PETITION FOR THE AMERICAN MENTAL HEALTH CARE GUARANTEE ACT
# Petition for the American Mental Health Care Guarantee Act
## Mental-Health Care Is Health Care—and No American Should Be Denied Treatment Because They Cannot Afford It
To the President of the United States, the United States Congress, state governors, state legislatures, and local governments:
The United States is facing a mental-health crisis, but millions of Americans cannot obtain timely, affordable treatment.
People seeking help encounter unaffordable bills, insurance denials, long waiting lists, closed facilities, staff shortages, inadequate crisis services and a severe lack of inpatient and outpatient treatment.
Some people must deteriorate until they become a danger to themselves or others before meaningful help becomes available. Families call for assistance but are told that nothing can be done. Emergency rooms release patients without continuing care because appropriate beds and community services are unavailable.
Too often, police officers and jails are forced to handle mental-health emergencies that should be addressed by trained clinicians, crisis teams and hospitals. People experiencing illness may be arrested for conduct connected to an untreated condition when appropriate treatment could have prevented the crisis.
Mental illness is not a crime. A psychiatric emergency is a medical emergency.
We call upon Congress to pass and fully fund the **American Mental Health Care Guarantee Act**, establishing comprehensive mental-health care as a guaranteed service available to every person in the United States without out-of-pocket costs.
## We demand that the legislation:
### 1. Guarantee mental-health care without financial barriers
Every person must have access to medically necessary mental-health and substance-use care regardless of income, employment, insurance status, disability, age, race, location, immigration status or ability to pay.
Covered services must include:
* Mental-health evaluations
* Individual, family and group therapy
* Psychiatric appointments
* Prescription medication
* Medication monitoring
* Crisis intervention
* Inpatient psychiatric treatment
* Outpatient and intensive outpatient programs
* Partial hospitalization
* Substance-use treatment
* Peer-support services
* Case management
* Long-term treatment for serious mental illness
These services must be available without deductibles, copayments or surprise bills.
### 2. Restore and protect government funding
Federal and state governments must provide permanent, protected funding for public mental-health care.
Essential mental-health funding must not be eliminated, redirected or reduced without a public impact assessment, legislative vote and plan ensuring that patients will not lose services.
Funding must keep pace with population needs, inflation, workforce costs and increases in demand.
Mental-health programs must not depend entirely on temporary grants that disappear after communities build services around them.
### 3. Rebuild the mental-health workforce
The nation must recruit and retain:
* Psychiatrists
* Psychologists
* Licensed therapists and counselors
* Psychiatric nurses
* Social workers
* Substance-use treatment professionals
* Crisis workers
* Case managers
* Peer-support specialists
* Youth and school mental-health professionals
The federal government must fund scholarships, paid training, apprenticeships and student-loan forgiveness for professionals who serve in public clinics, rural communities and areas with severe shortages.
Public facilities must offer competitive salaries, manageable caseloads, safe working conditions and protection from chronic understaffing and burnout.
### 4. Establish nationwide staffing and access standards
Mental-health facilities receiving public money must meet enforceable staffing and safety standards.
Patients must have access to:
* Emergency evaluation immediately
* Urgent appointments within a defined number of days
* Routine therapy and psychiatric care within reasonable national time limits
* Follow-up care promptly after hospitalization or a crisis
* Continuous treatment when a provider leaves or a facility closes
Governments must publicly report wait times, staffing levels, facility closures, denied admissions and unmet treatment needs.
### 5. Create a complete mental-health crisis-response system
Every community must have access to:
* A properly staffed 988 crisis service
* Mobile crisis-response teams
* Walk-in crisis centers
* Short-term crisis-stabilization facilities
* Inpatient psychiatric beds
* Safe transportation to treatment
* Follow-up care after every crisis encounter
Whenever circumstances safely permit, mental-health professionals—not armed law-enforcement officers—should lead responses to behavioral-health emergencies.
Police, fire departments and emergency medical services must be able to request immediate assistance from trained crisis professionals.
### 6. Educate police and other first responders
All law-enforcement officers, dispatchers, correctional officers, firefighters and emergency medical personnel must receive recurring, evidence-based education concerning:
* Recognizing psychiatric and neurological emergencies
* Crisis de-escalation
* Suicide prevention
* Trauma-informed response
* Autism and developmental disabilities
* Post-traumatic stress disorder
* Dementia and cognitive impairment
* Medication-related emergencies
* Substance-use and withdrawal
* Communicating with people experiencing psychosis
* Avoiding unnecessary force and arrest
* Connecting individuals with treatment
Training must include realistic practice, evaluation and accountability—not merely a short online presentation.
