Mental Health Block Grant

Adults with serious mental illnesses. Includes persons age 18 and older who have a diagnosable behavioral, mental, or emotional condition—as defined by the Psychiatric Association’s Diagnostic and Statistical Manual (DSM) of Mental Disorders. Their condition substantially interferes with, or limits, one or more major life activities, such as: 

• Basic daily living (for example, eating or dressing)
• Instrumental living (for example, taking prescribed medications or getting around the community)
• Participating in a family, school, or workplace

Children with serious emotional disturbances. Includes persons up to age 18 who have a diagnosable behavioral, mental, or emotional issue (as defined by the DSM). This condition results in a functional impairment that substantially interferes with, or limits, a child’s role or functioning in family, school, or community activities.

SAMHSA’s definitions of children with serious emotional disturbances and adults with serious mental illness were provided in a 1993 Federal Register notice (May 20, 1993; 58 FR 29422).

Each grantee has a designated unit of the executive branch that is responsible for administering the MHBG (for example, the Division of Behavioral Health).

SAMHSA expects block grant recipients to satisfy the following performance requirements:

• They must submit a plan explaining how they will use MHBG funds to provide comprehensive, community mental health services to adults with serious mental illnesses and children with serious emotional disturbances. SAMHSA also requires recipients to provide annual reports on their plans.

• They may distribute funds to local government entities and non-governmental organizations.

• They must ensure that community mental health centers provide such services as screening, outpatient treatment, emergency mental health services, and day treatment programs.

• They must comply with general federal requirements for managing grants. They must also cooperate in efforts by SAMHSA to monitor use of MHBG funds. For example, each year, CMHS conducts investigations (site visits) of at least ten grantees receiving MHBG funds. This is to assess how they are using the funds to benefit the population. These evaluations include careful review of the following:

  • How the grantees are tracking use of MHBG funds and their adult and child mental health programs
  • Data and performance management systems
  • Collaboration with consumers and the grantees' mental health planning council

• Grantees receiving MHBG funds are required to form and support a state or territory mental health planning council.

• • A Primer on Maintenance of Effort Requirements for Substance Abuse Prevention and Treatment Block Grant & Community Mental Health Services Block Grant (PDF | 832 KB) — An overview of MOE requirements for the two block grant programs that are vital to state substance use disorder prevention, treatment, and recovery services and state mental health services.

  • Assistant Secretary for Mental Health and Substance Use Letter to the State Authority for Mental and Substance Use Disorders (PDF | 636 KB) — Guidance to states for both the SABG and MHBG regarding a MOE waiver for any state that experiences extraordinary economic circumstances in a state fiscal year.

  • Frequently Asked Questions Regarding Block Grant Maintenance of Effort Requirements for the Mental Health Block Grant (MHBG) (PDF | 295 KB) — FAQs on waivers, material compliance, and deadlines/notifications in regards to when a state has not met the MOE.

  • Mental Health Block Grant 5 percent Crisis Set-Aside Guidance (PDF | 192 KB) Guidance for the required 5 percent set aside of the Mental Health Block Grant (MHBG) allocation for each state to support evidence-based crisis systems as directed by Congress through the Consolidated Appropriations Act, 2021 and the Coronavirus Response and Relief Supplement Appropriations Act, 2021 [P.L. 116-260].

  • MHBG 10 Percent Set-Aside Guidance (PDF | 92 KB) — Mental Health Block Grant 10 percent Set-Aside Guidance: Guidance for the required 10 percent set aside of the Mental Health Block Grant (MHBG) allocation to support evidence-based programs that address the needs of individuals with a first episode psychosis as directed by Congress through its FY 2016 Omnibus bill, Public Law 114-113.

• • Mental Health Block Grant Coronavirus Response and Relief Supplement Guidance (PDF | 276 KB) In accordance with the Coronavirus Response and Relief Supplement Appropriations Act, 2021 [P.L. 116-260], the document provide guidance to the states on the use of the additional $825 million distributed through the Community Mental Health Services Block Grant (MHBG) program to assist in response to the COVID-19 pandemic.

  • American Rescue Plan Act Guidance (PDF | 309 KB) —This document provides guidance to the states for the funds distributed through mental health and substance abuse block grants in accordance with Public Law 117-2, the American Rescue Plan Act of 2021 (ARPA) to address the effects of the COVID -19 pandemic for Americans with mental illness and substance use disorders.