The Omnibus Spending Package Left Out Mental Health Reform

By Jace Peterkin

With the passage in December of the Consolidated Appropriations Act—also known as the fiscal year 2023 omnibus spending package-—Congress made headway in increasing funding for mental health resources. But policymakers have more work to do. In particular, the package failed to make major reforms in our mental health system that Black, Indigenous, and other people of color (BIPOC) need.

The law includes funding to expand and develop programs for virtual peer support, behavioral and substance use health support, and maternal mental health care. Following are ten critical mental health investments included in the bill. Despite these increases, lawmakers have a long way to go before we can truly change our mental health system to serve everyone.

The omnibus package includes the following provisions related to mental health:

Funding Amount

Program

Details

$1.01 billion Mental Health Block Grant To develop, expand, and enhance national, statewide, or community-focused programs, including virtual peer-support services and technology-related capabilities.
$501.6 million Suicide Prevention Lifeline To transition to the new 988 crisis line, which aims to provide suicide prevention and mental health support nationwide.
$385 million Certified Community Behavioral Health Clinics To support individuals who need behavioral and substance abuse health support.
$130 million Children’s mental health services To identify the best clinical practices for children in need of behavioral support.
$111 million U.S. Department of Education To mental health programs dedicated to increasing the accessibility of mental health services in schools.
$94 million National Child Traumatic Stress Network To improve access and raise the standard of care for children, families, and communities that have experienced trauma.
$24 million Into the Light for Maternal Mental Health and Substance Use Disorders program To provide screening and treatment for maternal mental health to birthing persons across the country. In addition, the package includes $10 million for the Maternal Mental Health Hotline to provide mental health support for expecting persons.
$10 million Children exposed to violence (through the U.S. Department of Justice) To support children and families exposed to violence.
$10 million TRIUMPH Act Requires the development of a task force on maternal mental health to research, support, and develop a national strategy around maternal mental health.
$5 million Maternal mental health and crisis care needs TO research and support maternal mental health programs.

As lawmakers propose changes to the mental health system for fiscal year 2024, CLASP recommends the following:

1. To tighten equitable mental health resources, we must redefine what we currently see as “treatable” in mental health. Often policies are reactive rather than proactive. We can avoid some mental health crises by focusing investments on preventative measures.

2. Congress should use lessons learned from the Medicaid continuous coverage period over the past three years, including incentivizing or requiring states to provide at least 12 months of continuous Medicaid coverage for those enrolled. The omnibus bill does require all states to adopt 12-month continuous eligibility for children beginning in 2024. And the law made permanent the state option to extend Medicaid postpartum coverage to 12 months. However, people need continuous coverage at all points in life, not just at certain times. To support people’s mental health effectively, we must expand Medicaid, and ultimately provide universal healthcare for all.

3. To make an inclusive mental health system, we must acknowledge and take action to remove systemically racist practices in prevention, care, and treatment. For instance, the system’s current structure heavily relies on Western treatment practices that are based on a white-centric approach. This system often does not recognize practices like peer support specialists that have been proven effective with people in Black and brown communities. By investing where the need is greatest, lawmakers will help bolster and expand community-based solutions, which are proven to reduce trauma and stress.

The role of the legislative branch is to create laws for the benefit of everyone. Increasing funding for mental health services is a step in the right direction. Still, the current spending package did not have the needs of people of color in mind. Policymakers must restructure the mental health system to ensure Black and brown young people and adults can access support services where they live, work, and play.