Idaho cut mental health services. Patients, sheriffs warn of danger to public
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- Sheriffs and providers warn cuts will raise crises, ER visits and jailings.
- Plaintiffs say cuts violate ADA and predict escalating harms to patients, the public.
- State cites budget cuts and Medicaid rate reductions amid a growing deficit.
Since he was diagnosed with schizoaffective disorder as a young adult, Cameron has struggled to manage his condition. He often refused to take his medications or report to appointments, and he cycled through periods of homelessness, incarceration and institutionalization.
Now 31, he’s not generally a dangerous person. But he’s occasionally become so angry about his medications that he has been physically violent with his parents — and has had episodes of believing he was possessed by demons, which prompted thoughts of harming others, according to a lawsuit filed in federal court on his behalf.
Cameron, whose last name was not included in the lawsuit, was a participant in Idaho’s Assertive Community Treatment program, which provided care for hundreds of the state’s residents with severe mental illness until the Idaho Department of Health and Welfare cut the program Dec. 1.
Without it, plaintiffs warn of a “real risk to public safety.”
The program focused on reaching out to patients who hadn’t responded well to traditional mental health treatment methods, serving as a “treatment regime of last resort” for people who would otherwise likely be forced into mental health institutions or long-term hospitalization.
Cameron and four other patients sued department Director Juliet Charron and two other Health and Welfare officials on Nov. 26, asking that the lawsuit be certified as a class action representing other patients too. Without Assertive Community Treatment, they argue, the state is violating the anti-discrimination provision of the Americans with Disabilities Act by failing to provide community-based treatment services.
They want a judge to require the state to restore the program.
Health and Welfare has not yet formally responded to the lawsuit, filed in Boise. Department spokesperson AJ McWhorter, told the Idaho Statesman that it would not comment on pending litigation.
Plaintiffs also predicted “cascading negative consequences” for patients and their families, including more intense symptoms, more frequent mental health crises and an overall decline that would affect their own well-being and “the safety of others and the public at large.”
Those concerns were echoed by a separate lawsuit behavioral health providers filed against the department in state court, and by a joint letter the Idaho Sheriffs Association sent to Gov. Brad Little and legislative leaders Dec. 1.
“We know from the history of the mental health system in Idaho (that) when these services are reduced or eliminated, we see an increase in crisis events, emergency room utilization and incarceration in county jails,” sheriffs wrote.
Without Assertive Community Treatment and other behavioral-health programs the state is cutting, Idaho law enforcement officials will feel the impact first, they added.
“As upstream services reduce, more Idahoans fall into crisis — and when that happens, local law enforcement becomes the default responder,” they wrote. “These decisions will increase: Call volumes for patrol deputies and emergency medical services, increased involuntary holds at emergency rooms, incarcerations in county jails, civil and criminal court cases and negative outcomes for people who were otherwise stable in the community.”
Amid Idaho’s budget deficit — currently $60 million, and projected to top $500 million by 2027 — Little in August required all state agencies other than public schools to cut spending by 3%.
In response, Health and Welfare cut pay rates for Medicaid providers and for private companies that manage Medicaid benefits, including behavioral health contracts like the one for the Assertive Community Treatment program. Magellan, the company that manages Medicaid mental health benefits for the state, announced that it would cut its pay rates by at least 4%, the Idaho Capital Sun reported.
McWhorter said the behavioral health cuts were necessary to achieve the budget trims Little called for. “There are no easy options to achieve the needed budget reductions,” McWhorter told the Statesman.
There have been “preliminary discussions” among lawmakers about possible funding sources to restore behavioral health funding, said Sen. Julie VanOrden, R-Pingree, who chairs the Senate’s Health and Welfare Committee. But she told the Statesman she didn’t know how quickly such changes could take effect.
Idaho sheriffs called the cuts “self-inflicted by an overly aggressive tax reduction stance” in the Idaho Legislature, and a “complicit” executive branch.
“As sheriffs, our foremost duty is to protect the people of Idaho,” they wrote. “We urge state leadership to recognize the real-world public-safety consequences of these decisions.”
This story was originally published December 9, 2025 at 4:00 AM.
