Mental health issues and the importance of treatment have become regular news stories—from anecdotal evidence of Britney Spears checking herself into a mental health facility recently, to the Centers for Disease Control and Prevention reporting that suicide among adults has risen in almost every state, to mass shooting events—the crisis is clear. However, despite growing demand, American mental health services remain inadequate, and the steps to address this are less defined. We’re going to analyze some key issues causing these problems and highlight some solutions currently being implemented, as well as examine how we should address this growing problem moving forward.
Lack of insurance coverage makes mental health services expensive
When you go see the doctor when you are sick, they treat your illness, and your insurance usually pays for the services without a problem. But when it comes to mental health treatment, insurance coverage is not so clear cut.
After the Great Recession of 2008, states drastically cut funding for the already fledgling public mental health system by around $4 billion. Additionally, a report from JAMA Psychiatry shows that psychiatrists are significantly less likely to accept insurance than other physicians, meaning the average American may not be able to afford mental health treatment even with insurance.
Because many mental health counselors working in private practice know that insurance companies may not reimburse them, they will often charge patients out-of-pocket. These hourly costs can range from $75-150 in most areas or up to $200-300 an hour in a larger city like New York. Many therapists will work on a sliding scale fee schedule, which is based on your income, but regardless, the patient is usually left footing the bill for mental health treatment.
John Kluczynski, Psy.D., adjunct faculty in The Chicago School’s Psy.D. in Clinical Psychology program explains, “There was a time when psychologists couldn’t bill for insurance, and I’m talking about during my career,” he says. “When Obamacare was first proposed and began being implemented there was a bright light that has kind of gone away now. There were people that could afford all kinds of health care for the first time in their lives—and reasonable health care. People could come and see a psychologist and know that it would be paid for. In private practice, we can only do so much pro bono work.”
Crisis hits harder because of a lack of qualified professionals
Studies show that the shortage of mental health professionals is an escalating crisis in the U.S. A 2016 report by the Health Resources and Services Administration projects that the mental health care field will be 250,000 workers short of the projected need by 2025.
While dealing with a lack of clinicians everywhere, rural areas continue to be hit the hardest. A study in the American Journal of Preventive Medicine shows that 65 percent of rural counties do not have a psychiatrist. More mental health professionals tend to live in urban areas, which clusters the available resources for patients and often leaves rural areas without help.
This means non-metro patients are forced to drive to nearby cities and cover the additional cost this causes; frequently, many will simply choose not to seek treatment because of this cost and inconvenience.
This affects children and adults in negative ways. The National Association of Mental Illness reports that 60 percent of adults and nearly 50 percent of youth between 8-15 years old, with a mental illness did not receive mental health services in the previous year.
Poor access to mental health professionals and treatment options can result in higher rates of suicide and drug addiction, both of which are disproportionately more prevalent in rural areas. The domino consequences for the lack of help in rural areas continues.
Qualified professionals find innovative ways to meet needs
While insurance coverage and the shortage of qualified professionals for treating mental health are problems unlikely to be addressed quickly, there have been innovative solutions developed to address the growing need for mental health services. From community centers that determine charges based on income, to online solutions through telemedicine, practitioners are finding creative ways to alleviate access issues.
The Chicago School offers mental health services to those in need through a variety of renowned counseling centers in Southern California in addition to a diverse range of community partnerships around the nation. Counseling centers can operate with little to no charge by enlisting master’s and doctoral-level interns working toward licensure to provide the services. These clinics can offer services that normally couldn’t be afforded by patients at no cost or an income-based repayment.
The opportunities for telemedicine continues to grow as online access also grows. Online therapy is often much less expensive for patients, and unlike in-person sessions, it doesn’t matter where the patient and the practitioner are located. Telemedicine can also allow psychiatrists to provide insight and suggestions to primary care physicians who are often on the frontline of mental illness.
The Bureau of Labor Statistics projects that the mental health field will grow by 14 percent from 2016 – 2026. While there is no simple solution to addressing the problem of access for those affected, future mental health professionals should continue to focus on finding new creative ways to increase access for patients.
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