Education should prepare police to respond safely when they are needed, but it must not make law enforcement the nation’s primary mental-health system.
### 7. Replace unnecessary incarceration with treatment
No person should be jailed merely because appropriate mental-health services were unavailable.
Federal funding must expand:
* Pre-arrest diversion
* Mental-health courts
* Crisis stabilization
* Competency-restoration treatment outside jail when safe and appropriate
* Assisted outpatient services with due-process protections
* Community treatment
* Supportive housing
* Reentry services
* Voluntary substance-use treatment
When a person poses a genuine and immediate danger, they must be taken to an appropriate medical facility whenever legally and safely possible—not placed in a jail unequipped to treat the underlying condition.
Diversion must never prevent prosecution for serious criminal conduct solely because a person has a diagnosis. Decisions must consider the individual facts, public safety, treatment needs and legal rights.
### 8. Require adequate treatment inside jails and prisons
People who are incarcerated retain the right to medically necessary mental-health care.
Correctional institutions must provide:
* Prompt mental-health screening
* Suicide prevention
* Necessary medication
* Qualified clinical staff
* Protection from harmful isolation
* Hospital transfer when a higher level of care is required
* Continuity of treatment after release
No person should leave jail or prison without medication, treatment records, identification, health coverage and a scheduled follow-up appointment.
### 9. Expand hospitals and community treatment
The country needs sufficient inpatient beds, but hospitals alone cannot solve the crisis.
Funding must support a complete system that includes:
* Public psychiatric hospitals
* Crisis-stabilization units
* Community mental-health centers
* Certified behavioral-health clinics
* Residential treatment
* Assertive community treatment
* Supportive housing
* Home-based services
* Long-term outpatient care
Facilities must be safe, humane and adequately monitored. Expanding treatment must never mean returning to abusive institutions or stripping people of their civil rights.
### 10. Guarantee access to necessary medication
People must not lose stability because they cannot afford medication or obtain a timely appointment.
The law must:
* Cover medically necessary psychiatric medication without out-of-pocket costs
* Prevent dangerous interruptions caused by insurance changes
* Limit inappropriate prior-authorization requirements
* Require emergency prescription refills when clinically appropriate
* Support medication delivery and monitoring in underserved areas
* Prevent detention facilities from unnecessarily stopping established medications
Medication decisions must remain between patients and qualified medical professionals.
### 11. Enforce true insurance parity
Insurance companies must cover mental-health and substance-use treatment as fully as physical health care.
They must not use narrower provider networks, stricter authorization rules, lower reimbursement, arbitrary visit limits or more restrictive medical-necessity standards for mental-health treatment.
“Ghost networks”—directories listing providers who are unavailable, unreachable or not accepting patients—must be prohibited and penalized.
Insurers must maintain accurate directories and enough participating professionals to provide timely care.
### 12. Protect children and families
Schools and communities must have adequate counselors, psychologists, social workers and crisis professionals.
Children must be able to receive early treatment without waiting until they are suicidal, hospitalized, suspended, expelled or involved with the juvenile-justice system.
Parents and caregivers must have access to:
* Family education
* Respite support
* Crisis planning
* Affordable treatment
* Navigation assistance
* School-based services
* Help locating appropriate residential care when necessary
A family should never be forced to surrender custody of a child solely to obtain mental-health treatment.
### 13. Reach rural and underserved communities
Every state must maintain a plan for serving rural, tribal, low-income and medically underserved communities.
The plan must include:
* Mobile clinics
* Telehealth
* Transportation
* Rural crisis teams
* Incentives for professionals to practice in shortage areas
* Reliable internet access
* Partnerships with local hospitals and community organizations
Telehealth must expand options, but it must not become a substitute for in-person treatment when in-person care is medically necessary.
### 14. Protect veterans, older adults and people with disabilities
Dedicated services must address the needs of:
* Veterans
* Older adults
* People with serious mental illness
* People with intellectual or developmental disabilities
* People with traumatic brain injuries
* Survivors of violence and abuse
* People experiencing homelessness
* People living with dementia or neurological conditions
Mental-health, medical, disability, housing and social-service systems must coordinate care instead of sending vulnerable people from one agency to another.
### 15. Protect patient rights
Expanding care must preserve human dignity and civil liberties.
