2014 State Profiles
State behavioral health agencies (SBHAs) are the nation’s safety net in ensuring the delivery of evidence-based, high-quality services for individuals with mental and substance use disorders (M/SUDs). SBHAs include state mental health agencies (SMHAs) and single state agencies (SSAs) for substance abuse services. These agencies focus on the provision of M/SUD services for individuals who lack insurance or for those whose insurance will not pay for needed services. Annually, SBHAs expend over $45 billion providing services and supports to over 10 million individuals. The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead federal agency within the U.S. Department of Health and Human Services (HHS) that is responsible for working with SBHAs. SAMHSA ensures that quality services are available to individuals who need them and helps SBHAs adapt to the changing health care environment. SAMHSA awards two types of Block Grants, the Substance Abuse Prevention and Treatment Block Grant (SABG) and the Community Mental Health Services Block Grants (MHBG) (See http://www.samhsa.gov/grants/block-grants). States and Territories must apply for block grant funding. In the past 2 years, two landmark federal laws have greatly affected the delivery of SBHA services. The mandates of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) require issuers of commercial insurance and Medicaid managed care plans to bring existing restrictions on M/SUD services offered through their plans to a level of parity with existing restrictions on physical health care. The Affordable Care Act expands the parity protections of MHPAEA and extends insurance coverage to millions of individuals through expansions of Medicaid, the government subsidization of insurance purchased through Marketplace Exchanges, and other insurance reforms.