AUGUSTA, Maine -- With about three weeks left in the legislative session, mental-health advocates want lawmakers to increase the funding for essential MaineCare services in order to attract more badly needed staff.
Experts contended long waiting lists often mean families can't get counseling and end up in crisis.
Amy Cohan, vice president of outpatient and community services for Spurwink Services and a licensed clinical social worker, said at times there have been as many as 500 families waiting for in-home counseling, especially people who live away from the I-95 corridor.
"Insufficient rates make it really impossible for providers to travel to families' homes, particularly in rural parts of the state, in a financially sustainable way," Cohan explained.
Cohan noted during the pandemic, calls to hotlines, rates of anxiety and depression, suicidal thinking and suicides all rose sharply. In addition, opioid overdoses increased to record levels, reversing progress made in recent years.
Multiple bills, including Legislative Document 432 and Legislative Document 1173, which are intended to address the situation, are waiting to get a vote. Lawmakers need to finalize the budget before the session ends on June 16.
Opponents objected to the cost of raising providers' pay, but supporters countered it's crucial in order to attract more people to the social-services profession.
Rep. Colleen Madigan, D-Waterville, co-sponsored several bills to help alleviate some pressure.
"There needs to be more money put into put state now so that kids can stay at home," Madigan asserted. "They can be treated in their communities, and they can get the behavioral health care they need before they wind up in an emergency room or needing inpatient hospitalization or residential care."
Madigan pointed out many programs have been forced to cut services for lack of staff, leaving families no option but to send their children out of state to find a residential placement.
David McCluskey, executive director of Community Care, a nonprofit that treats people with mental illness, said the staff shortages translate into a broken system that causes real suffering for families.
"So there's people who are waiting to leave psychiatric hospitals because there's no place for them to step down to," McCluskey stressed. "And then there's also people waiting to get into hospitals. And so the system is sort of frozen."
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The growing crisis in Ohio's child welfare system is drawing attention, particularly for its impact on children's mental health.
Across the state, children with complex behavioral needs are struggling as placement options shrink and demand for specialized care reaches an all-time high.
Lindsay Sparks, protective services administrator for the South Central Ohio Job and Family Services, Children's Division & Adult Protective Services, noted that despite efforts with mental-health providers, many agencies lack the resources to handle severe cases.
"We have had a young child, under the age of 10, who we have about 45 denials across the state, they feel that they cannot meet that child's needs," she said. "Children have had to spend the night at our agency. That is not ideal for our children, for our staff, for anyone - but it has happened."
In some cases, Sparks added, agencies are forced to seek out-of-state placements - which can further complicate care for children already facing significant challenges. Recruitment efforts for foster families are ongoing, but the gap remains wide.
The crisis extends beyond placement shortages to escalating mental health concerns. Jody Walker, executive director of South Central Ohio Job and Family Services, highlighted how these issues have worsened over the past decade.
"The types of children that we're seeing coming into care, that have more severe behavioral mental health issues, and our system really hasn't been able to keep up with types of placements that benefit these kids the most," he said. "The cost for those placements went up, at the tune of 300% in the last 10 years."
As Ohio faces rising costs and limited resources, the County Commissioners Association has made child welfare a top priority in the upcoming biennial budget. The association is applauding Governor Mike DeWine's commitment to children, and stresses that counties play a vital role in protecting them.
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As mental health challenges continue to rise among young people, advocates across North Carolina are pushing for increased access to mental health services in schools.
They are watching the upcoming election for North Carolina Superintendent of Public Instruction closely.
Kathleen Daughety, vice president of campaigns and engagement for the mental health advocacy organization Inseparable, said the outcome could significantly help fill gaps in access to mental health services for children across the state.
"Increasing access to mental health care is our focus because half of people in the US who need mental health care are not getting it today," Daughety pointed out. "That number is even worse for children; 70% of children who need mental health care aren't able to access it."
A recent poll by Inseparable showed it is an issue resonating with voters. About 88% believe expanding mental health care access should be a top priority for elected officials.
Graham Palmer, director of systems innovation and policy for the nonprofit Rural Opportunity Institute, explained barriers like broadband and workforce shortages and limited funding make it difficult to provide the necessary services, especially in rural areas. He believes schools can make a life-changing difference for kids.
"Sometimes schools are the only access point that systems of care can get to for kids, because there's transportation challenges," Palmer explained. "There may be time challenges, if the student has a job or they just don't have extra time to be driving an hour to see a therapist."
The Superintendent of Public Instruction would play a key role in shaping school policies, funding, and resources directly affecting whether schools can provide mental health services. The Democratic candidate, Maurice "Mo" Green recently signed Inseparable's "Mental Health Now" statement of support. He worked as the superintendent of North Carolina's third-largest school district and pointed out addressing the workforce is going to be crucial to giving students the support they need.
"The school psychologist's major association would recommend a ratio of about one school psychologist," Green noted. "For every 500 students, in North Carolina that ratio is almost 1 to 1,800."
Green is facing off against Republican nominee Michelle Morrow, who is a nurse and homeschool educator in Wake County. Her campaign website shows she supports school choice and increasing school resource officers.
Advocates are also calling for state policymakers to invest in expanded school-based mental health programs and improve crisis response efforts.
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Mental health is a top issue for voters, and candidates running for office across Colorado are pledging to make it a priority if elected.
Kathleen Daughety, vice president of campaigns and civic engagement with Inseparable, said if people can get treatment, they can thrive. But if they can't, the situation can get much, much worse.
She pointed to a recent survey showing that half of all Americans who need mental health care aren't able to get it, and said one of the biggest barriers is that health insurance companies aren't doing their part.
"People are buying insurance policies expecting to get care when they need it. And then when they are sick, insurance companies are denying the care that their doctors are prescribing," she explained.
Nearly nine in ten voters say expanding access to mental health care should be a priority, ranking it just as high as lowering the cost of living. So far, 80 Colorado candidates have signed a Mental Health Now statement of support, more than any other state. The statement calls for policies that increase access to mental health care, improve crisis response, and expand youth mental health services, especially in schools.
Colorado is one of many states that lack facilities to place people experiencing severe mental illness. In 1955, there were nearly 6,000 psychiatric beds in the state. In 2023 the number dropped to 482.
Dusty Johnson, R-Fort Morgan, is running unopposed for House District 63 and signed the Mental Health Now statement of support.
"We shouldn't be using jail as a place to get mental health resources. But when you have nowhere to take them, they end up in our prisons, or back on the street, and then they go and hurt themselves worse, or hurt somebody else. It would be nice if we had places that would take them on the spot," Johnson said.
Since 2015, one out of five people killed by police were experiencing a mental health emergency. Daughety said the goal for politicians should be to make law enforcement involvement in crises the exception, not the rule.
"If someone is having a mental health emergency, they need a mental health specific response, they don't need a law enforcement response. Law enforcement says these calls are really stressful. They're not trained for them," Daughety contended.
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