Patients must have:
* Informed consent
* Confidentiality
* Freedom from discrimination
* Access to advocates
* Clear appeal procedures
* Protection from abuse, neglect and unnecessary restraint
* Treatment in the least restrictive appropriate setting
* Meaningful judicial review when treatment is involuntary
Mental-health policy must never be used to punish poverty, homelessness, disability, unusual behavior or political disagreement.
### 16. Address housing and other barriers to recovery
Mental-health treatment cannot succeed when a person has nowhere safe to live, no food, no transportation and no way to obtain medication.
The program must coordinate treatment with:
* Supportive and affordable housing
* Homelessness prevention
* Transportation
* Nutrition assistance
* Disability benefits
* Employment support
* Domestic-violence services
* Legal assistance
* Recovery and peer-support programs
### 17. Require national accountability
Federal and state governments must publicly report:
* Mental-health spending
* Staffing levels and vacancies
* Treatment wait times
* Psychiatric-bed availability
* Insurance denials
* Crisis-response outcomes
* Suicides and deaths in custody
* Arrests involving behavioral-health crises
* Use-of-force incidents during crisis responses
* Emergency-room boarding times
* Patient complaints
* Treatment interruptions caused by facility closures or funding reductions
Independent inspectors must investigate unsafe conditions, neglect, misuse of funds and civil-rights violations.
## Why This Matters
Mental illness can affect any family.
People should not have to become suicidal, homeless, incarcerated or dangerous before they qualify for meaningful help. Parents should not spend months desperately searching for a therapist for their child. Families should not be told to call police because no treatment team is available. Officers should not be expected to perform the work of psychiatrists, social workers and crisis clinicians.
Jails should not function as substitute psychiatric hospitals.
Emergency rooms should not become waiting rooms for a mental-health system without enough beds or staff.
Insurance coverage should not exist only on paper.
Treatment provided early is more humane than intervention after a person’s life has collapsed. A functioning mental-health system can reduce suffering, suicide, homelessness, family disruption, hospitalization, incarceration and repeated emergency calls.
We therefore call upon Congress to introduce, pass and fully fund the **American Mental Health Care Guarantee Act**, creating a coordinated national system in which every person can obtain appropriate mental-health care without financial barriers.
**Mental illness is not a crime. Treatment is not a privilege. Mental-health care is health care, and every American deserves access to it.**
Signera petitionenSignera petitionen## Mental-Health Care Is Health Care—and No American Should Be Denied Treatment Because They Cannot Afford It
To the President of the United States, the United States Congress, state governors, state legislatures, and local governments:
The United States is facing a mental-health crisis, but millions of Americans cannot obtain timely, affordable treatment.
People seeking help encounter unaffordable bills, insurance denials, long waiting lists, closed facilities, staff shortages, inadequate crisis services and a severe lack of inpatient and outpatient treatment.
Some people must deteriorate until they become a danger to themselves or others before meaningful help becomes available. Families call for assistance but are told that nothing can be done. Emergency rooms release patients without continuing care because appropriate beds and community services are unavailable.
Too often, police officers and jails are forced to handle mental-health emergencies that should be addressed by trained clinicians, crisis teams and hospitals. People experiencing illness may be arrested for conduct connected to an untreated condition when appropriate treatment could have prevented the crisis.
Mental illness is not a crime. A psychiatric emergency is a medical emergency.
We call upon Congress to pass and fully fund the **American Mental Health Care Guarantee Act**, establishing comprehensive mental-health care as a guaranteed service available to every person in the United States without out-of-pocket costs.
## We demand that the legislation:
### 1. Guarantee mental-health care without financial barriers
Every person must have access to medically necessary mental-health and substance-use care regardless of income, employment, insurance status, disability, age, race, location, immigration status or ability to pay.
Covered services must include:
* Mental-health evaluations
* Individual, family and group therapy
* Psychiatric appointments
* Prescription medication
* Medication monitoring
* Crisis intervention
* Inpatient psychiatric treatment
* Outpatient and intensive outpatient programs
* Partial hospitalization
* Substance-use treatment
* Peer-support services
* Case management
* Long-term treatment for serious mental illness
These services must be available without deductibles, copayments or surprise bills.
### 2. Restore and protect government funding
Federal and state governments must provide permanent, protected funding for public mental-health care.
Essential mental-health funding must not be eliminated, redirected or reduced without a public impact assessment, legislative vote and plan ensuring that patients will not lose services.
Funding must keep pace with population needs, inflation, workforce costs and increases in demand.
