2023 Mental Health Legislative Agenda

group of teens sitting together and talking


Voices empowers children, youth, and families disproportionately impacted by inequitable outcomes as agents in the creation of policy solutions to ignite change in their communities. Through our direct engagement with youth advocates and hearing from the professionals serving families, Voices embraces a variety of perspectives to create trauma-informed and healing centered spaces for advocates to share their stories and reconcile trauma through systems change.

For far too long, policies in our country and Commonwealth have perpetuated racism interpersonally, institutionally, and systemically, known as structural racism. The impact of historical racism and trauma show up in disparities in access and outcomes, including income and wealth, educational opportunities, and health. Our young people today still face the impact of historical racism within the systems they encounter and the communities they live. To ensure all children in Virginia have the opportunity to thrive despite race, geography or income, we must focus on the root causes that have produced inequitable distribution of resources, eliminate barriers to fair and equal participation and dismantle social and institutional biases.

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Mental Health

We will not accept a mental health system that treats children and youth as “phase two” — our system should prioritize children and youth to foster a lifetime of mental health and wellness.

There is a crisis in children’s mental health with more than 40% of high school students in Virginia indicating that they have felt sad or hopeless for two weeks or more. Children’s mental health has been declared a national emergency, yet there is little sense of urgency to respond to the crisis. And there are too few mental health professionals to meet the current demand. We must raise the sense of urgency and build a system for children that promotes positive mental health and a full continuum of crisis response.

The ideal system offers children and youth mental health support whenever and wherever they need it. But the reality is right now children and youth don’t have access to crisis response services, evidence-informed practice, or school-based services depending on where they live, who pays for their care, and who helps them identify resources. The mental health system in Virginia desperately needs more mental health professionals, particularly for children and youth, and every effort should be made to grow, support and retain the mental health workforce, particularly a culturally and linguistically diverse workforce.

Meeting this moment for youth mental health will also require major shifts in how children and youth are prioritized in our system. Currently, new initiatives or expansions will delay the implementation of child- and youth-focused plans until “phase two” — a step we often wait too long to achieve. Young people in Virginia deserve:

  • A fully resourced mental health system that offers services in schools and within their communities by providers and peers they trust.
  • Support before witnessing or becoming victims of violence in their communities, not after the fact.
  • To be treated as the experts in their own lives to identify the solutions to promoting positive mental health in their schools and communities.

Mental Health Priorities:

  1. Attract a diverse workforce by offering incentives to enter the behavioral health field, achieve licensure, and receive appropriate compensation.
  2. Sustain the increased Medicaid reimbursement rates for community-based behavioral health services and early intervention services to ensure families receiving Medicaid have access to a wide variety of community-based mental health providers.
  3. As Virginia builds out crisis response and stabilization services, we must ensure services are designed for the developmental needs of children and youth and available in every region. New proposals and expansion of crisis response must include components specific to children and youth and provide adequate resources to build the capacity of the system.
  4. Improve access for children and youth to receive behavioral health care in schools by supporting a Medicaid rate study to create new services under school-based mental health services that includes youth input and engagement and provides technical assistance to school divisions to bill Medicaid for school-based services.
  5. Support proposals to invest in community-based gun violence prevention and provide Medicaid coverage immediately to children and youth who witness violence or are victims of trauma. Community services should be better equipped to respond with trauma-informed care, better resourced to retain and attract professionals through more competitive reimbursement and serve all children who are exposed to violence and community-level trauma regardless of diagnosis.

Governor’s Proposed Budget: 

  • Includes $58.4 million to increase funding for the comprehensive crisis services system. 
  • Includes $20 million to fund comprehensive psychiatric emergency programs or similar models of psychiatric care in emergency departments. 
  • Includes $20 million for the one-time costs of establishing additional mobile crisis services in underserved areas. 
  • Includes $15 million to provide school-based mental health integration grants to 30 school divisions. 
  • Includes $9 million for telehealth mental health services in schools and higher education.   
  • Includes $3 million to expand loan repayment for child and adolescent psychologists.

House and Senate Budget Negotiations: 

  • Support $54.4 million in state and federal funds from the Senate to fund a 10% Medicaid rate increase for behavioral health services. 
  • Support House and Senate proposals of $8.4 million for children’s behavioral health services in communities. The House-approved budget includes a language update to support flexible use of the funds. We support the additional funding and flexible language included by the House.  
  • Support $7.9 million from the Senate to expand Virginia Mental Health Access Program (VMAP) to include children aged 0-5 by training early childhood medical providers. 
  • Support $500,000 in state and federal funds from the Senate to provide technical assistance to school divisions to bill for Medicaid.  
  • Support $450,000 in state and federal funds from the Senate to begin a rate study for Medicaid to redesign behavioral health services, including school-based mental health services.
  • Support $181,250 from the Senate to create a social media campaign geared towards young people, and with youth consultation, for suicide prevention. 
  • Both House and Senate budgets remove elementary and secondary education from telehealth mental health supports.  
  • The House proposes moving $15 million in school-based mental health programs to the Department of Education.  


For more information, email info@vakids.org.