Dear Representative,

When the institutions for the mentally ill were closed, the promise made both to them and the public was that the institutions would be replaced by a system of easily accessed Public Mental Health clinics that would provide quality care on an outpatient basis in a timely manner.  We're still waiting.  In many states the care is hard to access and of dreadful quality as shown by NAMI's recent grading of the States. Now, not only is Public Mental Health in danger from many direct budget threats but because of how many States have been shoring it up using Medicaid, it's also facing risks from the cuts Medicaid faces.  Perhaps more problematic is that in many areas, Medicaid is a requirement to use Public Mental Health.  This gets to be a really troublesome issue when you consider that in many States, one of the first places to cut the Medicaid budget is Medically Needy (MNP) Medicaid.  With so many of the mentally ill childless but disabled by their condition, this combination will leave many with nowhere to turn for very necessary mental health care. With no access to care, the mentally ill face hard choices: get their care from the ER when in crisis or go without care and stay untreated which means risking suicide, "self-medicating" via any of many kinds of substance abuse, getting in trouble with the law, going to court, ending up in jail or prison, being the victim of a crime, etc.  Seems to me that any cost savings in Public Mental Health or Medicaid at this point is more cost shifting to all these other programs and at a high risk to many human lives. Either way, a person left to become disabled by their mental illness - or (and perhaps worse) forced to become so just to have access to care - is left to face a dire level of poverty with little chance to escape.  Is this humane treatment? Isn't failure to address this a violation of the human rights of the mentally ill? I realize the nation is facing hard times and must face tough choices, but is now when mental health care is going to be so necessary to so many really a time when we can afford <b>not</b> to finally properly reform and fund Public Mental Health?  After all, doesn't everyone have the right to timely access to competent, professional mental health care if they need such care?

[Your name here]