With Florida facing a youth mental health crisis, outdated Medicaid reimbursement policies are leaving schools struggling to meet growing demands, despite opportunities to utilize federal funding to expand services.

Karen Thomas, Medicaid coordinator for Leon County Schools, advocated for significant changes to how mental health services are funded in schools. Recognizing schools are often a trusted resource where students are more likely to seek help, Thomas called for a funding model for mental health services similar to Medicaid's support for school nurses, ensuring schools can effectively address students' needs.

"Bring that funding source up to date," Thomas urged. "Draw down those additional funds and to change the thinking of the state Medicaid agency to help them align with what the federal government supports which is paying for those mental health services at school because that ultimately helps to make kids healthier, more productive."

Currently, Florida schools are reimbursed for mental health services using outdated data from 1997. Thomas argued it is a mismatch between what schools are reimbursed and the real cost of services today. Florida's School Mental Health Report Card showed more than two-thirds of children with major depression did not receive treatment in 2022.

Angela Kimball, chief advocacy officer for the mental health advocacy organization Inseparable, emphasized school-based mental health programs are among the most effective.

"Research is showing that youths who can get school-based services are six times more likely to complete a full course of treatment than with community-based treatment," Kimball reported.

According to the Mental Health Report Card, the state's ratio of one school counselor for every 459 students falls far below the recommended 1:250 standard, creating significant barriers to access.

According to Inseparable, half of youths aged 12-17 with depression are not receiving the treatment they need. Cost, transportation challenges, lack of providers, insurance barriers and stigma influence the gap.

As Mississippi grapples with a growing mental health crisis, state and local leaders are being urged to prioritize diversion programs and crisis care systems to prevent the unnecessary incarceration of people with mental illness.

It is estimated 2 million people with serious mental illness are booked into jails across the U.S. each year.

Shannon Scully, director of justice policy and initiatives for the National Alliance on Mental Illness, said in Mississippi, where mental health resources are often scarce and the incarceration rate is among the highest in the nation, it means more than 19,000 people in state custody.

"The criminal justice system disproportionately impacts people with mental illness," Scully explained. "They are overrepresented in those spaces, and that's mostly because historically, our communities have underfunded and under-resourced behavioral health."

The Bureau of Justice Statistics reports 44% of people in jails and 43% in state and federal prisons have a mental illness. The Magnolia State has made some progress in recent years, leveraging federal funding to expand mental health services. However, advocates warned proposed budget cuts could jeopardize the gains.

Mississippi's prison system has long been under scrutiny for overcrowding and poor conditions, and a lack of mental health services exacerbates the problem. Scully pointed to "nuisance laws" criminalizing behaviors associated with untreated mental illness, such as public disturbances or sleeping in public, as key drivers of incarceration.

"Instead of implementing policies that may connect these folks to crisis services or to supportive housing, they are charged with a crime or they are ticketed," Scully emphasized. "They become involved with the criminal justice system."

As March marks Criminal Justice Awareness Month, she urged Mississippians to learn more about how mental health intersects with the justice system and to push for reforms. Scully promotes the importance of community engagement, pointing to resources like reimaginecrisis.org, where people can track legislation and advocacy efforts for mental health diversion and crisis care in their state.

Researchers at the University of Michigan have found that Black students attending Historically Black Colleges and Universities and Predominantly Black Institutions experience better mental-health outcomes compared with their peers at other institutions, but challenges remain.

The Healthy Minds Network, based at U of M, partnered with UCLA, Wayne State, and Boston University, to conduct the study in collaboration with the UNCF Institute for Capacity Building and the Steve Fund. Akilah Patterson, a doctoral candidate at the University of Michigan's School of Public Health, led the research and said the study involved 16 HBCUs and two PBIs, with more than 2,500 students participating.

"About 45% of them are flourishing mentally," she said. "Most notably, we saw that 83% of HBCU and PBI students reported having a sense of belonging in their campus community, compared to about 73% nationally."

However, the data also reveals significant challenges. More than half of the students report that their financial situation is "always" or "often" stressful, and 78% of those facing financial hardships are also dealing with mental-health issues.

In light of these challenges, the study recommends that colleges and universities address unmet mental-health needs, alleviate financial stress, expand on-campus mental-health resources and strengthen student-faculty connections.

Patterson said she hopes the report also underscores the importance of fostering a strong sense of belonging on campus and the crucial role HBCUs play in students' lives.

"HBCUs have a very long tradition of being centers of excellence and academic achievement," she said, "but this work also highlights that there are some mental-health challenges that do need to be addressed on those campuses so students can very much thrive academically."

As of 2023, HBCUs enrolled approximately 293,000 students. While originally established to serve Black students, as of 2015, non-Black students constitute about 22% of enrollment, up from 15% in 1976.


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Nebraska mental health professionals worry the Trump administration's proposed $880 billion in Medicaid funding cuts would threaten progress the state has made in providing help to those who need it.

The reductions could have a dramatic impact on the 345,000 Nebraskans who rely on Medicaid as their only source of health insurance.

Aileen Brady, president and CEO of Omaha-based Community Alliance, said Nebraska has had recent success in getting higher Medicaid reimbursement rates for providers, and has expanded services.

She added that cuts would hurt people who need help the most - those struggling with mental health problems, people with disabilities, and kids.

"Nearly half of Medicaid enrollees in Nebraska are under the age of 20," said Brady, "and I think people need to understand that impact it'll have on our children in Nebraska - and that means our future in Nebraska."

A recent survey by the Centers for Disease Control and Prevention says at least 50% of American adults will need treatment for a mental health issue during their lifetime.

Brady said such steep cuts at the federal level would require dramatic cuts in services to Nebraskans, especially when considering the degree to which the state relies on the federal money.

"Fifty-eight percent of every dollar is a federal dollar, 42% of those dollars are state dollars," said Brady. "If those cuts would come into play, that $880 billion over a period of time, that's going to create a fundamental shift in how services are delivered - the shift of cost to the states - or it's going to result in a significant cut."

The Trump administration is following through on a campaign promise to cut federal spending across the board.