Arizona’s public behavioral health care system, which serves some 150,000 mentally ill and vulnerable state residents, is wrestling with a number of urgent challenges. In addition to budget cuts resulting from the current economic crisis, and the demands of a 28-year-old class-action lawsuit, the system has been repeatedly criticized in several areas, including for inadequate staff, data, housing support, and crisis services. On July 22, a panel of professionals who play key roles in the system discussed these and other issues before some 300 behavioral health providers, supervisors, and policymakers at the annual Summer Institute hosted by Arizona State University’s Center for Applied Behavioral Health Policy. This paper provides an abbreviated report of that discussion, which was partially designed and moderated by ASU’s Morrison Institute for Public Policy.

Severe and widespread budget cuts in behavioral health and substance abuse services for lower-income Arizonans who don’t qualify for AHCCCS have already taken effect across the state. Even before these cuts were implemented, it was clear that the publicly-supported behavioral health system in our state was not adequately serving many Arizonans who needed mental health or substance use disorder treatment. This paper represents an effort by Arizona State University’s Centers for Applied Behavioral Health Policy and the Morrison Institute for Public Policy to promote and enrich Arizona’s public dialogue about these problems and potential solutions.

Per capita earnings in Arizona has been lower than the national average for decades. The 2011 differential of 19 percent is the largest on record; the typical differential has been between 10 and 15 percent. Thus, for residents who have spent some or all of their working life in the state, the state’s historically low per capita earnings help to explain the state’s below-average per capita property income.