Rusty Selix
Executive Director, Legislative Advocate
California Council of Community Mental Health

In April 2012, Fred Paroutaud, a California man with no history of mental illness, experienced a psychotic episode. Mr. Paroutaud was hospitalized and diagnosed with bipolar disorder. Just 72 hours after he was admitted, and despite the fact that he was still experiencing hallucinations, he was discharged and referred to outpatient group therapy. Because his condition remained unstable he requested alternate therapy and one-on-one sessions with a psychiatrist. He was denied both by his health plan and his condition deteriorated.

Concerned by his worsening depression, his wife appealed to the health plan again and again. She pleaded that her husband required more supervised and personalized treatment. While waiting for an appointment with his psychiatrist, and just two months after his first psychosis, he died by suicide.

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Paul Gionfriddo
President Mental Health America

That’s the bottom line message in a recent report, entitled Parity or Disparity: The State of Mental Health in America 2015, released by Mental Health America (MHA).

But the good news is that there are plenty of things we can do to change that – if we’re willing to change the way we approach mental illnesses in general.

MHA produced this report because we aren’t satisfied with the narrowness of the policy debate we have been having. It has been too much about public safety and post-crisis intervention, leading to a focus on inappropriate, back end, post-crisis care. These interventions occur long after mental health concerns—if identified and treated early—could be eliminated or mitigated, avoiding crises and tragedies.

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Ken Dolan-Del Vecchio, LMFT, LCSW, DVS, CEAP, SPHR
Vice President, Health and Wellness, Prudential Financial, Inc.

I read Carolyn Beauchamp’s recent post CFYM with interest, but not surprise. Ms. Beacuchamp discusses the inadequacies of insurers’ behavioral health networks and highlights the challenges that insured patients encounter when seeking mental health care. Often network information is outdated or incorrect, and it can be extremely time-consuming and frustrating to obtain an appointment. For someone in a worsening mental health state, such obstacles are frustrating at best, catastrophic at worst.

While Carolyn’s piece sheds light on this important issue, it is—unfortunately—not news to those of us who work in the behavioral health field. As a practitioner, I experienced the frustrations of patients struggling to find an in-network provider or schedule an appointment within a reasonable time frame. Now, in my current role as Vice President, Health and Wellness, at Prudential Financial, I work to combat these challenges and reduce obstacles to care.

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A provider’s perspective on the limited access to mental health care

Dr. Philip R. Muskin
Professor of Psychiatry
Columbia University Medical Center

As a practicing psychiatrist and patient advocate, I strongly believe that equal treatment and quality care should apply to someone who has a chronic mental health illness, like schizophrenia or major depressive disorder, requiring ongoing therapeutic and complex medical management, just as would apply to a patient in need of cardiovascular treatment or other chronic medical issue.

I’m troubled and frustrated by the rash of recent studies finding that patients across the United States are unable to obtain a timely appointment with a local mental health provider, notably a psychiatrist, who accepts their insurance coverage. This growing problem, old news to those of us practicing in the field, is multi-faceted and a fix will require a significant commitment to change on the part of many involved in the delivery and financing of health care. Unfortunately, it’s not clear such a commitment yet exists.

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Carolyn Beauchamp
President and CEO, Mental Health Association in New Jersey
Mental Health Association of NJ Finds Access to Providers Lacking 

Rhonda’s story 
Rhonda, a young woman living with both bipolar disorder and an eating disorder for most of her life, was frustrated. She’d been trying for weeks to find a new psychiatrist, after being released from an inpatient clinic, where she was treated for a severe bipolar episode. On a list of 15 providers, several were simply unreachable, either wrong numbers or no answer. When she got through to the others, they were either not accepting her insurance or had a 4-6 week wait for an appointment. She felt distraught and hopeless. She didn’t know how she would cope.

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Donna Holland Barnes, PhD
President/Co-Founder, National Organization for People of Color Against Suicide
Howard University, Department of Psychiatry

Now is a frustrating time to be working in suicide prevention. While death rates for the other leading causes of death are mostly decreasing or holding steady, death rates for suicide continue to climb. In 2000, the U.S. suicide rate was 10.4 deaths per 100,000 people, according to the Centers for Disease Control and Prevention (CDC). By 2011, the rate had climbed to 12.3 deaths per 100,000 people. Suicide rates among middle-age adults rose at an even higher rate, jumping nearly 30 percent between 1999 and 2010, according to the CDC.

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Kimberly Morrow, LCSW

Practical advice for obtaining quality mental healthcare when money is tight

Thanks to mental health parity, many more people have access to psychotherapy than in the past. But two great barriers to treatment remain. The first is shame, as the stigma of mental illness still prevents many from seeking professional help. The second is cost, because even when people have health insurance, the expense of co-pays and high deductibles can be too much when money is tight.

For some people, the predicament of needing mental health treatment, but not being able to afford it is doubly shameful, and so they never seek the care they need.

But I’m here to tell you there are ways to obtain high-quality therapy for little or no cost, and people should never let shame get in the way of wellness. Here are some tips for talking to mental health providers about cost concerns, as well as suggestions for ways you can get free or discounted care.

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Ron Manderscheid, PhD
Executive Director
National Association of County Behavioral Health & Developmental Disability Directors

Now is the time to help the 7 million uninsured Americans with behavioral health conditions understand their health coverage.

In a recent post, Hannah Sentenac discussed the challenges young adults face accessing mental healthcare. Because many Millennials are choosing job flexibility and self-employment over traditional employment, they are faced with the costly prospect of purchasing their own health insurance; and many have simply chosen to go without. Even for Millennials who have insurance (either employer-sponsored or self-purchased), high co-pays and hefty out-of-network charges have prevented many from obtaining mental health treatment, she states.

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