Marilyn Ricci, Member of NAMI Palm Beach County and Former President of NAMI’s national organization
During my time as President of the National Alliance on Mental Illness (NAMI), I worked with patients and their families to overcome the burdensome delays that insurers and Medicaid create for individuals with schizophrenia. But I also experienced the issue of healthcare delays in my own home since my son has schizophrenia. Thankfully, Florida’s Medicaid program updated its step therapy requirements for schizophrenia this year, which improved access to care for Floridians living with schizophrenia.
In Florida, hundreds of thousands of adults live with serious mental illness. Yet, too many have faced obstacles to the treatments they need to lead stable, productive lives. Schizophrenia, in particular, is a complex and highly individualized condition. Treatment decisions should be made between the provider and patient or care partners, not dictated by insurance hurdles or antiquated policies.
Timely access to the right medication is often the difference between recovery and relapse. Unfortunately, many conventional schizophrenia treatment options were developed more than three decades ago. While they’ve helped countless individuals, they are not the most effective option for everyone. Schizophrenia treatment continues to evolve, with recent developments expanding options for patients and providers. This is a milestone that brings new hope to patients and families like mine.
The consequences of unmanaged or undertreated schizophrenia are devastating. Without access to the right treatment, patients with schizophrenia could be subject to frequent hospitalizations, increased interactions with the criminal justice system, and long-term disability. These outcomes place enormous emotional and financial strain on families and our communities.
Florida’s growing behavioral health workforce shortage only heightens the urgency of ensuring patients have access to the right treatment the first time. When patients are unable to access their prescribed treatment, the provider’s ability to deliver individualized care is limited, and the patient-provider relationship is strained. This often leads to burnout for our medical professionals who are tired of fighting with insurers over their ability to provide patients with the most effective treatment.
Thankfully, Florida leaders have taken meaningful steps to modernize mental health care and expand access to treatments for Medicaid patients, recognizing that innovation is key to improving outcomes. With these smart policy improvements, more Floridians living with serious mental illness can now get the right medication without unnecessary delays or step therapy obstacles.
But the work isn’t done. Meaningful progress means continuing to prioritize access, innovation, and adherence, so that no patient is left behind due to administrative hurdles. Florida has set a national example in access to mental health care and innovation. We are entering a new era of psychiatric care: one where recovery is possible, and people living with serious mental illness are finally being met with solutions, not roadblocks.
As a mother and an advocate, I urge policymakers and stakeholders to keep putting patients first by ensuring access to the right treatment, at the right time, for every individual. When we remove barriers and embrace innovation, we not only improve health outcomes; we strengthen families, communities, and the future of Florida.
Imagery for the 2016 National Alliance on Mental Illness: coverage of the NAMI National Convention at the Sheraton Denver Downtown Hotel in Denver, Colorado, on Saturday, July 9, 2016.
Photo Steve Peterson
Marilyn Ricci is a family advocate, a member of the National Alliance on Mental Illness (NAMI) in Palm Beach County, and a former president of NAMI’s national organization.


