Understand the Mental Health System
Please do not hesitate to contact NAMI Wisconsin to learn more about any of the issues discussed on this page.
What Do We Mean By “Mental Health Services”?
Mental health services is a very broad term. It does not just refer to medication or therapy, but also to case management services, treatment teams (such as assertive community treatment), residential treatment, supported employment, supportive housing, peer support and more. For more information, visit the Navigating the System section of this website to download NAMI Wisconsin’s 5th Edition Resource Guide.
Where Do People Go to Receive Mental Health Services?
People receive mental health services in many different places: their homes, private and public hospitals, clinics, in the community at locations convenient for them, emergency rooms and more.
If you need to find mental health services in your community, please visit the Find Help Near You section of this website.
How Are Mental Health Services Paid For?
This pie chart gives a basic breakdown of how mental health services are paid for in the United States. For a primer on how mental health services are paid for, check out this report from the Kaiser Family Foundation. For an overview of how YOU can pay for mental health services, download NAMI Wisconsin’s overview of Mental Health Financing.
Mental Health Funding:
27% Private insurance
27% Medicaid/CHIP Program
18% State & local funding
12% Out-of-pocket spending
5% Other federal funding
3% Other private funding 3%
Source: Garfield (2011) Mental Health Financing in the US: A Primer, Kaiser Commission on Medicaid and the Uninsured
NOTE: This breakdown is from 2011. Due to recent eligibility changes to our state’s Medicaid program and the Affordable Care Act (“Obamacare”), the current data will be slightly different.
What Is Health Insurance?
Health insurance means that you pay an insurance company a certain amount of money each month for an insurance plan and a certain amount of money each time you receive services. In exchange, the insurance company pays health care providers (e.g., your therapist, psychiatrist, etc.) for the services they provide.
In real life, it’s more complicated than that. For example, some insurance companies will only sell plans that cover certain services or will only pay a certain portion of the cost of some services.
For more information and an overview of some basic terms associated with health insurance, download NAMI Wisconsin’s overview of Health Insurance.
Are Mental Health/Substance Abuse Services Covered By Insurance in the Same Way As Medical/Physical Health Care?
The short answer is yes. Before a legal change in 2008, insurance companies did not have to cover mental illness/substance use in the same way as physical illnesses. Today, they do. This is called “mental health parity.” This refers to the equal coverage of mental and physical health services. In 2013, the rules around the mental health parity law were clarified. This made parity easier to enforce. For more information, visit NAMI.org’s policy topics page covering parity.
What Is Health Care Reform?
The Affordable Care Act (ACA), also called “Obamacare” or simply “health care reform,” is a huge law that has many parts. Some of the main elements include insurance company regulations that protect health care consumers, requirements to have health insurance (with several exceptions) and new ways to select and pay for health insurance. For a brief overview of important parts of the law, download NAMI Wisconsin’s overview of Health Care Reform.
Or, watch a five-minute overview with this fun, interactive video!
Who Makes Decisions About How We Pay For and Access Mental Health Services?
There are many people and entities that make decisions about our mental health services. Some of the main players include the following:
- The federal government decides who is eligible for Medicare. Federal and state governments decide who is eligible for Medicaid.
- The Wisconsin state government can allocate funding for mental health services out of our general state budget. Along with the federal government, the state government decides who is eligible for Medicaid.
- County elected officials and county mental health administrators. In Wisconsin, we have a county-based mental health system. This means that each county offers a fairly unique set of services. County elected officials and mental health administrators make many decisions about which services are offered, who can access them and how they are delivered.
- Department of Health Services. Our state Department of Health Services (DHS), which answers to the state government, administers our state’s public mental health services. They can make administrative rule changes that affect how and who accesses which services.
What Does the Legislative Process Look Like in Wisconsin?
For an overview of the legislative process in Wisconsin, download NAMI Wisconsin’s overview of the Legislative Process.
How Can I Influence Mental Health Policy?
You don’t need to be a policy expert, brilliant speaker or writer to be an advocate. You just your personal passion and experience!
Everyone who experiences mental illness deserves the right mental health services and supports at the right time. Because with those key supports in place, recovery is possible. To make that happen, we have to let elected officials, the media and the general public know what is needed.
To learn about opportunities to get involved with mental health advocacy, reach out to your local NAMI affiliate and/or NAMI Wisconsin! NAMI was built from grassroots advocacy and continues to thrive because of passionate local voices.
Influencing mental health policy can take many different forms. A few examples include the following:
- Advocating for a bill with funding attached
- Advocating for a bill with wording that supports or helps to legitimize our issues
- Advocating for a bill with regulations that benefit people affected by mental illness
- Advocating for a local ordinance that supports your issue
- Working to foster administrative support for a particular issue
- Working to raise awareness or foster public support for a particular issue
- Educating yourself and/or others about current issues
Why and How Should I Learn About the Issues?
Under the Capitol dome, your representatives are debating issues that affect the affordability, accessibility and quality of mental health services. They are making decisions on behalf of people living with mental illness, family members, friends and advocates. In short, our elected officials make decisions that have huge impacts on our daily lives and well-being. We need representatives that share our dedication to improving the lives of people affected by mental illness. Here are some simple ways to make this happen!
LEARN ABOUT THE ISSUES!
FIND OUT WHERE YOUR ELECTED OFFICIALS AND CANDIDATES STAND!
- To find out who represents you in the WI state legislature and Congress, visit legis.wisconsin.gov
- To find out how your representatives voted on key issues, check out NAMI Wisconsin’s overview of overview of key legislation.
- To find who is running to represent you, visit wisconsinvote.org/candidates-and-races
For information about voting (where to register, voter rights, how to vote early, etc.), election results and upcoming elections, visit wisconsinvote.org.
For more resources on voting, check out NAMI.org’s webpage Mental Health Care Gets my Vote!
Again, please do not hesitate to contact NAMI Wisconsin to learn more about any of the issues discussed here.