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Fiscal Focus: Mental Health

Each Fiscal Focus will look at our vision for key areas of public investment in Ohio and provide insight into current budgetary trends for that sector. All Ohioans are impacted by our elected officials’ budget decisions. In 2013, a new two-year state budget will be crafted – this series will provide a comprehensive overview of the major questions and concerns for Ohio’s 2014-15 biennial budget.


Why the Public Should Invest We should not allow any members of our community to go without the treatment and assistance they need. 1 in 17 Americans live with a severe mental health issue. Un-treated severe mental illness, like schizophrenia, increases the likelihood of homelessness, family dysfunction, inability to maintain stable employment, and other barriers to stability and security. Nationally, untreated mental illness costs more than $100 billion annually. And more important than the money is the human suffering of an individual and their family.

The Current Reality The Ohio Department of Mental Health (ODMH) administers the majority of public support of mental health services in Ohio.  In 2010, ODMH directly served 360,000 people through the public mental health system.  Ohio has six regional psychiatric hospitals, but the majority of state services are administered through 50 county level boards that contract with over 400 local agencies to provide diverse services.  Other agencies, like Ohio Department of Alcohol and Drug Addiction Services (ODADAS), have cross over and provide related mental health services.

In 2009, ODMH had a budget of $511.9 million and in 2012; ODMH’s budget is $485 million.  That is more than $26 million less in services that can be provided (not even accounting for inflation).  These funds are spent through the state hospital system and at least a quarter of all of these General Revenue Fund (GRF) dollars are sent to the local level for local boards and their community partners. ODADAS has an additional $60 million budget from the state which comes primarily from the GRF.

The 2014-15 Budget The most crucial issue for mental health funding will be the amount of money available in the GRF.  We need to recognize that flat level funding at $485 million is unacceptable. The Governor asked state agencies to prepare two budgets.  The first will be with flat level funding and the second is at a 90% level.  As a result of normal economic inflation, flat level funding is a cut in services available in our communities.  A 90% budget would be especially severe, especially on top of the reductions already seen in recent years.  In 2009, programs were funded at higher levels than they are under either of these plans.

The 50 local boards in Ohio are funded through federal, state, and local revenues.  One upcoming budget issue that will have a direct impact on our mental health services will be Medicaid expansion.  Ohio policymakers have a choice on whether they want to accept a federal expansion of Medicaid or not.  It is important to remember that fewer people covered under Medicaid will mean fewer people that can receive mental health services in our communities.

A second issue that may be contentious in the next budget debate is the planned merger of ODADAS with ODMH.  While the two agencies collaborate on many projects, mergers of agencies can be difficult and program elements can easily be lost in the move. If the state goes through with the merger, they must be cautious to enhance the quality of service.  The reduction of administrative agencies in Columbus cannot translate into a reduction of social workers, service providers and dedicated individuals throughout the state that provide essential services.

Speak Up! If you would like to get involved as the state budget nears and our advocacy increases, please follow us on Facebook, Twitter, or sign up for our emails. Please read our past Fiscal Focus articles on K-12 education, state parks, or privatization.

If you’re interested in additional information on state parks in the state budget or have any other related question, please contact us.

#FiscalFocus #MentalHealth

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