When he campaigned for governor in 2018, Ron DeSantis promised he would "maintain" the state's social safety net. In particular, he pledged to "advocate for expanded access to and early intervention of mental health and substance abuse treatment programs."

Shortly after the governor took office, his wife and first lady, Casey DeSantis, announced "Hope for Healing," an initiative focused on mental health and substance abuse. What that meant was additional funding and resources, according to a December 2020 press release from the Governor's Office. 

The state's mental health assistance allocation increased by $25 million to $100 million from the Florida Education Finance Program, the state's funding formula that allocates funds to school districts. It also put $23 million in federal CARES Act funding toward providing mental health and substance abuse treatment for Floridians. 

Following the start of the pandemic, Casey DeSantis' programs specifically targeted students who might be struggling with remote learning. She worked with the Florida Department of Education on a grant to fund increased access to mental health and student support services for 18 rural school districts. She also announced $5.2 million to expand telemental health services for families affected by Hurricane Michael in northwest Florida. 

More recent efforts hit on specialized mental health programs for specific groups. The state's 2021-22 budget secured even more funding — $120 million — from the Florida Education Finance Program for school district mental health assistance programs and $5.5 million for "evidence-based training" to help school employees "identify and understand the signs of mental health and substance abuse." 

That same year, the state set aside $12 million to expand peer-to-peer mental health services for first responders. The state also allocated $4.7 million for "evidence-based suicide prevention efforts" and pointed to a year-over-year decline in suicides from 2019 to 2020 as evidence of success. 

This year, the Legislature's budget included $126 million in recurring funds for mental health services, suggesting a continued dedication to the issue.

In 2022, Melanie Brown-Woofter, CEO and president of the Florida Behavioral Health Association, a treatment providers trade group, wrote a column for Mental Health Month and praised DeSantis for his dedication to funding mental health and substance abuse treatment. 

"The Florida Behavioral Health Association's members are incredibly grateful to Gov. Ron DeSantis for his leadership and recognition of the importance of mental wellbeing and to the Florida Legislature for funding a record $126 million in recurring general revenue for mental health and substance use services," she wrote. "This investment ensures community providers can help Floridians access life-changing mental health and substance use services."

DeSantis also recently announced the expansion of an opioid recovery program that applies a "comprehensive approach" to substance use after overdose, according to program materials. The state also appointed a statewide opioid recovery director, who will offer clinical services for addicts seeking treatment, according to a state press release.

Although it's clear DeSantis acted to fund treatment for mental health and substance abuse, metrics show Florida has still lagged far behind other states in its spending.

Florida ranked near last in per capita mental health spending compared with other U.S. states, according to the 2019 Marjory Stoneman Douglas High School Public Safety Commission report. In 2022, Florida placed 49th of all states and the District of Columbia in Mental Health America's ranking for access to mental health care. (This metric does not, however, include the state's most recent budget.)

DeSantis said he would advocate for expanded access to mental health and substance abuse treatment and early prevention programs. He didn't specify that he would improve Florida's mental health ranking as compared with other states or that he would increase funding by a specific level. Given his initiatives in the last four years, we rate this Promise Kept. ​

While campaigning for governor, Ron DeSantis promised he would advocate for more access to mental health and substance abuse treatment.

This is one of 15 campaign promises by the Republican governor we are tracking on our DeSant-O-Meter as part of our effort to hold politicians accountable for their promises.

DeSantis tried to get started on this promise in his first budget proposal for the 2019-20 fiscal year. (The Legislature, in session until early May, will have the final say.) A DeSantis spokeswoman cited three line items in his budget proposal related to his promise:

•$84.6 million to address the opioid epidemic (which includes $49 million in federal funding),

•$10 million for mental health care in Florida schools,

•$25.7 million for mental health needs, especially funds to expand support for children and youth who are in crisis. That includes money both for experts who will work with families in the community and for in-patient beds.

The budget by DeSantis is a step in the right direction, but Florida has a lot of catching up to do, said Anne Swerlick, a health care policy analyst at the Florida Policy Institute.

She pointed to a report by Mental Health America that ranked Florida 44th on access to care in 2018. The national advocacy group's rankings takes into account access to treatment, insurance, special education, and workforce availability.

Florida has also lagged behind the nation on mental health spending for years.

The budget proposal by DeSantis takes into account the state's growing opioid epidemic. In 2017, there were about 6,200 opioid-related deaths, an 8 percent increase from the year before, according to the Florida Department of Law Enforcement. (The statistic is based on medical examiner data and includes those in which opioids were the cause of death or found in the body of the decedent. That results in a higher statistic than the U.S. Centers for Disease Control's count of opioid deaths.)

Jane E. Johnson, spokeswoman for the Florida Council for Community Mental Health, said the proposed pots of money will help provide services in Florida communities. That includes the much-needed investment in schools as "students are experiencing unprecedented levels of anxiety disorders, suicide attempts and addictive behaviors."

However, she said that when the federal opioid grant expires, there will be a significant gap. That's why the state needs a long-term strategy for addressing the opioid epidemic.

Health policy advocates say that the Florida Legislature has missed a key tool to provide care by forgoing Medicaid expansion as part of the Affordable Care Act.

The Henry J. Kaiser Family Foundation, a nonpartisan expert source on health care research, found that compared to non-expansion states, Medicaid expansion states have seen greater improvements in access to medications and services for the treatment of behavioral and mental health conditions. That included studies showing Medicaid expansion is associated with increased prescriptions to treat opioid use disorder and opioid overdose.

DeSantis used broad language for this promise and didn't provide any metrics to measure it on the campaign trail. However, his budget proposal is a first step. We rate this promise In the Works.