According to the National Alliance on Mental Health, approximately 51.5 million adults in the U.S. (about 1 in 5 adults) experienced mental illness in 2019. With demand for mental health services only increasing, ensuring that we have enough providers to treat mental illness is paramount.
Community mental health centers are critical to meeting the demand for mental health treatment across the country. Filling the gaps when individuals are unable to obtain treatment from private providers, community mental health centers operate on the front line in helping individuals contend with challenges to their mental health.
What is community mental health? Understanding the important role of addressing mental health issues in our communities is key for students who pursue Master of Arts in Counseling programs.
Defining Community Mental Health
The American Psychological Association defines community mental health as activities that promote mental health that are performed in the community instead of institutional settings.
According to the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA), the concept of community mental health originated with the Community Mental Health Act of 1963. Prior to the passage of that act, individuals with mental illness in the U.S. were frequently institutionalized, and the quality of the treatment they received varied significantly.
SAMHSA information on the history of community mental health indicates that, after 1963, the focus of mental health treatment shifted from institutionalization to treating individuals where they live, and communities across the country began establishing their own mental health centers. The premise of the shift was the theory that communities would best establish the mental health facilities that fit their unique needs.
Community Mental Health Centers
According to the American Psychological Association, a community mental health center is a facility or facilities that are community-based and provide mental health services, sometimes as an alternative to the care that mental hospitals provide.
SAMHSA reported that, as of 2019, approximately 2,700 community mental health centers were in operation. They are supported by sources such as county and state funding programs, federal funding through programs such as Medicaid and Medicare, private insurance and cash payments. The centers treat both children and adults, including individuals who are chronically mentally ill or have been discharged from an inpatient mental health facility.
The Mental Health Professionals Who Work at Community Mental Health Centers
Social workers, psychiatrists, counselors, psychologists and peer support specialists are some of the professionals who provide services at community mental health centers. In addition, community mental health centers frequently contract with other providers in the community for their services; they also refer clients to other types of providers such as residential treatment centers.
Community Mental Health Centers That Participate in Assertive Community Treatment Teams
Community mental health centers can choose to be part of a team that provides assertive community treatment (ACT). Under the ACT model, providers with a variety of expertise form a team to assist individuals in the community who have persistent and severe mental illnesses. The teams provide individuals with a variety of services to help them function independently. These services include:
- Housing assistance
- Financial management
- Mental health services
- Employment services
Services That Community Mental Health Centers Provide
Understanding the type of services that community mental health centers provide can help clarify what community mental health is within the mental health care landscape.
Community mental health centers primarily offer outpatient mental health services, but they are not limited to that. Examples of the specific services they may offer to individuals with mental illness include:
- Diagnostic evaluation
- Screening for possible admission to a mental health facility
- Emergency care
- Crisis intervention services
- Partial hospitalization or day treatment
- Psychosocial rehabilitation
- Medication management
- Substance abuse treatment
Moving Beyond Traditional Services
Some community mental health centers have branched into offering other nontraditional services such as:
- Mobile crisis units
- Vocational and educational services
- Consultation services through which they coordinate with people and entities such as clergy members, schools and social service agencies
- Training services for mental health staff
To effectively provide services to all community members, community mental health centers must be able to assist individuals who do not speak English. According to the U.S. Department of Health and Human Services, as of 2019, 84% of community mental health centers offered services in languages other than English.
Transitioning to Telehealth
Spurred by the COVID-19 pandemic, many community mental health centers have begun offering their services via telehealth, for example, by conducting psychotherapy via video chat or over the telephone.
According to a study published in 2021 in the journal Implementation Science Communications, the community mental health center staff who were surveyed viewed telehealth positively. However, the study concluded that more research is necessary to determine whether community mental health centers should continue to provide telehealth services beyond the time frame of the pandemic.
A New Model to Address Challenges in Community Mental Health
While community mental health centers have helped a significant number of people over the years, numerous challenges continue to confront the effective provision of mental health services in communities across the country.
Suicide and Drug Abuse
Addressing the high rates of suicide and drug overdose remains challenging. According to the National Council for Mental Wellbeing, suicide is the second leading cause of death for individuals aged 10 to 34.
Lack of Providers
Shortages of mental health professionals have resulted in inadequate access to treatment. The National Council for Mental Wellbeing asserts that roughly 12% of individuals who need substance abuse treatment actually receive that treatment.
Overburdened Jails and Emergency Rooms
Jails and emergency rooms are being increasingly charged with treating individuals navigating mental illness and substance abuse concerns. Both have struggled to treat individuals who might be better served in other settings.
Funding issues have left some community mental health centers unable to hire the staff they need to offer the programs people require.
A New Method of Service Delivery
Fortunately, in 2014, federal law established a new model for what community mental health is. Specifically, the Protecting Access to Medicare Act of 2014 created the concept of certified community behavioral health clinics (CCBHCs). CCBHCs are entities that provide comprehensive mental health and substance use services to individuals. For example, CCBHCs are required to:
- Offer a standardized array of mental health and addiction services
- Coordinate care with local entities such as providers of primary care and law enforcement
- Ease access to care, reduce long wait times and provide services regardless of individuals’ ability to pay
- Provide continuous mobile crisis services
- Comply with staffing requirements, such as having a psychiatrist who serves as medical director and staff with credentials in substance abuse disorders
- Comply with reporting requirements regarding how they are addressing the suicide crisis
Meeting those requirements enables CCBHCs to receive Medicaid payments that cover the actual costs of delivering enhanced services to more patients. This significantly reduces uncertainties about funding that have plagued traditional community mental health centers.
The CCBHC program began as a demonstration program in eight states, and by 2020, 113 CCBHCs were operating in 21 states. New federal funding made available in 2021 aims to expand the total number of CCBHCs to 340. CCBHCs may be one answer to the challenges that community mental health faces.
Community Mental Health: A Critical Part of the Mental Health Landscape
Community mental health services are critically important elements in getting individuals the mental health care they need to function in their everyday lives. Individuals who feel called to learn more about what community mental health is and how they can play an important role in a growing field of mental health can explore the University of North Dakota’s online Master of Arts in Counseling program and its Community Mental Health track Find out how the program can help you pursue your professional goals. Discover your place in a rewarding field today.
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, “National Mental Health Services Survey (N-MHSS): 2019, Data on Mental Health Treatment Facilities”