Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders (2025) / Chapter Skim
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6 Funding for Prevention of Mental, Emotional, and Behavioral (MEB) Disorders
6 Funding for Prevention of Mental, Emotional, and Behavioral (MEB) Disorders
Pages 181-216
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From page 181... ...
is supported by a patchwork of federal grants, state and local funding, and smaller amounts of private-sector support. Better and more sustainable funding for prevention of MEB disorders could lead to better outcomes (e.g., healthy MEB development in children, prevention of some mental illnesses, of suicide, and of substance use disorders)
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This chapter provides an overview of the funding available to prevent MEB disorders, drawing in part on a comprehensive review of primarily federal funding sources developed by a consultant and provided in Appendix C The funding approaches discussed would largely support and scale universal (i.e., directed at the entire population)
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Both programs and policies can provide ROI, making the case for the value of investing in prevention broadly and prevention of MEB disorders in particular (Le et al., 2021)
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. FEDERAL FUNDING FOR PREVENTION OF MEB DISORDERS Most federal prevention funding for MEB disorders comes from the Department of Health and Human Services (HHS)
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in its Behavioral Health Spending and Use Accounts (Dunn, A., personal communication, December 11, 2024)
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-- which allocate funding to states according to a formula) , and discretionary funding through a variety of grants for MH, substance use treatment, and SUD prevention programs (e.g., Strategic Prevention Framework -- Partnerships for Success, Tribal Behavioral Health)
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Trust for America's Health (TFAH) has called for increases to CDC's FY 2025 budget for programs important to promoting MEB health (TFAH, 2024)
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. Other called-for increases would also benefit prevention of SUD and mental disorders, including increases to the public health infrastructure and capacity, public health data modernization, social determinants of health (from $6 million to $100 million)
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. Stressed and overworked providers may be less able to support the MEB health needs of children in the system.
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Also, additional research on funding needs for the prevention of MEB disorders could better inform funding decisions. Most of the funding for behavioral health services is currently directed toward treatment and addressing the opioid crisis; more is needed to support primary prevention.
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, that would cost approximately $14 billion in new funding. This is a large investment but is potentially transformative given the evidence about intervening in early life on risk factors for MEB disorders.
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. In April 2024, the Innovation Center issued a new Behavioral Health Strategy, which "focuses on three key areas: 1)
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. There is evidence that value-based payment reform has a positive association with improved behavioral health outcomes (e.g., reduced emergency department visits)
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. In 2024, California, Colorado, Connecticut, Illinois, Maryland, New York, and Oregon allowed Medicaid to reimburse for violence prevention services (Barna, 2024)
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Relates to the provi sion of and payment for violence prevention programs. https://www.nysenate.gov/legislation/ bills/2023/S580/amendment/A (accessed February 28, 2025)
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, to deliver group BH therapy and counseling, and there is a Medicaid reimbursement category for "Behavioral health prevention education" (H0025)
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disorders and promote MEB health and well-being could be supported through a range of approaches that create more sustainable, coordinated, and adequate funding beginning with greater flexibility and innovation in the use of federal funding.
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States have the ability to reimburse providers for Screening, Brief Intervention, and Referral to Treatment for substance use and alcohol, and in 2023, 38 states did so, in addition to providing reimbursement for other health education and counseling. A noteworthy example of state funding innovations is found in the prevention of Adverse Childhood Experiences, major risk factors for 8 See https://hscrc.maryland.gov/Documents/Modernization/OBC/Diabetes%20OBC%20 Methodology%20Summary%209182019.pdf (accessed December 11, 2024)
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studied the potential of cannabis taxes and showed how a quarter of revenue in nine states with recreational cannabis excise taxes could be invested in MH, including in mobile psychiatric crisis unit and National Suicide Prevention Lifeline encounters. As of August 2024, 21 states are collecting cannabis taxes: Alaska, Arizona, California, Colorado, Connecticut, Illinois, Maine, Maryland, 9 Revised Code of Washington §82.14.46 Sales a use tax for chemical dependency or mental health treatment services or therapeutic courts.
