What a government shutdown might mean for mental health care

Lawmakers are still in a gridlock over how to allocate spending, which means a government shutdown is imminent.

In the event of a shutdown, many government programs will be working with a skeleton staff, which will either halt or slow down services. 

One of those services is federally funded community health centers, or FQHCs. These clinics provide primary care, but also mental health and dental care, to mainly uninsured or underinsured people.

Dental and mental health care are often the first to be cut, says Carolyn McClanahan, a physician turned certified financial planner and founder of Life Planning Partners in Jacksonville, Florida.

“The shutdown is going to stop the bread-and-butter mental health care that keeps people out of trouble,” she says. 

‘Emergency rooms are not set up to treat regular mental health issues’

There are more than 1,400 FQHCs in the United States, according to the Health Resources & Services Administration.  In 2022, 90% of patients were at or below the 200% poverty line.

If the government shuts down, FQHCs would lose their second-largest revenue stream. This would compound the effects of inflation, which has increased the price of medical supplies and made it more difficult for clinics to retain staff in a competitive labor market.

Of the 30.5 million patients the clinics served last year, 2.7 million sought mental health care. And a whopping 70% of patients older than 12 have received depression screenings and follow-up plans, when needed. 

Unlike some of the services provided by primary care, those who seek treatment for mental health issues often need ongoing, consistent care. 

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“You don’t just go to a mental health provider once,” McClanahan says. “It takes a long time for people to work through their issues.”

Ongoing mental health care is not something other medical resources are equipped to provide. 

“If someone is depressed or anxious, emergency rooms are not set up to treat regular mental health issues,” she says. 

No one can say for sure what clinics will opt to cut should the government shut down.

“Many are always operating on a shoestring budget, so they are waiting on their checks to be able to keep their services going,” McClanahan says.

“As soon as there is a threat of something looming they are starting to figure out: What are we going to cut  and who are we going to make stay home first?”

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