use and mental health services provided through the Substance Abuse and Mental Health Services Administration (SAMHSA) and pass legislation that enhances counties’ ability to provide local systems of care. Future appropriations bills should meet or exceed FY 2022 funding levels, particularly for the Community Mental Health Services (MHBG) and Substance Abuse Prevention and Treatment (SAPT) block grants, which allow counties to direct resources to those with the most need.2023-02-01Policy Brief2023-02-01 -
ACTION NEEDED:
Urge your members of Congress to maintain consistent funding for substance use and mental health services provided through the Substance Abuse and Mental Health Services Administration (SAMHSA) and pass legislation that enhances counties’ ability to provide local systems of care. Future appropriations bills should meet or exceed FY 2022 funding levels, particularly for the Community Mental Health Services (MHBG) and Substance Abuse Prevention and Treatment (SAPT) block grants, which allow counties to direct resources to those with the most need.
BACKGROUND:
America’s 3,069 counties are integral to the nation’s behavioral health system. Counties annually invest more than $80 billion in community health systems, including behavioral health services, and county-based behavioral health services exist in 23 states that represent 75 percent of the U.S. population. Through 750 behavioral health authorities and community providers, county governments plan and operate community-based services for persons with mental illnesses and substance use conditions. Counties also help finance Medicaid, the largest source of funding for behavioral health services in the U.S., and serve as the local safety net, administering wrap-around human services supports.
SAMHSA, an agency of the U.S. Department of Health and Human Services (HHS), administers programs such as the Community Mental Health Services (MHBG) and Substance Abuse Prevention and Treatment (SAPT) block grants, which help counties provide direct behavioral services to those individuals in most need. Such services improve community well-being, reduce counties’ health care and justice system costs and provide savings to local taxpayers.
Mental and behavioral health disorders remain prevalent and largely untreated. One in five adults in the U.S. experience a mental health condition, with less than half receiving treatment. One in twenty experience a serious mental illness, with only two-thirds receiving treatment. In 2020, over 40 million Americans (15 percent) reported having a substance use disorder, with only 10 percent of people receiving treatment, and only 6% of those needing both mental health and substance use disorder treatment received both services.. As of 2021, nearly 37 percent of the U.S. population, or 122 million American lived in areas experiencing mental health professional shortages, with approximately two-thirds of these shortages in rural or partially rural areas.
The combined total of FY 2023 appropriations amounts to $385 million for the Certified Community Behavioral Health Centers (CCBHCs) program (a $70 million increase over FY 2022), $2 billion in SAPT funding (an increase of $100 million over FY 2022) and $1.01 billion in MHBG funding (an increase of $150 million over FY 2022).
KEY TALKING POINTS:
-
Congress should meet or exceed FY 2023 appropriation and supplemental levels for the Community and Mental Health Services (MHBG) Block Grant in future appropriations. The MHBG is the principal federal discretionary program supporting community-based mental health services for adults and children. Counties may use block grant dollars to provide a range of services for adults and children with serious mental illnesses, including employment and housing assistance, case management (including Assertive Community Treatment), school-based support services, family and parenting education and peer support. The MHBG received a total of $1.01 billion in the FY 2023 appropriations bill passed by Congress in December 2022 and 250 million in supplemental funding in June 2022 through the Bipartisan Safer Communities Act.
-
Congress should meet or exceed FY 2023 appropriation and supplemental levels for the Substance Abuse Prevention and Treatment (SAPT) Block Grant in future appropriations. County behavioral health authorities use the SAPT block grant to serve vulnerable, low-income populations, such as those with HIV/AIDS, pregnant and parenting women, youth and others by ensuring access to substance use disorder services. An independent 2009 study of the SAPT block grant found that the program produces positive outcomes, including increased abstinence from alcohol and other drugs, increased employment and decreased criminal justice involvement. SAPT received $2 billion in the FY 2023 appropriations bill enacted by Congress in December 2022.

About Blaire Bryant (Full Bio)
Legislative Director – Health | Large Urban County Caucus
More from Blaire Bryant
-
Blog
HHS awards CCBHC planning grants to 15 states to help address ongoing mental health crisis
On March 16, the U.S. Department of Health and Human Services, through the Substance Abuse and Mental Health Services Administration, awarded 15 states with a one-year planning grant to assist with establishing a Certified Community Behavioral Health Clinic. -
County News
Maryland rural health program aims to prevent teen pregnancies, STIs
“True You Maryland” aims to reduce rural Maryland county teen birth rates by 15 percent, STI rates by 10 percent and racial disparities in teen birth and STI rates by 20 percent through educational partnerships with county health departments. -
Reports & Toolkits
Mental Health Awareness Month: County Participation Toolkit
This May, we invite the nation’s 3,069 counties, parishes and boroughs to participate in Mental Health Awareness month. -
Blog
Senate HELP Committee seeks comments on pandemic and all-hazards preparedness
On March 15, Chairman Bernie Sanders (I-Vt.) and Ranking Member Bill Cassidy (R-La.) of the U.S. Senate Health, Education, Labor and Pensions Committee (HELP) released a request for information seeking input from public health officials, health care providers and other stakeholders on policies the Committee should consider during the reauthorization of the Pandemic and All-Hazards Preparedness Act. -
Blog
NACo submits comments to Senate HELP Committee on health care workforce shortages
On March 2, the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) Committee released a request for information from health care stakeholders on the causes of and solutions for current health care workforce shortages. -
Blog
Webinar Recap: County Strategies to Recruit and Retain a Strong Behavioral Health Workforce
For county governments, a strong and fully staffed behavioral health workforce is key to supporting people living with behavioral health conditions. Like other sectors, county governments are experiencing a shortage in local behavioral health workforce.
