New NRI State Profiles report: State Mental Health Agency Organization and Reorganization

State Mental Health Agencies (SMHAs) are responsible for administering over $51 billion dollars each year to provide mental health services to more than 8 million individuals. SMHAs vary widely regarding how they are organized within state governments and how they organize the delivery of mental health services within each state.

State Mental Health Agencies (SMHAs) are most often administratively located within a larger umbrella human services agency. In 2023, 19 SMHAs were located within state Departments of Human Services or Departments of Social Services, six SMHAs were in Health Departments, three were located in the Medicaid Authority, five were in a Department of Health and Human Services, and four SMHAs were located in some other state department. Fourteen SMHAs were either independent state Departments of Mental Health, Department of Behavioral Health (combining mental health and substance use services) or Departments of Behavioral Health and Intellectual Disability.

In addition to mental health services, the SMHA is often responsible for providing other disability services. In 39 states, responsibility for both mental health (MH) and substance use services (SUD) are combined into a single agency. 

Profiles reports are available at: www.nri-inc.org/profiles. State Mental Health Agency staff have access to detailed accompanying materials through the NRI’s State Profiles restricted access website. Please contact NRI at [email protected] with any questions or comments.