The Substance Abuse and Mental Health Services Administration (SAMHSA) Spending Estimates (SSE) initiative was created to provide policymakers with essential information on expenditures for mental health (MH) and substance abuse (SA) treatment services, sources of financing, and trends over time.1 The SSE has helped to document past inequities through its ability to compare spending and financing sources for MH and SA treatment with those for all-health spending. Such comparisons can be performed because the SSE was designed to closely mirror the National Health Expenditure Accounts (NHEA), which are produced annually by the Centers for Medicare & Medicaid Services (CMS). The current report presents estimates and analyses from 1986 through 2009. The results serve as a baseline for understanding the impact of coverage and eligibility expansions anticipated beyond 2009 and how the structure of financing will be affected. They will also allow policymakers to gauge the effectiveness of parity and coverage expansion from the financing perspective and point out unanticipated consequences, if any.
The six policy questions are addressed in this report for a baseline period of 1986–2009, before the implementation of the new laws that are changing behavioral health care in the United States