-
Webinar
County Leaders Championing Justice Efforts in Local Communities
April 5, 2023 , 2:00 pm – 3:00 pmCounties are directing resources to programs, practices and policies to reduce the overuse and misuse of the criminal legal system, improve public safety, better serve residents with behavioral health conditions and improve community stability and health.04052:00 pm<p>Counties are directing resources to programs, practices and policies to reduce the overuse and misuse of the criminal legal system, improve public safety, better serve residents with behavioral health conditions and improve communit
-
Webinar
Reducing Jail Populations: Lowering Recidivism through Jail- and Community-Based Treatment and Services
April 6, 2023 , 2:00 pm – 3:00 pmReducing recidivism through effective jail- and community-based services can decrease jail admissions and populations and improve outcomes for people with criminal histories.04062:00 pm<p>Reducing recidivism through effective jail- and community-based services can decrease jail admissions and populations and improve outcomes for people with criminal histories.</p>
-
Webinar
Strategies for Leveraging County Health Rankings Data to Improve Community Health
April 19, 2023 , 2:00 pm – 3:00 pmCounties play a key role in public health at the local level, as the conveners of multi-sector stakeholders, administrators of federal health-funding programs, like Medicaid, and providers of many crucial health services for residents.04192:00 pm<p>Counties play a key role in public health at the local level, as the conveners of multi-sector stakeholders, administrators of federal health-funding programs, like Medicaid, and providers of many crucial health services for residen
-
Basic page
The Stepping Up Initiative
In May 2015, NACo and partners at the CSG Justice Center and APA Foundation launched Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails.pagepagepage<table border="1" cellpadding="1" cellspacing="1" style="width:100%" summary="call-out">
<tbody>
<tr>
<td> -
Reports & Toolkits
COVID-19 Recovery Clearinghouse
The COVID-19 Recovery Clearinghouse features timely resources for counties, including allocation estimations, examples of county programs using federal coronavirus relief funds, the latest news and more.Reports & Toolkitsdocument03127:15 pmReports & Toolkits<table border="1" cellpadding="1" cellspacing="1" style="width:100%" summary="ad-block no-top-margin no-bullets">
<caption>Jump to Section</caption> -
Basic page
Live Healthy U.S. Counties
The National Association of Counties (NACo) Live Healthy Prescription, Health & Dental Discount Program is a NO-COST program available to all member counties.pagepagepage<h1>With <a id="naco" name="naco">NACo</a>, Saving Feels Better</h1>
-
Reports & Toolkits
Opioid Solutions Center
NACo’s Opioid Solutions Center empowers local leaders to invest resources in effective treatment, recovery, prevention and harm reduction practices that save lives and address the underlying causes of substance use disorder.Reports & Toolkitsdocument10123:30 pmReports & Toolkits<p>NACo's Opioid Solutions Center empowers local leaders to invest resources in effective treatment, recovery, prevention and harm reduction practices that save lives and address the underlying causes of substance use disorder.
Contact
-
Legislative Director – Health | Large Urban County Caucus(202) 942-4246
Related News
-
BlogHHS awards CCBHC planning grants to 15 states to help address ongoing mental health crisisMar. 29, 2023
-
County NewsMaryland rural health program aims to prevent teen pregnancies, STIsMar. 27, 2023
-
BlogNACo submits comments to Senate HELP Committee on health care workforce shortagesMar. 23, 2023
Related Resources
-
Reports & ToolkitsMental Health Awareness Month: County Participation ToolkitMar. 24, 2023
-
Reports & ToolkitsPlanning Principles ToolkitMar. 6, 2023
-
DocumentThe Principles Quick Guide to Conducting a Needs AssessmentFeb. 27, 2023
Related Events
-
5Apr2023Webinar
County Leaders Championing Justice Efforts in Local Communities
Apr. 5, 2023 , 2:00 pm – 3:00 pm -
6Apr2023Webinar
Reducing Jail Populations: Lowering Recidivism through Jail- and Community-Based Treatment and Services
Apr. 6, 2023 , 2:00 pm – 3:00 pm -
19Apr2023Webinar
Strategies for Leveraging County Health Rankings Data to Improve Community Health
Apr. 19, 2023 , 2:00 pm – 3:00 pm
Upcoming Events
-
5Apr2023Webinar
County Leaders Championing Justice Efforts in Local Communities
Apr. 5, 2023 , 2:00 pm – 3:00 pm -
6Apr2023Webinar
Reducing Jail Populations: Lowering Recidivism through Jail- and Community-Based Treatment and Services
Apr. 6, 2023 , 2:00 pm – 3:00 pm -
11Apr2023
More From
-
Opioid Solutions Center
NACo’s Opioid Solutions Center empowers local leaders to invest resources in effective treatment, recovery, prevention and harm reduction practices that save lives and address the underlying causes of substance use disorder.
Learn More