Ideas to End IMD Exclusion for Mentally Ill (from NAPHS)
The most important change Congress can make to improve care for the most seriously mentally ill is to end the Institutes for Mental Disease (IMD) Exclusion. The IMD Exclusion is a provision in Medicaid that prevents persons with serious mental illness from receiving hospital care when needed. This October 2017 White Paper contains ideas from The National Association of Psychiatric Health Systems (NAPHS) on how to change the IMD Exclusion so it allows coverage for people with mental illness and those who suffer from substance use disorder. Their specific ideas related to serious mental illness are highlighted in this PDF document. NAPHS is the trade association for private and non-profit hospitals so this paper focuses on them. It is important to note that the majority of psychiatric hospitalizations are in public hospitals. Reform of IMD Exclusion could make private and for-profit hospitals more willing to serve the seriously mentally ill.