NC lawmakers propose $1 billion investment in mental health

In North Carolina, one person dies by suicide about every six hours. Suicide is among the leading causes of death for those aged 10 to 34, and more than half of those with mental illness don’t receive treatment.

Those alarming statistics have led state lawmakers to propose a major investment in mental health care — a rare display of bipartisanship that could help address this growing crisis.

House Bill 855, titled “Strengthening Care for Families and Children,” would invest $1 billion in improvements to the state’s mental health system. The bill has wide bipartisan support, with nearly 50 Democrats and Republicans in the House signing on as co-sponsors.

Rep. Donny Lambeth, a Forsyth County Republican and the bill’s primary sponsor, said in a committee hearing Tuesday that this is a “once in a generation opportunity to strengthen our care.”

And it is — but it’s also long overdue. This investment wouldn’t be possible had North Carolina lawmakers not decided to finally expand Medicaid, as the state will receive a $1.8 billion bonus from the federal government for doing so. The $1 billion plan resembles a similar proposal made by Gov. Roy Cooper earlier this year, and the N.C. Department of Health and Human Services is also on board.

Lawmakers plan to invest the money in three key areas: improving access to care, building a stronger system of support for people in crisis and building a database to better track access and health outcomes.

The bill includes $40 million to improve behavioral health services at schools, about $100 million to expand the number of beds in state-run psychiatric facilities and $20 million to increase access to telehealth services for people in rural areas. It would also spend $225 million to increase Medicaid reimbursement rates for behavioral health care providers. Those rates haven’t been raised in a decade, which means many providers don’t accept Medicaid patients.

A significant chunk of funds would be used to recruit and retain the state’s mental health workforce. One report estimates that only 13% of the state’s mental health care needs are being met due to a shortage of providers, and those shortages are even worse in rural areas. An undersupply of workers makes it even more difficult for the state to operate its psychiatric facilities at the level necessary to accommodate demand.

Even a billion dollars probably won’t be enough to address the full scope of North Carolina’s mental health crisis, but it’s a much-needed start. North Carolina ranks 39th in the country for access to mental health care, according to Mental Health America. The state’s mental health system has been underfunded for years, leaving us ill-equipped to meet demand for mental health services.

As the years have gone by, that demand has only grown. Since the pandemic, the number of people experiencing mental health issues has become higher than ever. People spend days, even weeks, in the emergency room because there aren’t any available beds in psychiatric hospitals. The wait for a state psychiatric hospital bed is, on average, 16 days.

Among young people, the crisis is particularly acute — anxiety, depression and suicidal ideation have all increased, especially among teenagers. In 2020, more than one in 10 children had a diagnosis of depression or anxiety — a 49% increase from 2016. A recent report card from N.C. Child gave North Carolina an “F” for children’s mental health.

It’s not supposed to be that way.

In a recent interview with WFAE, Lambeth admitted that state lawmakers should have begun to address North Carolina’s mental health challenges much earlier.

“I had my hands full in other sessions,” Lambeth told WFAE. “I was letting things go with mental health, and I sort of regret it. We should have been dealing with some of the mental health challenges before now.”

Lambeth is right. North Carolinians are paying for the state’s missteps, but it’s not too late to stop the trends from worsening further. But as some lawmakers pointed out in Tuesday’s committee hearing, the funds allocated in this bill will only last a few years. If legislators don’t continue to prioritize improvements to the mental health system, any progress they make now will quickly be erased.

A $1 billion investment is a positive first step to repairing North Carolina’s broken mental health care system. It’s exactly the kind of work that lawmakers should spend their time doing.