On April 21, the Kaiser Family Foundation released a brief offering an overview of the U.S. behavioral health system, outlining the sources of behavioral health financing, and discussing the relationships between payers.  Noting that Medicaid pays for 25 percent of all behavioral health expenditures, the brief focuses on Medicaid’s role in financing behavioral health services.  The brief claims that, although service utilization has increased, both insured and uninsured individuals continue to have unmet treatment needs.  The brief notes that over 60 percent of adults with a diagnosable mental health disorder do not obtain treatment while nearly 90 percent adults with a substance use or dependence disorder did not receive specialty treatment.  The brief concludes that policymakers must consider the behavioral health financing system when determining how to reform the national health care system.

From the report:

The behavioral health care system to provide mental health and substance abuse services in the United States is financed through multiple sources. These include states and counties, the federal-state Medicaid program, the federal Medicare program, private insurance coverage, patients’ out-of-pocket expenditures, and a host of smaller public and private programs. The various funding sources form a complex patchwork of programs, each with particular eligibility rules and benefits packages. The complexity of the system challenges policymakers’ ability to undertake reform in mental health policy. This primer provides an overview of behavioral health care, reviews the sources of financing for such care, assesses the interaction between different payers, and highlights recent policy debates in mental health.

Full report:  Mental Health Financing in the United States: A Primer (PDF | 2.41 MB)

Kaiser Family Foundation.  (2011).  Mental health financing in the United States: a primer.  Garfield, R.