Federal Efforts to Help People with Mental Illness

miaw-logo-greenSome 10 million Americans suffer from serious mental illness. We focused on services for them in a previous WatchBlog post, but they are part of a bigger picture: about 43 million adults—roughly 1 in 5—live with some form of mental health illness, according to 2013 data from the Substance Abuse and Mental Health Services Administration (SAMHSA).

For Mental Illness Awareness Week, read on about how the federal government could improve its programs and services to help people with mental illness.

Serving those with serious mental illness

Our earlier findings highlight the need to coordinate programs that support people with serious mental illness. Less than half of the 30 programs serving them had been evaluated, and there are no plans for future evaluations. We made multiple recommendations to help determine where there might be gaps in program delivery.

Ensuring people get the care they need

In 2013, SAMHSA’s Center for Mental Health Services received about $915 million for grants to states, territories, and nonprofit organizations to provide certain mental health services. This year, we reported that SAMHSA lacks the documentation it needs to oversee the organizations it funds with such grants. We looked at 5 grant programs that fund a variety of organizations serving people with mental illness, including people at risk for abuse and neglect; children, youth, and their families; and veterans.

But when we went looking for documentation about the grantees’ applications for funding and how they spent that money, a lot of it was missing. We couldn’t find information on how a third of the grantees qualified for funding. The people reviewing the applications are supposed to complete a checklist marking how the grantee would meet the requirements of the grant, but when we looked at 4 of those checklists for one program, we found multiple “N/A” or blank responses.

Further, for each grantee we reviewed, there was at least one instance in which the documentation used to oversee grantees was either missing entirely, stored someplace other than where it was supposed to be, or just not readily available to the people who should have access to it.

Missing or poor documentation is an oversight problem. How else would you know if a program is meeting its goals, in this case the prevention and treatment of mental illness? We recommended better documentation of how the grants are awarded and overseen.


  • Questions on the content of this post? Contact Linda Kohn at KohnL@gao.gov.
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