Mental Health: Community-Based Care Increases for People with Serious Mental Illness
Because of your long-standing concern with the availability and financing of mental health services, you asked us to review mental health services for people with SMI. Specifically, you asked us to (1) provide information on mental health spending and how it has changed since the 1980s; (2) identify the types of community-based services that are provided to adults with SMI, including people who are homeless, and difficulties in providing these services; and (3) determine how the Health Care Financing Administration (HCFA), which administers the Medicaid program, supports the provision of community-based services for adults with SMI who are eligible for Medicaid.
To answer these questions, we interviewed and obtained documents from officials at the Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA), HCFA, and the National Institute of Mental Health (NIMH). We also visited state mental health and Medicaid officials and service providers in Michigan and New Hampshire, states that have been identified as operating exemplary community-based programs. In addition, we reviewed documents from the National Association of State Mental Health Program Directors (NASMHPD). Finally, we interviewed officials from several organizations concerned with mental health issues as well as individual experts on mental health. We conducted our work between May and November 2000 in accordance with generally accepted government auditing standards. (GAO)
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