Mental-health programs must not depend entirely on temporary grants that disappear after communities build services around them.
### 3. Rebuild the mental-health workforce
The nation must recruit and retain:
* Psychiatrists
* Psychologists
* Licensed therapists and counselors
* Psychiatric nurses
* Social workers
* Substance-use treatment professionals
* Crisis workers
* Case managers
* Peer-support specialists
* Youth and school mental-health professionals
The federal government must fund scholarships, paid training, apprenticeships and student-loan forgiveness for professionals who serve in public clinics, rural communities and areas with severe shortages.
Public facilities must offer competitive salaries, manageable caseloads, safe working conditions and protection from chronic understaffing and burnout.
### 4. Establish nationwide staffing and access standards
Mental-health facilities receiving public money must meet enforceable staffing and safety standards.
Patients must have access to:
* Emergency evaluation immediately
* Urgent appointments within a defined number of days
* Routine therapy and psychiatric care within reasonable national time limits
* Follow-up care promptly after hospitalization or a crisis
* Continuous treatment when a provider leaves or a facility closes
Governments must publicly report wait times, staffing levels, facility closures, denied admissions and unmet treatment needs.
### 5. Create a complete mental-health crisis-response system
Every community must have access to:
* A properly staffed 988 crisis service
* Mobile crisis-response teams
* Walk-in crisis centers
* Short-term crisis-stabilization facilities
* Inpatient psychiatric beds
* Safe transportation to treatment
* Follow-up care after every crisis encounter
Whenever circumstances safely permit, mental-health professionals—not armed law-enforcement officers—should lead responses to behavioral-health emergencies.
Police, fire departments and emergency medical services must be able to request immediate assistance from trained crisis professionals.
### 6. Educate police and other first responders
All law-enforcement officers, dispatchers, correctional officers, firefighters and emergency medical personnel must receive recurring, evidence-based education concerning:
* Recognizing psychiatric and neurological emergencies
* Crisis de-escalation
* Suicide prevention
* Trauma-informed response
* Autism and developmental disabilities
* Post-traumatic stress disorder
* Dementia and cognitive impairment
* Medication-related emergencies
* Substance-use and withdrawal
* Communicating with people experiencing psychosis
* Avoiding unnecessary force and arrest
* Connecting individuals with treatment
Training must include realistic practice, evaluation and accountability—not merely a short online presentation.
Education should prepare police to respond safely when they are needed, but it must not make law enforcement the nation’s primary mental-health system.
### 7. Replace unnecessary incarceration with treatment
No person should be jailed merely because appropriate mental-health services were unavailable.
Federal funding must expand:
* Pre-arrest diversion
* Mental-health courts
* Crisis stabilization
* Competency-restoration treatment outside jail when safe and appropriate
* Assisted outpatient services with due-process protections
* Community treatment
* Supportive housing
* Reentry services
* Voluntary substance-use treatment
When a person poses a genuine and immediate danger, they must be taken to an appropriate medical facility whenever legally and safely possible—not placed in a jail unequipped to treat the underlying condition.
Diversion must never prevent prosecution for serious criminal conduct solely because a person has a diagnosis. Decisions must consider the individual facts, public safety, treatment needs and legal rights.
### 8. Require adequate treatment inside jails and prisons
People who are incarcerated retain the right to medically necessary mental-health care.
Correctional institutions must provide:
* Prompt mental-health screening
* Suicide prevention
* Necessary medication
* Qualified clinical staff
* Protection from harmful isolation
* Hospital transfer when a higher level of care is required
* Continuity of treatment after release
No person should leave jail or prison without medication, treatment records, identification, health coverage and a scheduled follow-up appointment.
### 9. Expand hospitals and community treatment
The country needs sufficient inpatient beds, but hospitals alone cannot solve the crisis.
Funding must support a complete system that includes:
* Public psychiatric hospitals
* Crisis-stabilization units
* Community mental-health centers
* Certified behavioral-health clinics
* Residential treatment
* Assertive community treatment
* Supportive housing
* Home-based services
* Long-term outpatient care
Facilities must be safe, humane and adequately monitored. Expanding treatment must never mean returning to abusive institutions or stripping people of their civil rights.
### 10. Guarantee access to necessary medication
People must not lose stability because they cannot afford medication or obtain a timely appointment.
