State budget cuts, health care reform, and a crisis in rural community mental health agencies.

Between 2009 and 2011, states implemented significant budget cuts to community mental health agencies (CMHAs), which are frequently the sole provider of specialized behavioral health services in rural communities. Starting in 2010, federal policy changes created by health care reform and mental health parity are likely to increase the number of individuals who can afford to seek services for a mental illness. CMHAs under financial stress have begun to eliminate services and reduce staff.