ABLECHILD: Connecticut’s Mental Health Providers Beg for Increase in Medicaid, Despite Millions Spent and No One Getting Better

Guest post by JoeHoft.com and AbleChild- republished with permission

Summary Psychiatric Drug Use in Medicaid Population in Connecticut

Health care spending in the U.S. makes up 16.6% of the nation’s GDP, more than any other country in the world and mental health accounts for a reported 5% of that spending.

Make no mistake, mental illness in America is an extremely costly or profitable health care problem depending on who is paying, and who is getting paid, for treatment services.

What is also clear is that the numbers of Americans being diagnosed as mentally ill continually increases. At some point the question becomes with the hundreds-of-billions of dollars being dumped on mental health “treatment,” why isn’t anyone getting better?

In fact, as of April, the U.S. reports that one in five adults and up to 20% of children experience a mental illness with a price tag of an estimated $282 billion annually.

The mental health “providers,” those non-profit organizations that states contract with to provide the needed mental health “treatment” services, complain that reimbursement for services is wholly inadequate. Maybe, but how do these behavioral health providers work?

In a nutshell, the federal government provides the reimbursement money to states through Medicaid funding, states turn around and certify non-profit organizations (providers) to carry out mental health services for Medicaid recipients and then the “providers” are reimbursed at a specific rate determined by each state. Pretty straight forward financial arrangement.

The problem is that what services are being provided is cloudy at best and there is never any discussion between the providers and the oversight commissions about the numbers of patients that are being “treated” with psychiatric mind-altering drugs.

AbleChild regularly participates in Connecticut’s Behavioral Health Oversight Partnership Council by testifying on specific issues that are of concern, especially as mental health policy affects children in the state.

During the September 11, 2024, hearing, AbleChild was refused the right to speak so that a few of the non-profit mental health providers could essentially complain about the state’s Medicaid reimbursement rates.

Apparently, the Council was more concerned about hearing from providers who believe their services are not being compensated to a level that is commensurate with the increase in mental health needs than allowing even five minutes for public comment.

Beyond the obvious insult to AbleChild, it’s possible that the reimbursement rate is insufficient.

But it is also possible that given the nature of psychiatric diagnosing – no science to support any psychiatric diagnosis – there will never be a reduction in mental health treatment services and, most likely, the number of mentally ill will only increase. At what point does mental health price itself out of business?

Let’s be honest, it’s a certainty that mental health diagnoses will increase. The numbers haven’t decreased…ever. And let’s further consider that with the recently passed Safer Communities Act, mental health “services” are going to increase exponentially when school-based mental health care is thrust upon school-age children.

Hundreds of millions of dollars are being federally provided to states to infiltrate schools with mental health experts in order that mental health screening is available to kids on the spot, in school, between classes.

There is little doubt that reading, writing and arithmetic will take a back seat to the feelings of students once this legislation is enacted. And, it can be said that finding a psychiatric diagnosis is the bread and butter of the behavioral health industry. No abnormal behavior, no funding. Simple equation.

It is only logical that the new in-school diagnosing will create booming business for behavioral health providers. History shows that this is practically cradle to grave mental health services. And now that the behavioral health industry has literally infiltrated the nation’s education system, the diagnoses are going to skyrocket.

Ironically, too often, these mental health services include prescribing psychiatric mind-altering drugs. Already the amount of behavioral health drugging that is occurring in the 0-17 age range in Connecticut is shocking.

Thanks to the work provided by the Citizens Commission on Human Rights, (CCHR) a non-profit mental health watchdog, the outrageous Medicaid spending in Connecticut on psychiatric drugs for children is exposed. In 2023, 26,903 0-17-year-olds were prescribed psychiatric mind-altering drugs.

Among these data were 9,318 0-17-year-olds taking Antidepressants, 5,029 0-17-year-olds taking Antipsychotics, 5,475 0-17-year-olds taking Anti-Anxiety drugs, 15,422 0-17-year-olds taking Stimulants (like Ritalin), and 3,124 0-17-year-olds taking Mood Stabilizers. The total cost of Medicaid drugging 0–17-year-olds in Connecticut with prescribed psychiatric drugs was nearly $33 million. (note Anti-Anxiety Drugs in right column should be 2023).

The public would be unable to uncover these data as the state does not make it available. The fact that these data are not made publicly available is of interest as AbleChild has repeatedly requested the Behavioral Health Oversight Partnership Council to make these data available. And AbleChild questioned how the Council could conduct its oversight work without these data.

Whether the state Medicaid mental health providers need a reimbursement rate increase is questionable. It is of interest that the behavioral health industry in responding to a risk adjustment audit is provided tips on how to withhold case assessments and suggests that much of its information is protected by the Health Insurance Portability and Accountability Act (HIPAA).

But the question remains, how do these providers answer for the ever-increasing numbers of mentally ill who never leave the state’s mental health programs and literally reflect a failed business model. Afterall, if no one is getting better, just how helpful are the provider’s services?

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