Senate Passes Cantwell-Backed Legislation to Improve Community Mental Health Services

Bipartisan Excellence in Mental Health Act to strengthen community mental health systems


WASHINGTON, D.C. – Today, U.S. Senator Maria Cantwell (D-WA) applauded Senate passage of legislation she cosponsored that will support better community-based care to improve the lives of Americans who struggle with mental illness.

The U.S. Senate passed a demonstration project of the Excellence in Mental Health Act, originally introduced by Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO) and U.S. Representatives Doris Matsui (D-CA) and Leonard Lance (R-NJ) in the House of Representatives.  Cantwell cosponsored the Excellence in Mental Health Act, which creates a pilot program to strengthen community mental health systems by establishing higher standards of care and better coordination between providers. 

The bill was included as a demonstration project in the Protecting Access to Medicare Act of 2014, which the Senate approved today by a vote of 64-35. The House of Representatives passed the legislation last week, and it now heads to President Obama for his signature.

“Today, we took an important step towards improving the lives of millions of Americans who deal with mental illness,” Cantwell said in a speech on the Senate floor. “This legislation improves access to community health centers and leads to better quality of care. And most importantly, it will help save lives.”

Video of Cantwell’s speech is available here.

“In Washington state, 55 percent of those with mental illness are not getting treatment.  And when they reach a crisis point, it’s not just a burden on them and their families, but on our communities, our hospitals and our criminal justice system,” Cantwell continued.  “This important legislation will allow us to be smarter about community-based care that will keep people out of our emergency rooms and jails, and stop them from becoming the mental health clinics of last resort.”

There is currently no national standard for mental health services in community health facilities.

The Excellence in Mental Health Act’s demonstration creates an eight-state, two-year pilot program.  Participating states will certify that community behavioral health clinics meet a higher standard and deliver a wider range of services.  Some of these services are:

  • 24 hour crisis management.
  • Screening assessments and diagnosis services.
  • Outpatient mental health and substance-abuse services.
  • Outpatient primary care screenings to monitor the indicators of health conditions.
  • Peer support and counseling.

In exchange, participating states will receive enhanced Medicaid reimbursements that are equal to what Federally Qualified Health Centers (FQHCs) currently receive for primary care services.

Community mental health treatment centers are struggling to meet demand as states continue to work to balance their budgets.  According to the National Alliance on Mental Illness, states have cut more than $1.6 billion in their general mental health funds since fiscal year 2009.

Nationally, more than half of all those with serious mental disorders don’t get the treatment they need to lead productive, healthy lives. In Washington state, more than 500,000 people are not getting the help they need, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Unfortunately, individuals with serious mental disorders who can’t get help are increasingly being treated in emergency rooms or jails. This leads to higher costs for local governments and local health systems.  Washington state, which has one of the nation’s lowest per capita rates of in-patient psychiatric beds, has seen a dramatic rise in psychiatric “boarding” or “warehousing.”  Boarding happens when involuntarily committed patients must wait for hours or days in hospital emergency rooms because psychiatric facilities have no open beds.

Recent investigations by The Seattle Times and The News Tribune in Tacoma found that boarding has become routine in Washington state. Boarding costs the Washington state health system $10.5 million per year, according to the state.

More than 50 mental health, medical, and law enforcement groups support the legislation. They include: the National Sheriffs Association; the National Association of Police Organization; the American Psychological Association; the American Medical Association; and the American Federation for Suicide Prevention.