By Dottie Fuentes, Chief Clinical Officer, Northeastern Center

Indiana has spent years working to build a better behavioral health system, one in which a person experiencing a mental health crisis can receive behavioral health care.

But building a better system requires more than changing policies, creating innovative programs, or changing what we call the system.

It requires adequately funding the organizations and people expected to provide that care.

For years, Community Mental Health Centers have cared for some of the most vulnerable people across Indiana. During that time, the need for mental health and addiction services has grown. The cost of providing those services has risen. Administrative and regulatory requirements have increased.

Yet reimbursement has not kept pace with what it actually costs Community Mental Health Centers to maintain the level of care they are expected to provide.

We can debate how to pay for behavioral health care, but we cannot pretend we aren’t already paying the consequences when people cannot access it.

We pay for it in emergency departments.

We pay for it in jails.

We pay for it through law enforcement.

We pay for it in our schools, workplaces, and families.

And, sometimes, we pay for it with lives.

Indiana has an opportunity to strengthen this system through the Certified Community Behavioral Health Clinic, or CCBHC, model.

Indiana began its CCBHC Medicaid demonstration with eight pilot sites and has since been working toward expanding the model to additional communities across the state. CCBHC is designed to create a comprehensive behavioral health system that includes crisis services and expanded mental health and substance use treatment.

But transformation requires more than changing what we call the system.

Indiana’s own Behavioral Health Commission recognized this in a 2022 report. The Commission estimated that sustaining and expanding Indiana’s 988 and CCBHC behavioral health infrastructure would require approximately $100 million in State Fiscal Year 2026 and $120 million in State Fiscal Year 2027. With $50 million annually already appropriated through the Community Mental Health Fund, the Commission estimated an additional need of approximately $50 million in SFY26 and $70 million in SFY27 to continue building the system.

That investment should not be viewed only as another expense in the state budget. Effective community behavioral health and crisis services can reduce reliance on more costly systems, including emergency departments, inpatient hospitalization, law enforcement, and incarceration.

Indiana will pay for behavioral health needs one way or another. The question is whether we invest earlier in treatment, crisis intervention, and recovery – or pay later when people reach the most expensive and restrictive points in our healthcare and criminal justice systems.

For Community Mental Health Centers, these are not abstract budget decisions. They determine whether we can maintain the workforce necessary to provide care, expand crisis services in local communities, and adapt services to meet the unique needs of the communities we serve.

Locally, we are operating programs at a deficit, not because our staff are not working hard enough and not because the need for services is absent.

Quite the opposite.

The need is enormous.

Community Mental Health Centers operate differently from many other behavioral health providers. We maintain services for people with complex needs. We provide crisis response. We serve people experiencing serious and persistent mental illness, addiction, homelessness, and other significant challenges. We partner with hospitals, law enforcement, schools, and community organizations.

Community Mental Health Centers are not simply another type of behavioral health provider. We are an essential part of Indiana’s behavioral health safety net.

Indiana has spent years preparing for a transformation of its behavioral health system.

We now have an opportunity to decide whether we are willing to invest in sustaining it.

I am asking FSSA Secretary Mitch Roob, members of the Indiana General Assembly, and other state leaders to support the continued expansion and adequate funding of CCBHCs and Indiana’s community behavioral health system.

This isn’t simply about funding Community Mental Health Centers.

It’s about choosing a behavioral health system we want to be available when someone we love needs it.

Indiana’s communities deserve this investment.

So do the people who show up every day to provide the care.