Science has advanced our understanding of mental illness and made possible new opportunities for people living with mental illness. With appropriate treatment and support, people with mental disorders can now lead full and productive lives. For many, the newest and most effective medications are a critical component of services that enable them to succeed as integrated members of their communities.

As healthcare expenditures grow, however, many state public health programs are responding to the need to cut costs by increasing restrictions on access to medications. Some states have developed limited lists of medications, which contain the only drugs that can be accessed without complicated prior approval polices. Other programs are increasing prescription and dispensing limits or are increasing co-payments for some of our most vulnerable citizens. In the end, such policies not only risk consumer health, but can actually increase total health care costs by creating new expenses for such services as hospitalization, emergency rooms visits, and even incarceration.

"Just as our three national organizations have joined together, we call on policy makers to collaborate with the mental health community to find solutions that do not risk the lives of people with mental health needs," said Michael M. Faenza, President and CEO of NMHA. "We cannot solve our current budget crisis by restricting access to a critical component of our nation's already vulnerable system of care. We must continue to expand mental health services for millions of vulnerable Americans living with mental health needs ranging from depression and anxiety disorder to schizophrenia and bipolar disorder," said Michael M. Faenza, President and CEO of NMHA.

"Policymakers must not balance state budgets on the back of its most vulnerable citizens. Access to medications is essential for recovery from mental illness to be a realistic goal of treatment. Attempts to contain costs in Medicaid by restricting access to the new generation of medications may lead to some short-term budget gains. Policymakers must weigh the risks inherent in this strategy and who will bear them. The cost of this neglect and abandonment will not only be counted in human suffering, but it will reappear in other areas of state budgets and/or in other levels of government. The cataclysmic consequences of failing to provide children and adults with necessary medications will result in increased deaths, homelessness, incarceration in jails, prisons, and juvenile justice systems and immeasurable suffering. We must work together to assure that people with mental illnesses are not cast away in the fiscal storm that states are experiencing," said Richard C. Birkel, Ph.D., Executive Director of NAMI.

"The attempt to control Medicaid costs by restricting patients' access to the most effective drugs is not only bad medicine, it's doomed to failure as a cost-saving measure. Psychiatrists must be able to prescribe the drugs that are most appropriate for their patients' specific needs if we are to be able to keep treatment for mental disorders community based. Psychotropic medications are very different from other medications in the time it takes to be able to judge whether they've been effective and in the idiosyncratic reactions patients have to them. Only the patient's physician should make the decision which drug to prescribe. Patients who do not receive the right treatment at the right time often experience an intensification of their symptoms and may require more intensive, institutional-based care that will cost the tax payers far more than even the most expensive psychotropic drugs," said APA President Paul S. Appelbaum, M.D.