Finding mental health care shouldn’t be that difficult
Anyone who has had the experience of finding a therapist – especially one with insurance – can attest that this can be a daunting exercise.
It can be even more soul-crushing if you try to find psychological support that is culturally competent regarding race, sexual orientation, or gender identity.
It is hard enough to seek help yourself when dealing with anxiety, depression, or other mental illness (not to mention the persistent social stigma of mental health problems). Trying to navigate a complex and often frustratingly inadequate system can add to the despair.
Whenever I think about this problem, I always remember a fun dry scene from HBO’s “A Black Lady Sketch Show,” where Ashley’s friend Nicole Black’s character stages an elaborate engagement proposal for her. He gets down on one knee and says, âThis is a viral proposal! You always wanted that! “And she replies:” No! What I always wanted was to find a black therapist on the network, but I guess I dream too big. “
It’s funny because it’s true. Virtually every Facebook group I belong to is for people of color or queer, and transsexuals have post after post from people trying to find a therapist who will meet them with all of their overlapping identities. Many people, including myself, have bitterly given up on having their health insurer take over culturally competent therapy.
According to a report by the Seattle Times Mental Health Project reporter Hannah Furfaro, only 12% of Washington residents live in a place where the public’s mental health needs can be met. And systemic barriers like low reimbursement rates from insurance companies are forcing providers to only accept patients who can pay out of their own pocket, which increases equity gaps.
A report by Mental Health America suggested that more than 50% of Washington adults with mental illness are not receiving treatment, the story of Furfaro reads.
And the need is only growing. According to the Journal of the American Medical Association Network, the rate of depression in adults tripled during the pandemic.
It shouldn’t be like that. In 2008, Congress passed the Mental Health Equality and Equality Act of Paul Wellstone and Pete Domenici. The Parity Act required insurers to ensure mental health care at a level appropriate to physical health. But as the National Alliance on Mental Illness points out, equality doesn’t mean good coverage.
Worse still, insurers often just go by the name of “ghost networks” of providers that are either not admitting new patients, are retired, or in some cases are dead. In a 2014 study, researchers couldn’t make appointments with 74% of the psychiatric providers on their list. In response to these obstacles, California recently passed law requiring insurers to reduce waiting times for mental health care to no more than 10 days. Under the new law, insurers could finally be forced to strengthen their utility networks and take a more serious look at the reimbursement of care benefits.
Washington State MP Tina Orwall, D-Des Moines, who has a social work background, said the need for families is urgent. “I only speak to families and they have someone who is suicidal and they are told, ‘Well, it takes four to six weeks to get you an appointment.’ You can’t wait when you are in this crisis, âOrwall said. “And if our partners on the private insurance side really have equality in mental health – that’s what we need.”
Part of the job of improving access is to reduce stigma. While previous generations were not so open and concerned with mental health problems, Generation Z is paving the way for greater acceptance.
David Downing, the CEO of Youth Eastside Services, which cares for the mental health of children and adolescents, said the young people they worked with were more and more aware of mental health issues than older generations, even before the pandemic Awareness of the mental health implications associated with the COVID-19 pandemic reduced stigma even more.
“One of the things I really appreciate about young people is that they really understand the importance of mental health and that it is on par with physical health … much better than other generations,” Downing said. “Right now, our younger generation of children are the healthiest in this regard.”
That shift is badly needed because, Downing said, while Generation Z is more comfortable seeking care and talking about mental health, the rise of social media and the pressures it has brought about for perfection have caused unprecedented levels of depression and anxiety in young people . This has led to a dangerous increase in suicide and drug overdose deaths among this generation, Downing said. Last week, US surgeon General Vivek Murthy issued a rare public health guide to mental health challenges for adolescents.
If there can be a silver lining in this seemingly never-ending pandemic, it could be that we are finally starting to take mental health care seriously.
Accessible, culturally competent insurable mental health care should be the standard – not the exception. Providers should be able to deliver care from anywhere through telemedicine, provide better access to rural areas, and make color therapists more accessible. There should be sanctions for insurers who circumvent the parity law with ghost networks of providers. The need is great and we cannot afford to wait.
Michelle Baruchman, Mental Health Project Editor, contributed to coverage for this column.