Home / Opinion / Commentary / Medicaid expansion could help end unnecessary mental health suffering

Medicaid expansion could help end unnecessary mental health suffering

It’s no secret. Millions of Americans struggle with mental health issues. They’re ordinary people who make extraordinary contributions, each in their own, unique way.

They build, teach, volunteer and entertain. They own businesses, lead congregations, serve constituencies and run households. Their individual contributions are immeasurable, their impacts far-reaching.

They enjoy incredible, exceptional, American lives thanks, in part, to their ability to work closely with their doctors and properly manage their conditions.

Nearly one in four adults will be affected by a mental illness at some point in their lives. During the month of May, Americans will celebrate National Mental Health Awareness Month in an effort to heighten awareness, advance conversations and provide resources for those in need of prompt, adequate treatment.

Regardless the issue, its severity or even its root cause, these individuals all battle the stereotypical stigmas that are often wrongly considered as fact by the general public. At one time or another, even high-achieving, successful standouts can feel lost, marginalized and even ostracized.

Though life’s fears, stressors, issues and doldrums are common to us all, we generally are able to deal with them knowing that should we ever need treatment, counseling, medication or therapeutic assistance, services are accessible and available to us, usually through our employer’s benefits program and a relatively nominal co-pay.

For thousands more, however, the situation is unfortunately, much more critical. They are the unemployed and underemployed; with no real viable options for basic health care. They rarely consider applying for the specialized mental health assessments, treatments or care that they need. They know that door is closed.

Families and individuals who are often under insured or uninsured are most often forced to struggle with basic survival needs.
Immediate pressing needs like food, shelter and even personal and physical safety issues force them to put mental health concerns on the back burner.

With little understanding of mental health conditions, warning signs and symptoms, or the underfunded “system of care,” untold numbers of Arizonans are left in desperate situations that eventually lead them to face violent and even deadly consequences.

Frequent, one-time visits to the ER for episodic emergencies with no ability to pay and no plans to return for follow up care or continued support become common for these individuals. Altercations involving law enforcement eventually turn in to jail or prison time resulting from the inability to receive proper behavioral health care.

This month, however, Arizona legislators have an opportunity (and a duty), to put an end to this unnecessary suffering. Gov. Jan Brewer’s plan for Medicaid expansion will offer a true lifeline for those who have not been able to access necessary and ongoing whole health resources.

Arizona legislators should understand that supporting general and specialized mental health treatment for those in need can ultimately improve all of our lives.

Our strained health care system, already operating with minimal funding, will be able to provide care to all of Arizona’s citizens.

Hospitals caring for increasing numbers of the uninsured will be better able to provide compensated care and get back on track financially. The uninsured and the homeless will have access to doctors, who can treat and most often cure, diseases that may have gone undetected and untreated previously. Preventative general and routine care will alleviate the need for crisis interventions, generally followed by expensive and lingering hospital stays.

We must support the governor’s initiative to re-establish the connection between access to health care and increased public safety.

Law enforcement will see an immediate effect on how we will all, including those who need behavioral health treatment, be much safer in the future. Chronic, mental health conditions requiring even the most basic care, will directly impact the criminal justice system. Jails, courts and probation departments will start to see a reduction in violent activities, repetitive violations and unnecessary incarcerations as individuals are given what they need.
As legislators continue to debate and consider the program, citizens should understand the important financial gains that will be achieved through the passage of the proposed Medicaid plan for Arizona.

Augmented spending returns of federal tax dollars will not only be returned to our state, but will essentially triple in value as part of the government’s guaranteed match. With no need to increase the state budget, this generous, federal financial boost gives us the opportunity to improve public safety, strengthen Arizona’s economy, create new jobs, expand business opportunities and provide integrated health care for all. The time for this change is now.

Simply put: The governor’s plan for Medicaid support will increase Arizona’s budget by bringing in new revenues. It will also improve the health and lives of not only those who struggle with mental illness, but all segments of what will become a vibrant Arizona.

— Dr. Frank Scarpati is the president and CEO of Community Bridges, Inc., one of Arizona’s largest private, nonprofit providers of integrated substance abuse and mental health treatment.


  1. The State needs to find an alternative path to providing the care discussed – one not dependent on the Fed Govt funding support.

    When the Fed no longer can provide the funds assumed in Gov Brewer’s Medicaid Expansion, the State will be on the hook to pay for those added to the Health care rolls.

    Find another approach; don;t rely on the Fed Govt funding (it likely won’t be there in the long run due to the large Fed debt); don’t commit the State to programs it can’t support over the long term; better to phase in the health programs, in a way the State can pay for both in the short and long term.

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