Mental Health Reform Overview and Talking Points

October 19, 2016  |  Publications

More than 10 percent of people who seek substance abuse or mental health treatment in our public health system are homeless. And people who are in early recovery from these conditions are often at risk of homelessness. People suffering from mental illness or substance use disorders may be left without a steady source of income, stable housing, or social support as a result of their illness.

S. 2680, the Mental Health Reform Act of 2016 would provide more comprehensive mental health services within the public health system. The bill improves coordination between federal agencies in order to better serve people with mental illness, raises authorizing limits on grants to states to provide treatment and recovery, ensures that federal funding supports the development of evidence-based practice, and increases access to care for individuals seeking mental health care.

H.R. 2646, the Helping Families in Mental Health Crisis Act of 2016 identifies people experiencing homelessness as a priority population for mental health treatment and social supports.

Current Status

In late April, S. 2680 passed the Health, Education, Labor, and Pensions Committee, and is ready for consideration by the full Senate. In early July, H.R. 2646 passed the full House.


S. 2680 should be brought to a Senate floor vote as quickly as possible. This bill and H.R. 2646 should be brought to a conference committee to create comprehensive reform for the mental health system.

The final legislation should include grants that target mental health treatment to people experiencing homelessness, increase access to mental health services, and connect housing supports to treatment. Mental health reform is a key component of ending homelessness for the disproportionate number of people who experience homelessness while suffering from mental health or substance use disorders.

Specifically, these provisions that relate to homelessness from each bill should be included in the final legislation:

S. 2680, the Mental Health Reform Act of 2016

  • Request that the United States Interagency Council on Homelessness (USICH) and partner agencies design national strategies for providing services in supportive housing to assist in ending chronic homelessness and implement programs that address chronic homelessness.
  • Raise authorized spending levels for Community Mental Health Service Block Grant programs (MHBG), grants for treatment and recovery for homeless individuals, and Projects for Assistance in Transition from Homelessness (PATH) grants. The bill also requests that the funding formulas for the MHBG and PATH be reassessed. All of these grant programs can be used to fund important services for people who are experiencing homelessness or at risk for becoming homeless.
  • Require programs to report on reduction of homelessness and urge development of evidence-based practices.
  • Require the Department of Health and Human Services (HHS) to develop an action plan to enforce mental health parity and increase access to mental health care.

H.R. 2646, the Helping Families in Mental Health Crisis Act of 2016

  • Authorize an interdepartmental serious mental illness committee to develop a federal plan to improve outcomes for people with SMI and to reduce homelessness and increase employment for this population. This committee is directed to include a committee member who is an expert on homeless services.
  • Establish an Assertive Community Treatment (ACT) program with special consideration for grant applicants with potential to reduce homelessness.
  • H.R. 2646 also continues funding for MHBG programs. This bill’s language requires state plans to include descriptions for how the MHBG will serve people experiencing homelessness and provide employment and housing supports as components of mental health interventions.

Talking Points

  • Mental Health Reform will help to reduce homelessness among people with mental health or substance use disorders. Integration of mental health care into homeless services and coordination of care between providers can improve health outcomes and reduce homelessness.
  • Because of the direct link between mental illness and homelessness, Congress should reform our mental health system by passing S. 2680, the Mental Health Reform Act of 2016, and then passing final mental health reform legislation incorporating the best aspects of that bill and H.R. 2646, the Helping Families in Mental Health Crisis Act of 2016 (which already passed through the House).
  • Too many people are falling through the cracks of the current system.
    • More than 1 in 10 people who seek substance abuse or mental health treatment in our public health system are homeless.
    • Our resources are too limited. Between 2009 and 2012, states cut $5 billion in mental health services and nearly 10 percent of public psychiatric beds. Sixty percent of adults with mental illness received no mental health services in 2014.
    • A high percentage of people with mental illness experience homelessness without treatment. Describe how increased mental health services would help your community.
    • We need grant funding that targets the most vulnerable in our system. SAMHSA Homeless grants improve health outcomes and reduce homelessness. New grants such as the Assertive Community Treatment grant program can extend evidence-based treatment to communities. Describe how these grants have strengthened efforts to end homelessness in your community.
  • There is a lack of coordination and lack of access for individuals in the current system.
    • People experiencing homelessness often have complex conditions that require intensive care coordination. Multi-disciplinary support is required to keep them out of hospital emergency rooms, improve health outcomes, and help them gain housing and stability.
    • These reform bills promote strategies for providing services, increasing access and implementing programs that address mental illness and homelessness together.
  • Housing is a key component of any comprehensive mental health approach.
    • People with serious mental illness experience homelessness at more than four times the rate of the general population. Treatment for mental illness or substance abuse that is not paired with stability, including housing and employment, is ineffective.
    • Housing is a key component of intervention throughout both of these bills, and the grant programs included can provide housing support services and even fund housing.

I hope you will work with your colleagues to advance these important bills. We cannot address the mental health crisis in this country, and we cannot end homelessness, without reforming a system that has failed the most vulnerable populations. Grants to states and communities, improved coordination of care, and increasing stability for people with mental illness is a huge step toward solving two important issues.