By Chris Adams

Dr. Brian Hepburn, director of the organization that represents state mental health departments, has seen a dramatic change in the way public systems operate. One of the more dramatic shifts is that today state psychiatric hospitals are increasingly for people also caught up in the criminal justice system.

His organization, the National Association of State Mental Health Program Directors, is affiliated with about 195 state psychiatric hospitals. (The group’s strategic plan.)

In the past four decades, state mental health expenditures for psychiatric hospitals and for community-based outpatient services have flipped, with the hospital portion moving from two-thirds to less than a third.

In a session with National Press Foundation fellows, Hepburn also discussed the impact of the Affordable Care Act on access to mental health care services. The states that participated in Medicaid expansion saw an average increase of 10 percent in the number of people with Medicaid coverage for mental health care; states with no expansion saw no change.

He also discussed the sequential intercept model, or the effort to divert mentally ill criminal suspects before they fall too deeply into the criminal justice system.

Another resource for journalists, he said, is the NASMHPD Research Institute (presentation on its services) and its research director Ted Lutterman (703-738-8164); the research institute tracks financing and quality issues of state mental health systems.