Self-styled "mental health advocates" have accused Medicaid officials in Rhode Island of jeopardizing the health of mentally ill patients by encouraging the use of lower-cost generic drug treatments. The state's new emphasis on generic medicines came in the wake of efforts by Rhode Island lawmakers to authorize the use of a preferred drug list designed to control costs by limiting the medications that will be covered by Medicaid.

During a hearing by state health officials on that formulary, representatives of the National Alliance on Mental Illness urged Medicaid administrators to exempt the mentally ill from the new requirements. Noting that doctors must often try several drugs to treat mentally ill patients before finding one that works, officials from the alliance said that forcing these individuals to switch to generic versions could have "devastating" consequences for their treatment.

Antipsychotic drugs are specifically excluded from the proposed new Rhode Island formulary system. Mental health advocates want the state to create similar exclusions for antidepressant, antianxiety, and anticonvulsant drugs.