A Connecticut bill under consideration in the Legislature would establish peer-run respite centers to help people with mental illness.
Senate Bill 370 would establish eight centers, with three specific facilities for transgender, Spanish, and BIPOC communities. Unlike inpatient hospitalization, the programs are voluntary and allow a person to come and go.
Jordan Fairchild, executive director of the group Keep the Promise CT, said hospitalization can disrupt a person's life.
"If someone calls 988 and said the wrong thing or if they say the wrong thing to a provider, they can end up having the police show up at their door, be taken to the hospital against their will, be thrown in a locked ward, possibly forced on medication," Fairchild outlined.
She has heard of transgender people who've been hospitalized had hormone replacement therapy taken away, were called by their dead names and had to sit in groups with people who harassed them.
The bill garnered universal support during a public hearing last month but opponents questioned how the state will pay for the program. For now, the bill has been referred to the Office of Legislative Research and the Office of Fiscal Analysis.
Mindy Wallen, a certified recovery support specialist, came to Connecticut from Texas after her child, who has been hospitalized more than 20 times, came out as nonbinary. Wallen said even though hospitalizations helped develop a tool kit for her son to work on his mental health, there are lingering issues peer-respite centers can better address.
"You still have times when you might be dealing with like a recurrence of treatment-resistant depression, or, you know, like that sort of thing where there needs to be a kind of a more supportive environment, and a place to go just to kind of regroup and reset," Wallen explained.
Currently, 15 states operate peer-run respite centers, which have proven beneficial for more than just patients. A report from Washington State's Health Care Authority finds the centers can decrease the need for inpatient psychiatric care. It also noted the centers have lower costs than other facilities and have reduced Medicaid expenses.
While support for the bill is high, funding remains a challenge. Building and staffing these costs a little more than $8 million, less than 1% of the state's budget.
Matthew Blinstrubas, executive director of Equality Connecticut, said it is contradictory for such programs to hinge on money.
"This is a, for all intents and purposes, a cost-reducing measure," Blinstrubas pointed out. "It does require resources to get up and running. And so, that's where the conversation is now and we will know in the coming weeks where we stand in terms of what resourcing peer-respites will look like."
The centers are shown to cost less than more coercive options. The median cost of an inpatient psychiatric stay in Connecticut is more than $40,000, while a stay at a peer-run respite center in nearby Massachusetts costs around $3,200.
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Virginia is bolstering mental health care during and beyond Mental Health Month.
Since the pandemic, the need for behavioral health services has grown considerably, especially among young people. Social media and pandemic-era isolation contributed to an ongoing youth mental health crisis.
Bruce Cruser, executive director of Mental Health Virginia, said a spillover effect of the pandemic is the reduced stigma around mental health.
"You have more people willing to talk about their mental illness or the fact that they're not feeling well," Cruser observed. "It's good that more people are open about it and more people are asking for help when they need it. I mean, that's a good thing. The bad thing is that there's so much need."
The state has made progress in funding mental health services. Virginia's new budget provides an almost $2.5 million increase in children's mental health funding to $15 million for 2025 and 2026, but many other funding pots have been reduced, redirected or eliminated.
While the state is broadening the services provided, barriers to accessing them remain. Beyond existing stigma in certain communities, Cruser pointed out there are many reasons people are unable to get the help they need.
"For some people it's cost, because they still might not have insurance or know about available insurance options," Cruser acknowledged. "But even with insurance, there can be high copays, etc. But another one is availability of the service."
The federal Health Resources and Services Administration designated all of Virginia under a mental health professional shortage. Other reports show the state has few areas where youth behavioral health services are close to sufficient.
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Georgia is taking on its mental-health care challenges head-on through new legislation.
One bill is aimed at increasing the number of providers in the state. Senate Bill 480 offers loan repayment assistance to mental-health care professionals who choose to work in underserved areas.
Rep. Sharon Cooper, R-Marietta, highlighted the state's access landscape, noting that of its 18 public health districts, 12 are located in rural areas. She said the goal is to ensure equitable access to mental-health services for all.
"Georgia is terribly short of psychiatrists, psychologists, social workers, marriage and family providers, all levels of people that deal with various aspects of mental illness," said Cooper.
According to the Rural Information hub, most of Georgia struggles with having enough mental-health providers. The data shows out of 159 counties, only six have no shortage, and two only have shortages in parts of the county.
Cooper elaborated on the multifaceted challenges Georgia faces in mental-health care, citing historical underinvestment and rapid population growth as contributing factors to the current shortage. She described the evolution of mental-health care policy in Georgia, including previous legislative efforts to promote parity between mental and physical health care.
"We are trying to make up for mistakes of the past and trying to do what's right for mentally ill people and to put their illness on parity with anybody that would have a gallbladder or heart disease," Cooper added.
Cooper pointed out that in this past legislative session, 19 bills were signed to help increase the state's ability to care for mental- and behavioral-health needs. Other legislation includes SB 373, which helps provide expedited licenses to marriage and family therapists.
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New York's 2025 budget improves access to mental-health services.
Budget legislation stipulates commercial insurers have to pay rates similar to Medicaid for in- and-out-of-network behavioral health services.
While many New York adults can access care, younger people can't because of insurance coverage.
Matthew Shapiro - senior director of government affairs for the National Alliance on Mental Illness-New York State - said people are glad this broadens access to often limited mental health services.
"We hear from people all the time that they can't access care, they can't find a psychiatrist, they can't find a social worker, they can't find someone who'll prescribe medication," said Shapiro. "It can be very, very difficult, especially in parts of Upstate New York where these services just aren't readily available."
Some insurance companies pushed back, saying it would raise customers' rates. Shapiro noted that this will hopefully resolve long-standing issues in obtaining mental-health care.
A state Attorney General's office report finds 86% of the listed, in-network mental-health providers were either unreachable, not in-network, or not accepting new patients.
The budget allocates millions of dollars to other programs that establish new inpatient psychiatric beds statewide, and increase mental health support for first responders.
But, Shapiro noted that other insurance companies' barriers prevent New Yorkers from getting the best mental-health care they can.
"It's so important those people get the medications their doctor believes are best for them, and their individual set of symptoms as quickly as possible," said Shapiro. "So, eliminating things like fail-first procedures and what they call step-up procedures."
He added that these policies can significantly set back a person's recovery.
A 2024 survey finds 1 in 5 adults required to fail first had to visit the emergency room or be admitted to a hospital as a result of the policy.
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