Bipolar Me

You may have heard about the $700 million that the U.S. government has allocated for funding “behavioral health programs.” A number of different programs are getting slices of that money, as announced by HHS Secretary Robert F. Kennedy, Jr. The Safety Through Recovery, Engagement and Evidence-based Treatment and Support (STREETS) Program, for example, will receive $96 million, while those other programs get to split up $612 million, all in service of President Trump’s Great American Recovery Initiative. Kennedy said that the money would address the “addiction and serious mental illness that fuel homelessness across America.”

Where Is The Money Coming From?

Mindsite News reports that behavioral health experts responded to the announcement by saying that the $700 million was really the release of funds that Congress had already authorized. The spending was already planned to be spent before Secretary Kennedy’s announcement seemed to promise new funding. Until now, the money had been held up rather than being distributed to state and local treatment organizations. The STREETS funds may be pulled from existing programs as well.

Where Is the Money Going?

That $700 million is intended to benefit “multi-agency, street-based behavioral health systems integrating government, healthcare, housing, law enforcement, and courts for people experiencing homelessness with SMI/SUD.” Interestingly, according to Medical Economics, the money will “exclude housing-first approaches and harm-reduction services, aligning awards with the Great American Recovery Initiative and shaping allowable evidence-based models for homelessness-related behavioral health care.”

In other words, if I’m reading this correctly, the funds are really designed mostly to combat homelessness (which the Secretary says will “move people from the streets into treatment and recovery, strengthen families, save lives, and make communities safer”). Getting unhoused people off the streets and out of the public gaze seems to be a more important goal than mental health or addiction services per se. And it ignores the fact that most people with addiction problems or mental illnesses are not unhoused. They could use funding, too.

Experts have suggested that, rather than trying to fund new programs, the money should be spent on what is already working within the treatment and recovery community, as well as on deficiencies in the current state of affairs regarding mental illness, addiction, and homelessness. Kennedy claimed that new, innovative programs would result from the money spent, but behavioral health advocate and political consultant Andrew Kessler points out that many existing problems, such as “a shorthanded workforce, poor reimbursement, and not enough resources to handle the challenges we face,” could be addressed with increased funding.

If that $96 million portion for STREETS doesn’t sound like it will make a dent in the problems nationwide, well, it won’t. It’s going to eight communities, which will each get up to $3 million per year for four years, “to develop multisector, state-of-the-art care systems for people who are homeless and have substance use disorders, serious mental illness, or co-occurring disorders.” Presumably, any success in those locations will be replicated in other communities, or at least other communities will be encouraged to replicate it, though it seems unlikely that they will get federal money to do so.

988 UPDATE

When I posted about the 988 helpline a couple of weeks ago, I promised that if I heard anything new regarding Option 3 of the helpline, which is designated to help people in the LGBTQ+ community, I would let you know. Here it is:

Mindsite News, citing a story in The Advocate, reports that Congress has directed the agency that administers the 988 helpline “to reactivate the [Option 3 for LGBTQ+ crisis calls] service, but says it must do so in accordance with Trump’s Executive Order 14168, which recognizes only two sexes and rejects federal recognition of trans and nonbinary gender identities.” Mindsite adds that “the administration hasn’t explained how the two mandates can coexist or whether transgender youth will be included at all in any restored program.” The administration expects Option 3 to be restored by the end of the year.