A U.S. Department of Justice investigation has found Kentucky is failing to provide access to community-based mental health services for people who need them, and instead relies too heavily on psychiatric hospitals.

The report says the state is potentially in violation of the Americans with Disabilities Act, or ADA.

Licensed Psychologist Sheila Shuster, who is part of the Advocacy Action Network, said years of budget cuts have reduced or eliminated the city's crisis centers - such as the Living Room, which opened its doors in 2018 and was shut down within a year due to lack of funding.

"Three to four hundred people a month coming in and using the services, and getting referrals," said Shuster. "And then boom, it's gone. So, that was May of 2019, and we don't have anything like it back in place."

The University of Louisville Hospital provides emergency psychiatric treatment to more than 2,200 adults with serious mental illness each year.

In a separate investigation last year, the Justice Department concluded the city and the Louisville Metro Police Department violated the ADA by subjecting people with mental illness to an unnecessary police response.

While the new report raises awareness about the needs of people living with mental illness, Shuster said it doesn't capture the full picture.

She cited recent changes the city has made, such its 911 call diversion program for mental health-related incidents, as well as families' view of the role of hospitalization.

"By and large, what I hear from the family members is not that their loved ones are being kept too long in the hospital, but that they're not being kept long enough," said Shuster, "which I think is what is leading to the revolving door."

Marcie Timmerman, executive director at Mental Health America of Kentucky, said the focus should be on early intervention and treatment, so folks don't end up being involved with the police.

"We would love to have more providers available," said Timmerman. "I'm not sure that pinpointing our psychiatric hospitals is really helpful."

She added that a mobile crisis response system, and Medicaid-funded housing and support programs, could help reduce the number of people who continue to cycle through hospitalization and the criminal legal system.





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Researchers at the University of Michigan have found that Black students attending Historically Black Colleges and Universities and Predominantly Black Institutions experience better mental-health outcomes compared with their peers at other institutions, but challenges remain.

The university's "Healthy Minds Network" surveyed college mental health, in partnership with UCLA, Wayne State and Boston University.

Akilah Patterson, a doctoral candidate at the University of Michigan's School of Public Health, led the research and said the study involved 16 HBCUs and two PBIs, with more than 2,500 students participating.

"About 45% of them are flourishing mentally," she said. "Most notably, we saw that 83% of HBCU and PBI students reported having a sense of belonging in their campus community, compared to about 73% nationally."

However, the data also reveals significant challenges. More than half of the students report that their financial situation is "always" or "often" stressful, and 78% of those facing financial hardships are also dealing with mental-health issues.

In light of these challenges, the study recommends that colleges and universities address unmet mental-health needs, alleviate financial stress, expand on-campus mental-health resources and strengthen student-faculty connections.

Patterson said she hopes the report also underscores the importance of fostering a strong sense of belonging on campus and the crucial role HBCUs play in students' lives.

"HBCUs have a very long tradition of being centers of excellence and academic achievement," she said, "but this work also highlights that there are some mental-health challenges that do need to be addressed on those campuses so students can very much thrive academically."

As of 2023, HBCUs enrolled approximately 293,000 students. While originally established to serve Black students, as of 2015, non-Black students constitute about 22% of enrollment, up from 15% in 1976.


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Diagnoses of mental health conditions in children and teens are on the rise, including in Indiana. But getting kids the help they need can be a challenge.

About one-third of Indiana high school students reported "experiencing poor mental health, most of the time" in a 2023 survey.

But Jeff Reiter - a psychologist with Whole Team, a group that provides technical assistance to primary care clinics - said many parents have trouble accessing both medication and talk therapy for their kids.

He said he thinks what is most needed is more support for primary care providers - which is where mental health problems often are first identified.

"So they're getting those medications from a primary care provider," said Reiter, "a pediatrician, a family medicine, family doctor or something like that. And these are providers who don't have a lot of time in their visits, maybe 15 minutes. They're not specialists - they don't get a ton of training in how to work with psychiatric issues in kids."

Reiter advocated for placing mental health professionals in primary care clinics, to make them more easily accessible to patients and their parents.

He said he also supports what's known as parent management training as a non-medication option for youth with mental health concerns.

Advancements in mental health treatment programs and medications have been helpful. However, these services can be out of reach for a patient with limited or no insurance coverage.

Reiter said he agrees the traditional psychotherapy treatment model can be costly - a factor he said he sees as part of the access problem. But he maintained there's a more relevant issue.

"The point is, there are much more flexible and accessible ways that mental health professionals can practice," said Reiter, "and that's really what we need to be encouraging if we're going to have any chance of reaching more kids."

A study published in 2023 found in Indiana, in one recent year, untreated mental illness was associated with more than $4 billion a year in costs to society.





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Nebraska mental health professionals worry the Trump administration's proposed $880 billion in Medicaid funding cuts would threaten progress the state has made in providing help to those who need it.

The reductions could have a dramatic impact on the 345,000 Nebraskans who rely on Medicaid as their only source of health insurance.

Aileen Brady, president and CEO of Omaha-based Community Alliance, said Nebraska has had recent success in getting higher Medicaid reimbursement rates for providers, and has expanded services.

She added that cuts would hurt people who need help the most - those struggling with mental health problems, people with disabilities, and kids.

"Nearly half of Medicaid enrollees in Nebraska are under the age of 20," said Brady, "and I think people need to understand that impact it'll have on our children in Nebraska - and that means our future in Nebraska."

A recent survey by the Centers for Disease Control and Prevention says at least 50% of American adults will need treatment for a mental health issue during their lifetime.

Brady said such steep cuts at the federal level would require dramatic cuts in services to Nebraskans, especially when considering the degree to which the state relies on the federal money.

"Fifty-eight percent of every dollar is a federal dollar, 42% of those dollars are state dollars," said Brady. "If those cuts would come into play, that $880 billion over a period of time, that's going to create a fundamental shift in how services are delivered - the shift of cost to the states - or it's going to result in a significant cut."

The Trump administration is following through on a campaign promise to cut federal spending across the board.