Who gets mental health care in Black communities, and who decides the money?

On this page: Where we stand; Where the care is short; and Where the money comes from

Is this paid with your tax dollars? Yes. Public mental health care runs on federal tax dollars sent to the states, state tax dollars in each state's budget, Medicaid, and in some places county money. In fiscal 2026 Washington sent the states $946.1 million through one main channel, the Community Mental Health Services Block Grant. Here is how the money moves, so you can weigh it for yourself. Some people see these dollars as care that keeps families whole. Others see programs that should be run closer to home, or for less. SourceLine takes no side. The decision stays with you and the people you elect.

Where we stand

Start with what the record shows is holding. From 2018 to 2022, 8.0 of every 100,000 Black Americans died by suicide each year. For all Americans it was 14.0 (record, National Center for Health Statistics through County Health Rankings, age adjusted). In the ten states with the most Black residents, the Black rate ran from 5.1 in New York to 8.7 in California, and in every one of them it was lower than the rate for all residents. That is a strength worth naming and worth protecting.

Now the part that cannot wait. Among Black Americans ages 10 to 24, the suicide rate rose 29.4 percent from 2018 to 2023. Over the same years the rate for all young people that age fell 7.0 percent, and for White young people it fell 14.8 percent. Black youth were the only group with a significant rise (record, CDC, Morbidity and Mortality Weekly Report, September 18, 2025).

Care is harder to reach for us. Black adults were 36 percent less likely than adults overall to get mental health treatment in 2024 (record, HHS Office of Minority Health).

Where the care is short

The federal government marks places that do not have enough mental health professionals as shortage areas. As of October 29, 2026, 1,887 of the nation's 3,144 counties were shortage areas from end to end. Of the 96 counties where Black residents are the majority, 59 were (record, Health Resources and Services Administration, read by SourceLine). Most of those 96 counties are in Mississippi, Georgia and Alabama, and every majority Black county in Alabama is a shortage area from end to end.

A state's or county's Black rate is published only where at least 10 deaths happened in five years, so some places show no Black figure. A missing figure means too few deaths to publish, never zero.

Every state, side by side. The Black suicide rate, the rate for all residents, each state's block grant and how many of its counties are short of care are in one table: see every state.

Your state, your county, your city. Enter your address under Where you live to see your own numbers beside your state and the nation, whether your county is a shortage area, the public agency that serves it, and the people who decide.

Where the money comes from

From Washington. The mental health block grant to the states was $972.5 million in fiscal 2025 and $946.1 million in fiscal 2026, down $26.4 million, or 2.7 percent, before rising prices (record, SAMHSA final allotments). Every state's share went down except New Hampshire's, which rose by $7,112. Adjusted for rising prices, every drop is larger.

Washington also showed how fast the ground can move. On January 13, 2026, the Substance Abuse and Mental Health Services Administration ended about $2 billion in grants for mental health and addiction programs, saying they did not fit its priorities. The next evening, the Department of Health and Human Services reversed the decision and restored them (reporting, California State Association of Counties, January 15, 2026). The grants stand today.

From your state. Most public mental health care is paid for in each state's budget, written by the legislature and signed by the governor, and spent by a state agency. In most states that agency pays local public providers: community service boards, local behavioral health authorities or county departments. Where you live names yours where SourceLine has it on record.

What a state budget can hold, side by side, from one state's record. In Georgia, the Governor's plan for the year that began July 1, 2026 cut the state behavioral health department by $27.5 million, mostly through a lower payment toward employee health insurance, while adding $5.3 million for the 988 crisis line and mobile crisis teams and $9.3 million for housing vouchers (research, Georgia Budget and Policy Institute, February 5, 2026). The legislature added 900 slots for care at home for people with intellectual and developmental disabilities. When the Governor signed the budget on May 12, 2026, he funded 100 of them with $2,318,504 and withheld the other $9,274,016 (record, HB 974 as signed, the Governor's notice on line 789). Every state makes choices like these each year, and every one is on the record.

On this page: Who decides and What you can do

Who decides

• Congress sets the block grant each year in the Labor, Health and Human Services spending bill. Your two senators and your representative vote on it.
• Health and Human Services Secretary Robert F. Kennedy Jr. runs the department that ended and restored the January grants. The post that leads the Substance Abuse and Mental Health Services Administration is listed as vacant (record, HHS, October 2026).
• Your governor proposes your state's budget and signs or vetoes what the legislature passes.
• Your state legislators write that budget. Your state senator and state representative vote on it.
• Your state's mental health agency spends it, and its head answers to the governor.
• Your local public provider delivers care in your county, and in many places its board is appointed by your county.

Where you live fills in every one of these with real names for your address.

What you can do

1. Know your number. Enter your address under Where you live.
2. Ask one question at each level. Ask your county: who sits on the board of our public mental health provider, and how do residents get a seat? Ask your state legislators: what will next year's budget do for crisis care, and for the waiting lists? Ask your members of Congress: will you protect the mental health block grant in next year's spending bill?
3. Mark the next date. Most state legislatures write their budgets between January and spring.
4. Be counted. Under Tell us what this community needs, choose Health and say what your community needs. Your concern is counted with your neighbors' and matched to the body that can act on it.
5. Keep help close. If you or someone you love is in crisis, call or text 988, any hour.

SourceLine does not tell anyone how to vote. The record is here so that every official, in every party, answers for what it shows.

Suicide rates are age adjusted and published only where at least 10 deaths happened in five years; a missing figure is never zero. Frequent mental distress is an estimate for all adults. Money is shown in raw dollars with the year and never added across stages.