Systemic unfairness and a total lack of faith in government entities contribute to the mental health challenges of African Americans.
Many said the administration of President Donald Trump has only exacerbated that problem.
“We have a demagogue in office who is filled with hate, filled with disruption and who could care less about people who are not as wealthy as he is and people who don’t share the same background as he does,” Leslie Ferguson, a mental health aid in Southwest said.
“What we have is a president and an administration whose policies more than suggest that African Americans don’t matter. Latinos don’t matter and, if you have a mental illness and happen to be a minority…well, you are in trouble,” Ferguson said.
The nonprofit Alexandria, Virginia-based Mental Health America [MHA], which since 1909 has dedicated itself to addressing the needs of those living with mental illness and promoting the overall health of all Americans, examined Trump’s 2019 budget wish-list.
Typically, much of the budget takes form as a narrative about the administration’s strategy and perspective about the nation over the next ten years.
And though Congress is not bound by the president’s budget — the House and Senate agree to their own separate budget deal — the president’s budget is a request to Congress that highlights the Administration’s priorities.
MHA combed through the budget and found several key provisions that could affect people with mental health and substance use disorders.
The Fiscal Year 2019 budget submitted to legislators by Trump requested $68.4 billion for the Department of Health and Human Services, a $17.9 billion [or 21 percent] decrease from the 2017 enacted level.
And the budget includes $10 billion over five years to combat the opioid epidemic and serious mental illness to build upon the 21st Century Cures Act.
It promotes structural reforms to Medicaid to eliminate the funding gap between states that expanded Medicaid under Obamacare and those states that did not expand Medicaid — and asks states to choose between a per capita cap and a block grant.
Trump’s budget reduces Medicaid by $1.4 trillion, Medicare by $500 billion and Social Security Disability Insurance by $10 billion over ten years.
Medicaid and Medicare are currently the largest payers of behavioral health services in the country, MHA officials said.
For Medicare, they propose to test and expand nationwide a bundled payment for community-based medication assisted treatment, including, for the first time, comprehensive Medicare reimbursement for methadone treatment.
The president’s budget includes $15 million for a new Assertive Community Treatment for Individuals with serious mental illness and reduces funding for the Substance Abuse and Mental Health Services Administration’s Mental Health and Substance Abuse Treatment Programs of Regional and National Significance by $600 million.
It also discontinues funding for the Screening, Brief Intervention, and Referral to Treatment program and increases funding for the Criminal Justice and Juvenile Justice programs by $10 million to a total of $14 million.
The budget consolidates federal graduate medical education spending from Medicare, Medicaid, and the Children’s Hospitals Graduate Medical Education program into a single grant program for teaching hospitals and directs funding toward physician specialty and geographic shortages.
Further, it eliminates $451 million in other health professions and training programs and does away with funding for Minority Fellowship programs at SAMHSA.
A further examination of the budget revealed that it includes $500 million for the National Institutes of Health [NIH] to support and supplement existing efforts with a public-private collaborative research initiative on opioid abuse.
It integrates into one agency: The Agency for Healthcare Research and Quality, the National Institute for Occupational Safety and Health, the National Institute on Disability, Independent Living, and Rehabilitation and slashes the Supplemental Nutrition Assistance Program, also known as food stamps, by $17.2 billion or 16 percent.
Finally, Trump cuts funding for the Department of Housing and Urban Development by 18 percent and it does not request any of the $8 billion in funding currently allocated to the HUD public housing capital fund.
“It’s mean spirited,” Ferguson said. “It’s been painfully obvious that there’s a mental health crisis and we know it’s difficult for people of color to get help when they’re experiencing this. So, it’s easy to say that our president doesn’t care. It’s easy to say that mental health doesn’t matter to him.”
