A new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows the importance of public funding for mental health services and substance abuse during difficult economic times, when it helps those who might otherwise be unable to afford the help they need.
The National Expenditures for Mental Health Services and Substance Abuse Treatment, 1986-2009 shows that the annual growth rate for overall spending for the treatment of mental illness and substance use disorders was 6.1 percent from 2004-2007, before the recession. From 2007-2009, during the recession, that growth rate fell to 4.3 percent. This 1.8 percentage point decrease was driven primarily by broader spending changes on all health care by private insurance and in state and local spending (including the state share of Medicaid) during the recession. In the midst of this decrease, an increased federal Medicaid match helped reduce state costs, which allowed State funds to support behavioral health programs during the recession that otherwise might have faced budget cuts.
The report shows that public spending is critically important for the funding of mental health and substance abuse treatment services, especially compared to the role of public payers in all-health spending. In particular, the report shows that public spending (including the SAMHSA Substance Abuse Block Grant) accounted for 69 percent ($17 billion) of substance abuse treatment spending compared to the 49 percent ($1,141 billion) public spending share of all-health spending in 2009. For mental health treatment, the report shows that public spending (including the SAMHSA Mental Health Block Grant) accounted for 60 percent ($88 billion) of mental health spending compared to the 49 percent ($1,141 billion) public spending share of all-health spending in 2009.
In 2009 the nation spent a total of $172 billion on the treatment of mental illnesses and substance use disorders. Of this spending $147 billion was spent for mental health treatment and $24 billion was spent on treating substance use disorders. The report also provides a comprehensive breakdown on how much of this spending comes from private, federal, state and other sources. For example, 66 percent of mental health treatment and 42 percent of substance use disorder treatment spending in 2009 came from Medicare, Medicaid, and private insurance.
Data for the report comes from several public and private data sets. Actuarial methods modeled on those used by the Centers for Medicare and Medicaid Services Office of the Actuary in the development of the National Health Expenditure Accountswere used to estimate spending for treatment of mental illness and substance use disorders.
- The full National Expenditures for Mental Health Services and Substance Abuse Treatment, 1986-2009 report, is available free of charge at http://store.samhsa.gov/product/SMA13-4740.
- In addition, the data from the report is available in an article published in the May, 2013 edition of Health Affairs.