Counties are facing an acute escalation of the mental and behavioral health crisis. In a recent NACo survey, 75 percent of counties reported an increase in the incidence of behavioral health conditions over the past year and 89 percent reported an increase compared to five years ago. While counties work to respond, the financial and human cost of behavioral health is compounding across all county systems: 80 percent of counties indicated that they incurred associated costs in the legal system (courts and jails), 77 percent in law enforcement and 54 percent in the health system and hospitals.

Counties are integral to the local behavioral health system of care, investing $163 billion each year in community health, hospitals and social services, as well as $107 billion in justice and public safety systems. In at least 33 states, counties may provide traditional behavioral health services, but county leaders in every state are confronting the need to innovate when it comes to mental health, whether in county courts, jails, juvenile justice systems, hospitals, parks, libraries, housing and homelessness services or other service areas – especially other services to youth.

Despite the severity of the crisis and its strain on our resources, counties across the nation are: (1) Persevering in expanding direct or indirect behavioral health service systems to care for our residents, and (2) Advocating for federal and intergovernmental policies that support our goal of serving residents and addressing the mental and behavioral health crisis.

Download the Executive Summary Download Full Report

Related News

Doctor with tablet and patient
Advocacy

HRSA Releases Final Reentry Care Guidelines Following NACo Input

On November 29, the Health Resources and Services Administration (HRSA) released their final Policy Information Notice (PIN) with policy guidance for health centers who support transitions in care for justice-involved individuals reentering their communities. 

Image of GettyImages-898373354_boomers_rgb.jpg
Advocacy

U.S. Senate Committee approves legislation to reauthorize programs for older adults

On July 31, the U.S. Senate Committee on Health, Employment, Labor and Pensions (HELP) approved the bipartisan Older Americans Act Reauthorization Act of 2024 on a 20-1 vote. 

Woman on bench
Advocacy

Congress advances Second Chance Act reauthorization

On December 4, the Senate passed the Second Chance Reauthorization Act (S.4477) by unanimous consent, a major milestone for supporting county reentry programs. NACo supports this legislation, which would reauthorize funding for Second Chance Act programs for five years. 

public health
County News

Health does not have to be partisan: Talking about health in a way that resonates with everyone

The de Beaumont Foundation has identified tangible steps county officials can take to heal divides and talk about community health in a way that resonates with everyone.

Vaccination
Advocacy

Congress introduces legislation to restore critical public health funding

On November 14, the Public Health Funding Restoration Act was introduced in both the U.S. Senate and House of Representatives. This legislation would address a pressing need to strengthen the nation’s public health infrastructure through direct and flexible funding to local health entities.

Nurse and older woman
Advocacy

CMS finalizes Medicare rule with key improvements for justice-involved populations

On November 1, the Centers for Medicare & Medicaid Services (CMS) published a final rule that, in a major advocacy win for counties, will improving access to Medicare for justice-involved individuals who are in pre-trial status or who are reentering the community.