Which States are Naughty or Nice to Mentally Ill?

• Maine, Pennsylvania and Arizona are the most generous states.
• Arkansas, West Virginia, Idaho, Kentucky, Oklahoma, Louisiana and Delaware are the stingiest states.

Governors and legislators regularly claim, “we have to do more for the mentally ill.” But how much are they actually doing and how does one state compare to another? Using a novel metric, a new study from Mental Illness Policy Org, Funds for Mental Illness: Is Your State Generous or Stingy, determined that the most generous states in terms of allocating spending to mental health are Maine, Pennsylvania and Arizona. The stingiest states are Arkansas, West Virginia, Idaho, Kentucky, Oklahoma, Louisiana and Delaware. The most generous states, Maine and Pennsylvania (5.6%), allocate eight times more as a percentage of total state spending than the stingiest state, Arkansas (.7%).

Historically, advocates compared states commitment to the mentally ill by ranking them based on a state’s total expenditure for mental health programs. But this measure is not fair to poorer states since the income of the wealthiest states—Maryland, New Jersey, and California—is about twice as high as that of the poorest states—Mississippi, West Virginia, and Arkansas. Funds for Mental Illness ranks states based on the percentage of total state government expenditures that is allocated for mental health programs. Governors and state legislature make decisions regarding how much of the budget should go to mental health programs, and how much to education, corrections, roads and bridges, and other state projects. The percentage of the total budget allocated to mental health programs in a state is thus a fairer measure of the importance legislators and governors place on mental illness.

Put another way, this ranking determines which states have been "naughty or nice" to the mentally ill.

Equally important as the percentage of funds allocated to mental health services is whether the states allocate the funds effectively. As revealed in Insane Consequences: How the Mental Health Industry Fails the Mentally Ill by one the study’s authors, no state spends its funds effectively. New York and California are particularly problematic. Each allocates a respectable proportion of their budgets to mental health, but a high portion does not reach the seriously ill.

The authors recommend that states allocate more to mental illness and spend their funds on programs that reduce homelessness, arrest, incarceration, needless hospitalization and violence in people with serious mental illness rather than programs that do not improve those metrics.

Funds for Mental Illness: Is Your State Generous or Stingy is available at https://mentalillnesspolicy.org/national-studies/funds-for-mental-illness-is-your-state-generous-or-stingy-report-pdf.html. It was researched by DJ Jaffe and Dr. E. Fuller Torrey. DJ Jaffe is author of Insane Consequences: How the Mental Health Industry Fails the Mentally Ill (Prometheus Books, 2017) and executive director of Mental Illness Policy Org (mentalillnesspolicy.org). Dr. E. Fuller Torrey is founder of the Treatment Advocacy Center (treatmentadvocacycenter.org) and Stanley Medical Research Institute.