While New Jersey has recently been proactive in ensuring access to mental-health coverage, whether insurance companies are meeting those needs is a more complicated question.
In 2019, New Jersey passed a parity law requiring insurance companies cover mental-health conditions and substance-use disorders at the same level as physical conditions. Data from 2021 show New Jersey insurance providers have the highest out of network rate in the nation, at nearly 50% of all costs for behavioral-health care.
Matt Camarda, advocacy and public-policy director for the National Alliance on Mental Illness of New Jersey, said it often comes down to compensation.
"Insurers don't always do the best job when it comes to reimbursement rates for the providers within those networks," he said, "and so oftentimes, whether it's a therapist or psychiatrist, folks are discouraged from joining those networks. "
The state Department of Banking and Insurance is responsible for ensuring parity laws are being followed.
Data show New Jersey leads the nation in the number of psychiatrists, with the percentage of need met at more than 72%. Provider access has also recently gotten a boost with New Jersey joining interstate compacts for psychology and counseling. Legislation to join the Social Workers interstate compact has passed the Assembly and is now under consideration in the Senate.
Camarda said these kinds of compacts can help both patients and providers.
"It might be a situation where military families have to move periodically," he said, "and so a spouse might have a counseling role in one state and have to move to a different state, but they would like to still be able to practice their counseling services with some of the same people."
While interstate compacts may help improve access for patients in the state, these compacts also open up New Jersey-based practitioners to serve patients in other states.
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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.
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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.
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