MONTGOMERY, Ala. — A five-year plan from the Alabama Department of Mental Health to more than double the number of civil commitment beds in the state and nearly double the amount of mental health crisis centers is achievable, a legislative leader says.
Kim Boswell, the ADMH commissioner, told lawmakers Thursday the plan calls for the state’s civil commitment bed supply to be increased from 13.4 beds per 100,000 residents to 30 beds per 100,000. It would grow the existing number of Mobile Crisis Teams and Crisis Centers, which respond to people in emergencies, from 14 and 6, respectively, to 23 and 11. It also includes funding community mental health beds at a sustainable level.
“We’ve got to address it,” Rep. Rex Reynolds, R-Hazel Green, the chair of the House General Fund budget committee, told Alabama Daily News after Boswell’s presentation. “It’s going to be costly, I think we’ve got to get through the next couple of budget cycles and get the revenue in place for that second prison, and then that will give us some flexibility to do some things like that.”
Lawmakers were warned earlier this week to prepare for continued declines in General Fund revenues and to spend cautiously in 2026 and beyond.
The ADMH is asking for a total of $248 million for the 2026 General Fund budget, an increase of $10 million over this year. About $23.4 million of which would be for new civil commitment beds, enough to increase the state’s rate from 13.4 beds per 100,000 residents to 16.1 per 100,000.
Lawmakers and Gov. Kay Ivey have bolstered mental health funding in recent years after drastic cuts to services during the recession.
Alabama has struggled with funding an adequate number of mental health beds for years, and in the state’s rural areas, the issue has worsened due to rural hospitals increasingly shifting to a federal funding assistance model that mandates they shutter inpatient services.
“Rural hospitals are shifting their business models, and that means that the number of behavioral health beds in the community is decreasing,” Boswell told lawmakers during a budget hearing. “We’ve already seen this happen with one of the community hospitals, we lost 30 civil commitment beds because they’re shifting to a different model.”
While around $2 million of the state’s share of opioid settlement funds were recently allotted to the ADMH for new civil commitment beds, which Boswell shared would add 22 new beds, Reynolds told ADN that lawmakers could allocate as much as an additional $10 million in opioid settlement funds for additional beds in the future.
On increasing the number of Mobile Crisis Teams and Crisis Centers, ADMH is asking for $11.5 million in state dollars, which Boswell said would be enough to cover the entire state. Today, only 24 counties are covered.
And to increase the state’s community bed rates to a sustainable funding level, ADMH is asking for $13.2 million.
Rep. Pebblin Warren, D-Tuskegee, a member of the House General Fund committee, implored her colleagues to support Boswell’s ask and then some, and spoke to what she considered to be the dire state of mental health in Alabama.
“I think when you look at everything that we’re doing for mental illness in this state, we’re only putting bandages on one source, we’re not dealing with the true issue that we have with mental illness in this state,” Warren said. “When you look at the people that we have walking in the streets, the homelessness… we’ve got to find a way to provide long-term care in the state of Alabama for mentally ill people.”