The law must:
* Cover medically necessary psychiatric medication without out-of-pocket costs
* Prevent dangerous interruptions caused by insurance changes
* Limit inappropriate prior-authorization requirements
* Require emergency prescription refills when clinically appropriate
* Support medication delivery and monitoring in underserved areas
* Prevent detention facilities from unnecessarily stopping established medications
Medication decisions must remain between patients and qualified medical professionals.
### 11. Enforce true insurance parity
Insurance companies must cover mental-health and substance-use treatment as fully as physical health care.
They must not use narrower provider networks, stricter authorization rules, lower reimbursement, arbitrary visit limits or more restrictive medical-necessity standards for mental-health treatment.
“Ghost networks”—directories listing providers who are unavailable, unreachable or not accepting patients—must be prohibited and penalized.
Insurers must maintain accurate directories and enough participating professionals to provide timely care.
### 12. Protect children and families
Schools and communities must have adequate counselors, psychologists, social workers and crisis professionals.
Children must be able to receive early treatment without waiting until they are suicidal, hospitalized, suspended, expelled or involved with the juvenile-justice system.
Parents and caregivers must have access to:
* Family education
* Respite support
* Crisis planning
* Affordable treatment
* Navigation assistance
* School-based services
* Help locating appropriate residential care when necessary
A family should never be forced to surrender custody of a child solely to obtain mental-health treatment.
### 13. Reach rural and underserved communities
Every state must maintain a plan for serving rural, tribal, low-income and medically underserved communities.
The plan must include:
* Mobile clinics
* Telehealth
* Transportation
* Rural crisis teams
* Incentives for professionals to practice in shortage areas
* Reliable internet access
* Partnerships with local hospitals and community organizations
Telehealth must expand options, but it must not become a substitute for in-person treatment when in-person care is medically necessary.
### 14. Protect veterans, older adults and people with disabilities
Dedicated services must address the needs of:
* Veterans
* Older adults
* People with serious mental illness
* People with intellectual or developmental disabilities
* People with traumatic brain injuries
* Survivors of violence and abuse
* People experiencing homelessness
* People living with dementia or neurological conditions
Mental-health, medical, disability, housing and social-service systems must coordinate care instead of sending vulnerable people from one agency to another.
### 15. Protect patient rights
Expanding care must preserve human dignity and civil liberties.
Patients must have:
* Informed consent
* Confidentiality
* Freedom from discrimination
* Access to advocates
* Clear appeal procedures
* Protection from abuse, neglect and unnecessary restraint
* Treatment in the least restrictive appropriate setting
* Meaningful judicial review when treatment is involuntary
Mental-health policy must never be used to punish poverty, homelessness, disability, unusual behavior or political disagreement.
### 16. Address housing and other barriers to recovery
Mental-health treatment cannot succeed when a person has nowhere safe to live, no food, no transportation and no way to obtain medication.
The program must coordinate treatment with:
* Supportive and affordable housing
* Homelessness prevention
* Transportation
* Nutrition assistance
* Disability benefits
* Employment support
* Domestic-violence services
* Legal assistance
* Recovery and peer-support programs
### 17. Require national accountability
Federal and state governments must publicly report:
* Mental-health spending
* Staffing levels and vacancies
* Treatment wait times
* Psychiatric-bed availability
* Insurance denials
* Crisis-response outcomes
* Suicides and deaths in custody
* Arrests involving behavioral-health crises
* Use-of-force incidents during crisis responses
* Emergency-room boarding times
* Patient complaints
* Treatment interruptions caused by facility closures or funding reductions
Independent inspectors must investigate unsafe conditions, neglect, misuse of funds and civil-rights violations.
## Why This Matters
Mental illness can affect any family.
People should not have to become suicidal, homeless, incarcerated or dangerous before they qualify for meaningful help. Parents should not spend months desperately searching for a therapist for their child. Families should not be told to call police because no treatment team is available. Officers should not be expected to perform the work of psychiatrists, social workers and crisis clinicians.
Jails should not function as substitute psychiatric hospitals.
Emergency rooms should not become waiting rooms for a mental-health system without enough beds or staff.
Insurance coverage should not exist only on paper.
Treatment provided early is more humane than intervention after a person’s life has collapsed. A functioning mental-health system can reduce suffering, suicide, homelessness, family disruption, hospitalization, incarceration and repeated emergency calls.
We therefore call upon Congress to introduce, pass and fully fund the **American Mental Health Care Guarantee Act**, creating a coordinated national system in which every person can obtain appropriate mental-health care without financial barriers.
**Mental illness is not a crime. Treatment is not a privilege. Mental-health care is health care, and every American deserves access to it.**
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