When history writes of the behavioral health system in Indiana, 2023 may very well be a year of demarcation. Not since the federal Community Mental Health Centers Act of 1963, have we had the opportunity to significantly improve the mental health infrastructure in this State. As a result of the Indiana Behavioral Health Commission’s recommendations, the Indiana General Assembly passed SEA 1 and HEA 1006, enabling the creation of a new model of service provision. This includes the Certified Community Behavioral Health Clinics (CCBHCs), a 988 Crisis Service continuum, and the ability to provide treatment in lieu of incarceration. Mental health advocates owe a debt of thanks to Senator Mike Crider, Representative Ann Vermilion, Representative Greg Steuerwald, and many others as well.
As we know, Indiana does not fare well in national mental health rankings, as we are currently listed 42nd among the 50 states. To some degree, that ranking is based on our historical lack of commitment to funding—so the message this Session has been that Indiana requires full, long-term, sustainable funding. While HEA 1001 did appropriate $100M to SEA 1 for the biennium, advocates pushed for a surcharge on carriers as permitted by Congress as the preferred method to provide sustainable funding--though we were similarly supportive of an increase in the cigarette and/or alcohol tax. In this, we were not successful. One can certainly have conflicting emotions—on the one hand, the emphasis and focus on the mental health of Hoosiers this Session has been refreshing, and frankly, long overdue. On the other hand, the lack of a method for full, long-term, sustainable funding means that an evidence-based behavioral health infrastructure is still not guaranteed for Hoosiers and their ability to benefit from such an infrastructure remains in question.
Without the funding that we fought for, our reach remains more limited. Still, we remain committed to providing high quality outcomes to the extent funding is made available. We find ourselves not at a destination, but rather, in a new direction. With SEA 1, we have the opportunity to move forward with a CCBHC model and a Crisis Service continuum in an effort to build an infrastructure that will last the test of time. Clearly, this will take a great deal of collaboration among stakeholders, including legislators, the executive branch, providers, advocates, families, and consumers. With the funding made available, we can build on pilot sites to demonstrate their efficacy and cost-effectiveness--as we continue to make the case for full, long-term, sustainable funding.
The need for the advocacy effort we started this Session remains. The need for full and sustainable funding through a surcharge, cigarette tax, or alcohol tax remains. The need to build and maintain a behavioral health infrastructure remains.
The passage of SEA 1 is a huge accomplishment, but it is not the end, but rather the beginning of a new direction in the history of behavioral health treatment in Indiana.
As always, stay safe and be well.
Stephen C. McCaffrey, JD