Mental Health Department seeks beds, crisis centers and trauma program funding after years of cuts

Commissioner Kim Boswell of the Department of Mental Health told the Joint Interim Committees the department aims to rebuild the state mental-health infrastructure over five years, asking for funding to raise civil commitment beds, establish crisis services statewide and increase community-provider rates.

"We need to increase civil commitment beds to 30 per 100,000 Alabama residents," Commissioner Boswell said, citing a Treatment Advocacy Center report that found 30 beds per 100,000 as a minimum and 50 per 100,000 as an optimal level. She added Alabama currently stands at about 13.4 beds per 100,000.

Why it matters: Commissioners and county officials told the panel that Alabama’s shortfall of inpatient and crisis resources contributes to jails and emergency departments becoming default crisis settings. Boswell said rebuilding capacity is required to reduce avoidable hospital stays and to provide voluntary crisis care.

Capacity and costs: Boswell told the committee the state now has 88 civil-commitment beds and 16 crisis-residential beds operated by community mental-health centers; 214 contracted community hospital beds; and 285 beds at state hospitals. She said the department plans a 16-bed crisis residential unit opening in spring 2026 in Decatur and that the department can fund 22 co-occurring civil commitment beds in seven counties using opioid-settlement dollars.

Funding model and priorities: Boswell said the department proposed increasing crisis-residential rates toward the Medicaid daily rate of $850 and noted many crisis-residential units remain funded at $200–$250 a day. She told lawmakers the department had asked for funds to increase civil-commitment bed capacity and to stabilize funding for 988 call centers and mobile crisis teams.

Children, trauma and schools: Boswell highlighted a children's-services pilot to implement trauma-systems therapy in clinical and organizational settings, proposed as a one-time expense and to be piloted with Gateway and Family Services in Birmingham. She said the department has served more than 11,500 children in its school-based mental-health programs and asked to expand from 15 to 19 school systems and to increase therapists where demand is highest.

Veterans and public-safety interventions: Boswell said the Veterans Mental Health Steering Committee recommended a veterans resource center to integrate employment and health services and an expansion of the traumatic-brain-injury program to remove a two-year window that currently limits eligibility.

Public-safety measures: The department backs voluntary safe-storage legislation, "Safer Together," a bill that would let gun owners store weapons temporarily at participating gun stores or law-enforcement locations and provide civil immunity for those stores; Boswell said the measure creates time and space that can reduce suicide risk.

Questions and next steps: Representatives asked for detail about how proposed civil-bed funds would be allocated between crisis residential units and designated facility beds; Boswell said roughly 75% would go to crisis residential units and 25% to community hospitals if the requested funding is approved. Several members emphasized the long-term nature of the rebuild and cited the need to synchronize state and federal funding and local county-level resources.

Ending: Boswell closed by urging a cross-system approach and said the department will continue work with counties and community providers to deploy crisis services and expand pediatric and adolescent capacity.