Federal Block Grant
The federal government, through the Supreme Court's ruling in L.C.,
has clarified the duties of states to provide appropriate community services
in lieu of institutional care for people with mental illness. It would be appropriate,
at this time, for the federal government itself to increase its financial contribution
to spending on community mental health services through the major mental health
services program, the Community Mental Health Services Block Grant.
Over the past 18 years, federal appropriations for the mental health block
grant have fallen in real terms. In 1980, community mental health centers received
$293 million in annual federal appropriations—a small amount in overall
mental health spending, but nonetheless an important proportion of the resources
available for community care. However, even that modest amount looks significant
today. In 1981, when the community mental health law was repealed and the mental
health block grant was enacted to replace it, spending was reduced 14 percent.
Following this substantial cut, the block grant has continued to drastically
lose ground to inflation, as the graph below illustrates.
The federal government could, and should, do more to assist states in meeting
the needs of individuals who are unnecessarily institutionalized or at risk
of unnecessary institutionalization. In January 1999, the administration requested
that Congress increase appropriations for the mental health block grant by
$70 million. Such an increase, while helpful, is far short of the level needed
to restore lost spending power for the block grant. Advocates should urge the
administration and the Congress to increase federal appropriations for the
block grant to $1 billion. This would raise spending on mental health to a
level more commensurate with spending under the substance abuse block grant
($1.585 billion).
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