Public Policy Reports

NAMI publishes reports on critical, emerging issues to help inform the public about the importance of effective mental health policy.

Navigating Health Insurance Following a Suicide Attempt: Consumer Protections Under Federal Insurance Law (2021)
Individuals and families often struggle with navigating health insurance after a suicide attempt. Deciphering health insurance bills can be an overwhelming process, even in the best of times. This resource, created in collaboration with researchers at the Georgetown University McCourt School of Public Policy, outlines existing federal legal protections and limitations for coverage of injuries related to a suicide attempt, and provides a guide for how to act if you have been unfairly denied coverage.

Under-Covered: How "Insurance-Like" Products are Leaving Patients Exposed (2021)
This report, issued by a coalition representing millions of people with pre-existing conditions, details eight different types of health insurance plans that do not adhere to Affordable Care Act (ACA) consumer protections. The new report details the specific harms of many types of non-compliant health plans and urges federal policymakers to take immediate steps to protect people by limiting their expansion.

NAMI State Legislation Report: Trends in State Mental Health Policy (2020)
Many significant mental health policy decisions are made at the state-level. NAMI’s State Legislation Report: Trends in State Mental Health Policy (2019) summarizes and showcases significant state mental health legislation that was enacted (or nearly enacted) in calendar year 2019. The report explains key trends in mental health policy and offers lessons from NAMI State Organization leaders who played an important role in shaping some of these policies.

What the Affordable Care Act Has Meant for People with Mental Health Conditions — And What Could Be Lost (2020)
The Affordable Care Act has had an enormous impact on people with mental illness. This issue brief, What the Affordable Care Act Has Meant for People with Mental Health Conditions — And What Could be Lost, highlights the importance of the ACA and illustrates why we can’t go back to a time when health coverage for millions of people with mental health conditions was inaccessible, inadequate and unaffordable.

Divert to What? Community Services that Enhance Diversion (2020)
Many communities are committed to diverting people with mental illness away from the criminal justice system. However, in order to do so, communities need effective mental health services, such as outpatient, inpatient and crisis care. This publication is meant to help communities identify the gaps and opportunities in the existing system that will enhance their efforts to divert people from justice system involvement. 

Mental Health Parity at Risk: Deregulating the Individual Market and the Impact on Mental Health Coverage (2018)
NAMI collaborated with researchers at Georgetown University on a report that provides, for the first time, comprehensive data showing barriers and gaps in mental health and substance use coverage in the individual insurance market prior to the Affordable Care Act (ACA). This report highlights just how bad things were and emphasizes the dangers of turning back the clock.

The Doctor is Out: Continuing Disparities in Access to Mental and Physical Health Care (2017)
Despite the passage of the Mental Health Parity and Addictions Equity Act of 2008, significant barriers remain which keep many Americans from accessing mental health treatment and support. People who seek treatment must navigate a fragmented and costly system full of obstacles. As a result, many people cannot access mental health care when they need it most.

Out-of-Network, Out-of-Pocket, Out-of-Options: The Unfulfilled Promise of Parity (2016)
With the passage of the federal parity law, along with the Affordable Care Act and the decision by 32 states (including the District of Columbia) to expand Medicaid, Americans should have better access to mental health care than at any time in history.  Yet, people with mental health conditions who have insurance still struggle to find providers and services in their networks.

Engagement: A New Standard for Mental Health Care (2016)
NAMI knows that the U.S. system of mental health care is failing to engage many people who seek help. The first interaction between a service provider and a person seeking care for a mental health condition can start a journey to recovery and a satisfying life, or leave a person unsure or hopeless about the future. The same is true about interactions with other people in the community. This report calls for a culture shift towards a mental health system that engages people with mental health conditions and their families.

Preparing for the Unimaginable: How Chiefs Can Safeguard Officer Mental Health Before and After Mass Casualty Events (2016)
In the aftermath of the Sandy Hook Elementary School tragedy in 2012, NAMI worked with police chiefs from around the country to develop lessons learned on officer mental health. This report is designed to help police departments prepare for mass casualty events and support emotional resiliency for first-responders and their communities.

State Mental Health Legislation 2015: Trends, Themes & Effective Practices (2015)
NAMI’s third annual report on state legislation that took place across the country in 2015 found lots of good news, but unfortunately some bad news as well. 

 A Long Road Ahead: Achieving True Parity in Mental Health and Substance Use Care (2015)
Achieving true equity in accessing mental health and substance use disorder care requires vigilant attention by advocates and public agencies responsible for enforcement. This report describes a survey conducted by NAMI to assess the experiences of people living with mental illness and their families with private health insurance.

State Mental Health Legislation 2014: Trends, Themes & Effective Practices (2014)
Momentum for reform of the nation's mental health care system slowed in 2014 as a result of failure by Congress to enact comprehensive mental health care legislation and a decrease in the number of states strengthening investment in mental health services.

Road to Recovery: Employment and Mental Illness (2014)
One of the best steps in recovery from mental illness is a job, but the national unemployment rate for individuals receiving public mental health services is approximately 80%.

State Legislation Report, 2013: Trends, Themes and Best Practices in State Mental Health Legislation (2013)
The report surveys legislation enacted by state legislatures in 2013 and summarizes trends, themes and best practices in mental health legislation that will continue to be important in 2014.

Medicaid Expansion and Mental Health Care (2013)
The report calls for Medicaid expansion which will fill critical gaps in access to health and mental health care, reduce uncompensated crisis care and pave the way to recovery and economic self-sufficiency for millions of Americans.

Parity for Patriots: The Mental Health Needs of Military Personnel, Veterans and Their Families (2012)
The report calls for Purple Heart medals to be awarded for psychological wounds like posttraumatic stress disorder (PTSD) and for military commanders at all levels to be accountable for suicide prevention and elimination of stigma.

State Mental Health Cuts: The Continuing Crisis (2011)
A report documenting continuing mental health budget cuts and their devastating impact on Americans living with serious mental illnesses.

State Mental Health Cuts: A National Crisis (2011)
A report documenting the magnitude of mental health budget cuts between 2008 and 2011.

Grading the States: A Report on America's Health Care System for Serious Mental Illness (2009)
NAMI's second state-by-state report on the nation's mental health care system.

Supporting Schools and Communities in Breaking the Prison Pipeline: A Guide to Emerging and Promising Crisis Intervention Programs for Youth (2009)
This resource is designed to introduce children’s mental health advocates and other stakeholders to models and practices that effectively respond to youth in psychiatric crisis in schools and communities.  

Coverage for All: Inclusion of Mental Illness and Substance use Disorders in State health care Reform Initiatives (2008)
Written in conjunction with the National Council for Community Behavioral Health care, this report documents the failure of state health care reform packages to cover mental illness.

Grading the States: A Report on America's Health Care System for Serious Mental Illness (2006)
The first comprehensive survey and grading of state adult public mental health care systems conducted in more than 15 years.