An estimated 26.2 percent of Americans (over 57 million people), ages 18 and older suffer from some form of diagnosable mental disorder in any given year.¹ Many of those millions are a part of a family system which is undeniably affected by the disorder as well.  Family Systems Theory suggests that health and mental health issues, stress, and relational issues such as marriage, divorce, birth and death all impact the entire family system, even if only one member of the family is considered the “identified patient.”

Some family mental health issues that have the greatest impact on family systems include:

• Childhood mental health diagnoses, including pervasive developmental disorders, learning disabilities and attention disorders, and impulse-control disorders
• Youth and teen mental health issues, including eating disorders, suicide, and issues involving substance use, sexuality and sexual activity
• Parent/Caregiver chronic mental health concerns, such as depression, anxiety, stress, or substance abuse
• Problems that affect multiple family members, such as child abuse and neglect, domestic violence, and problems with the parent-child relationship.

Family Mental Health and the Nation

The Mental Health Parity and Addiction Equity Act (MHPAEA) passed in 2008, will offer families widely increased access to mental health and substance abuse treatment.  The federal law dictates that mental health and substance abuse treatment be covered with benefit levels comparable to medical/surgical benefits offered by a particular health insurance program.  Medicaid Managed Care plans in Missouri and Illinois are subject to this law, and regulations on the implementation of MHPAEA in Missouri were published on 2/2/10.

State Level:  Missouri and Illinois

The Missouri legislature has cut health and mental health expenditures due to budget shortfalls.  During the current fiscal year, the Governor made five rounds of budget cuts, cutting more than $900 million in order to balance the budget.  Mental Health services took deep cuts, as did the Department of Health and Senior Services.  Missouri Medicaid eligibility levels were already very low, and current cuts will eliminate many services to those just above those levels.  For more information, please refer to the Missouri Budget Project website.

Illinois faces a $13 billion dollar budget deficit, but legislators have been unable to agree on measures to either increase revenue or cut the budget.  In late May, the House approved a budget that would borrow billions of dollars and give Governor Pat Quinn broad control over spending.  The Governor’s plan includes $276 million in cuts to health and human services, including child care and community mental health services.  See Budget Illinois.gov.

In the St. Louis Metro

Children’s mental health issues have benefited greatly by the institution of Community Children’s Service Funds in St. Charles County and St. Louis City.  The newly established St. Louis County Children’s Service Fund will soon begin distributing money to child and family direct service agencies, resulting in millions of dollars in increased expenditures on family mental health.

The St. Louis area has a few local area collaboratives which are organizing family mental health professionals at the community level.  Two of note are the Family Mental Health Collaborative in St. Louis County and the Children’s Behavioral Health Coalition of St. Louis.

Local area agencies that are active in addressing family mental health issues tend to fall within one of the following five categories:

• Government Agencies – State and local governmental agencies administer and provide information and referrals, cash and subsidies, and programs and services. See the MO Dept. of Mental Health and the Division of Alcohol and Drug Abuse.  In Illinois, refer to the IL Dept. of Human Services Office of Mental Health and Office of Alcoholism and Substance Abuse.   Local area health departments are also attentive to some behavioral health needs.
• Behavioral Health Services – There are a wide array of direct service providers that treat adults and children with mental health and substance use disorders.  Many of these are connected with a local area hospital (BJC Behavioral Health, Hyland Behavioral Health (St. Anthony’s)) and others focus on specific populations, such as Kids In the Middle (divorce and separation) and The St. Louis Crisis Nursery (family emergency & child abuse and neglect prevention).
• Child Welfare – A smaller subset of agencies deal specifically with child welfare issues and deal with children in alternative care, child abuse and neglect, family reunification, etc.
• Housing, Shelter, Domestic and Family Violence – As a large percentage of the St. Louis homeless population is under the age of 18, local shelters and transitional housing services offer services for family behavioral and substance abuse, and for domestic violence.  Many local residential facilities offer programs and services for pregnant teens.
• Foundations and Funding Entities – Local Children’s Services Fund entities, including the St. Louis Mental Health Board and the St. Louis County Children’s Services Fund are major funding contributors to the accessibility and quality of local mental health services for children and families.

For more information on local area agencies which work in family mental health, please refer to Key Stakeholders.

¹NIMH. (2008). The Numbers Count: Mental Disorders in America.

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