Non-State Mental Health Services

The two significant components of Alaska's mental health system, other than the state mental health program, are federal programs and private providers. Information about clients served by federal programs such as the Indian Health Service (IHS) have yet to be obtained. These elements represent a relatively small part of the overall mental health system, with the exception of the IHS. In 1995, about 7% of the state's population was eligible for IHS services only (meaning not dually eligible for IHS and Medicaid). Most individuals eligible for IHS services are served by community mental health centers, however.

In examining private sector services, two points are important. Private psychiatric hospitals, residential centers, clinics, physicians, and psychiatrists provide Medicaid reimbursed services to a significant number of Alaskans. Second, several local hospitals provide psychiatric evaluation and/or treatment services under contract to the state. Other than these, private mental health services paid from other sources (private insurance, personal funds, etc.) are not captured in our data sources.

How significant a gap does this lack of information concerning private sector services represent? A clue may be found in 1996 CMHS national statistics.

· 75% of full-time equivalent staff employed in mental health organizations in 1994 were employed in organizations funded in full or in part by state mental health agencies.

· 72% of total 1994 episodes (ambulatory, residential, or inpatient) occurring in mental health organizations took place in organizations funded in whole or in part by state mental health agencies

CMHS statistics do not include "private office-based practices of psychiatrists, psychologists...and other mental health providers." How that exclusion affected the percentages noted above is unknown. However, Medicaid annually pays significant amounts to just such providers in Alaska. Medicaid mental health payments account for perhaps 45% of public mental health funding in Alaska. While this is speculation, it stands to reason that community mental health grants and Medicaid combined provide the great preponderance of all mental health services in Alaska. We estimate that the public system in Alaska accounts for well in excess of the 72% of all episodes nationally.