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compared tax policy implementers from Washington State and California and found broad support of the tax policies for the flexible resources they generated, some concern about design features that made reporting onerous and brought unwanted attention to the work, and also appreciation for other benefits of the tax policy, such as greater public awareness of behavioral health and decreased stigma. Private-Sector Funding Philanthropic funding has long played an important role in many aspects of public health and human services, and the philanthropic landscape for BH has grown and become more coordinated in recent years (KP, 2023; Sapatkin, 2024; Center for High Impact Philanthropy, 2020)
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. The funders collaborative has also supported school districts in implementing peer-to-peer suicide prevention programming (CCC, 2023)
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. Community benefit funding could serve as a potential resource for the promotion of MEB health directly by funding prevention and promotion programming in communities (which
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RECOMMENDATION 6-3: Congress should adopt and support the implementation of new or innovative funding mechanisms to generate sustainable and sufficient resources for promoting mental, emotional, and behavioral (MEB) health, and for prevention, particularly primary, of MEB disorders by a.
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• Line 7. "Community health improvement advocacy" includes, but isn't limited to, efforts to support policies and programs to safe guard or improve public health, address mental, emotional and behavioral health, access to health care services, housing, the envi ronment, and transportation.
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RECOMMENDATION 6-4: State and territorial legislatures and tribal councils, respectively, should adopt and support the implementation of new or innovative funding mechanisms to generate sustainable and sufficient resources for promoting mental, emotional, and behavioral (MEB) health and prevention, particularly primary, of MEB disorders.
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that will reap the savings from enhancing mental, emotional, and behavioral health at a popula tion level and eliminating MEB health disparities. The Congressional Budget Office could refer to this model in informing the work of policy makers, in addition to their own work of scoring proposed prevention-oriented legislation.
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. Joe Neigel from Monroe County, Washington State, shared the fund ing sources for prevention efforts in his community and outlined several key needs.
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See Box 6-3 for implementation considerations specifically related to funding MEB disorder prevention and health promotion programs. BOX 6-3 Implementation Considerations in MEB Disorder Prevention Funding Expanding Opportunities for MEB Health • State-level distribution of resources: 0 Needs assessment -- who is getting what 0 Transparency and accountability at the federal level • Availability of technical assistance for applications for block and other grants for everyone • Awareness among all communities of opportunities, and distribu tion of resources in a way that is commensurate with need • Capacity building • Funding for community engagement • Pre-implementation (using maximally participatory community planning processes, such as Gathering of Native Americans)
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From page 209... ...
2024. National Aging Services Network: Infrastructure Supporting Prevention Among Older Adults, presented to the Committee on Blueprint for a National Prevention Infra structure for Behavioral Health Disorders, Meeting 3.
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2024. State-level infrastructure to support prevention, presented to the Commit tee on Blueprint for a National Prevention Infrastructure for Behavioral Health Disorders, Meeting 3.
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2020. A scoping review of strategies for financing the implementation of evidence-based practices in behavioral health systems: State of the literature and future directions.
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2019. Economic analysis in behavioral health: Toward ap plication of standardized methodologies.
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2024. Infrastructure supporting prevention among children and adolescents, presented to the Committee on Blueprint for a National Prevention Infrastructure for Behavioral Health Disorders, Meeting 3.
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2024. A tale of two taxes: Implementation of earmarked taxes for behavioral health services in California and Washington state.
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2024. Perspectives on Community Based Prevention to Address Substance Use and Misuse, presented to the Committee on Blueprint for a National Prevention Infrastructure for Behavioral Health Disorders, Meeting 2.
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2024. Maximizing the impact of opioid settlement funds, presented to the Committee on Blueprint for a National Prevention Infrastructure for Behavioral Health Disorders, Meeting 3.
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