Access to mental health care tagged posts

Kimberly Morrow, LCSW

Editor’s Note: Over the course of the past several posts on depression treatment, we’ve focused on matching the treatment to the person. For most people with moderate to severe depression, medication is an element of treatment. Thus, the series includes discussion about making choices among medications to best align with the person living with depression’s goals, preferences, and priorities. We also acknowledge that talk therapy is often a core component of effective treatment and long-lasting wellness. In this archived post, we share strategies to access therapy services when cost is an issue.

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TAKE ACTION

Since the first of the year, CFYM has informed and educated our readers  about the issues of mental health parity. Our guest bloggers have asked, “If we don’t have access, do we really have parity?” Others have revealed the tragic results that can occur when access is lacking. Still others have pointed out the disparity between states.

The one point they all have in common is a plea for you, the reader, to take action! Taking action means getting involved. Below are some suggestions:

• Understand your insurance benefits
• Challenge stigma
• Contact your elected officials

While the words are simple on paper, actually taking steps is anything but. That is why CFYM, in partnership with the Depression and Bipolar Support Alliance (DBSA), wants to make getting involved easier for our readers.

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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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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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With today’s post, Dr. King closes out CFYM’s series on youth suicide prevention. We acknowledge the collaboration of National Network of Depression Centers and Active Minds with Care for Your Mind and we appreciate their contributions to our community.

Cheryl King, PhD
Institute for Human Adjustment, University of Michigan

While evidence-based education, prevention, and treatment intervention strategies exist to address the problems underlying youth suicide, significant barriers prevent young people from receiving the kinds of help that can make a difference. Public policy can impact the availability of services, but there’s debate on how to invest resources.

No Single “Right” Approach
When it comes to public policy and funding to address youth suicide prevention, there’s no perfect evidence to indicate a single best or preferred strategy. I personally look at it as a large magnet and, with every strategy, we “pick up” more of those who are at risk.

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Cheryl King, PhD
Institute for Human Adjustment, University of Michigan
National Network of Depression Centers

Suicide is the third-leading cause of death among 15-to-24-year olds, and youth suicide remains a challenging public health problem that is strongly linked with psychiatric disorders and other mental health issues.

Research shows that there are effective education, prevention, and treatment intervention strategies to address this problem. However, there are also barriers that prevent young people from receiving the kind of help that can make a difference.

Some Evidence for Effective Approaches
While it’s a challenge to gather evidence for strategies that address suicide prevention, research indicates that certain approaches lead to increased awareness of risk factors, more referrals to treatment for those at risk, and reduced suicidal thoughts. In some instances, the studies have been large enough to look at reduction in suicide attempts. But we can’t say we have data on treatments and interventions that are actually shown to reduce suicides in youth.

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Melody Moezzi

More than 60 percent of the population in U.S. prisons are minorities, and by some accounts, the three largest mental health facilities in the country are prisons. CFYM continues its interview with attorney, author and mental health activist Melody Moezzi as she points to educating ourselves and the public about our legal rights as a means to righting these injustices.

Criminalizing Mental Health in the United States

CFYM: Melody, in addition to being an award-winning author, you are a public speaker, attorney and an advocate, you also have a Masters in public health. What changes would you like to see in public health policy with respect to mental health care?

MM: First, we need to stop criminalizing mental illness in the US. The three largest mental health facilities in this country are prisons. That’s beyond unacceptable, and it needs to change, particularly in a country that imprisons more of its citizens than any other on the planet. Furthermore, the use of solitary confinement—both in prisons and hospitals—needs to end. I feel very strongly about this because I’ve experienced “isolation,” and I have no doubt that it is cruel, unusual and downright inhuman. No human being is meant to live like that, even for a short period of time. We are social creatures. We need contact with others; we need compassion; we need connection—especially when we’re going through a crisis. That’s just human nature.

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