ArticleThe Milbank quarterly2023
Earmarked Taxes for Mental Health Services in the United States: A Local and State Legal Mapping Study.
Article in The Milbank quarterly, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Mental Health in Regularly Collected Nationally Representative U.S. Surveys: What's Measured and What's Missing?Administration and policy in mental health · 2026Article
- A Mixed-Methods Exploration of the Implementation of Policies That Earmarked Taxes for Behavioral Health.The Milbank quarterly · 2024Article
- From plan to practice: A qualitative study of public mental health therapists' session-planning practices.Psychological services · 2024Article
- Operational and organizational variation in determinants of policy implementation success: the case of policies that earmark taxes for behavioral health services.Implementation science : IS · 2024Article
- A Tale of Two Taxes: Implementation of Earmarked Taxes for Behavioral Health Services in California and Washington State.Psychiatric services (Washington, D.C.) · 2024Article
- Acceptability and feasibility of policy implementation strategies for taxes earmarked for behavioral health services.Frontiers in health services · 2024Article
- Comparing organization-focused and state-focused financing strategies on provider-level reach of a youth substance use treatment model: a mixed-method study.Implementation science : IS · 2023Article
- Implementation of the 988 Suicide & Crisis Lifeline: Estimating State-Level Increases in Call Demand Costs and Financing.The journal of mental health policy and economics · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Policy Points Local governments are increasingly adopting policies that earmark taxes for mental health services, and approximately 30% of the US population lives in a jurisdiction with such a policy. Policies earmarking taxes for mental health services are heterogenous in their design, spending requirements, and oversight. In many jurisdictions, the annual per capita revenue generated by these taxes exceeds that of some major federal funding sources for mental health. CONTEXT: State and local governments have been adopting taxes that earmark (i.e., dedicate) revenue for mental health. However, this emergent financing model has not been systematically assessed. We sought to identify all jurisdictions in the United States with policies earmarking taxes for mental health services and characterize attributes of these taxes.
methodsA legal mapping study was conducted. Literature reviews and 11 key informant interviews informed search strings. We then searched legal databases (HeinOnline, Cheetah tax repository) and municipal data sources. We collected information on the year the tax went into effect, passage by ballot initiative (yes/no), tax base, tax rate, and revenue generated annually (gross and per capita).
findingsWe identified 207 policies earmarking taxes for mental health services (95.7% local, 4.3% state, 95.7% passed via ballot initiative). Property taxes (73.9%) and sales taxes/fees (25.1%) were most common. There was substantial heterogeneity in tax design, spending requirements, and oversight. Approximately 30% of the US population lives in a jurisdiction with a tax earmarked for mental health, and these taxes generate over $3.57 billion annually. The median per capita annual revenue generated by these taxes was $18.59 (range = $0.04-$197.09). Per capita annual revenue exceeded $25.00 in 63 jurisdictions (about five times annual per capita spending for mental health provided by the US Substance Abuse and Mental Health Services Administration).
conclusionsPolicies earmarking taxes for mental health services are diverse in design and are an increasingly common local financing strategy. The revenue generated by these taxes is substantial in many jurisdictions.
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