Using Medicaid to Support  Working Age Adults  With Serious Mental Illnesses in the Community

This Handbook is designed to improve understanding and provide greater clarity concerning Medicaid's contribution in supporting working-age adults with serious mental illnesses in the community. The Handbook focuses on working age adults between the ages of 21 and 64 with serious mental illnesses, whose need for support extends beyond mental health services that can be effectively provided by primary care physicians or periodic visits to outpatient settings.

The mental illnesses these individuals experience result in significant functional impairment and have serious repercussions when left untreated. They may need intensive services over an extended period of time, either continuously or episodically, as well as ongoing access to appropriate services and interventions while in recovery. Sometimes, these individuals are labeled as having severe mental disorders or severe and persistent mental illnesses. 

The decision to focus the Handbook on services for working-age adults stemmed from practical considerations and in no way discounts the importance of the needs of children and older persons who are affected by mental illnesses.

The Handbook assembles considerable information about pertinent federal policies into a single publication. It also contains information about how individual states have supported individuals with serious mental illnesses under Medicaid. 

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