Have We Reached the Tipping Point?
Another senseless tragedy has struck our country and the outcry for solutions pervades the media. How long, though, until we forget? Until the media attention fades? Until we are shocked, again, by the next mass shooting or stabbing or bombing?
There is not a simple solution to this problem. However, we must refuse to accept this string of violence as inherent or inevitable. Other developed countries do not have this problem. There is something in our society that needs attention.
Part of the habitual outcry relates to gun/weapon/violence control. The other, to which I will speak, is regarding mental health services. As a mental health professional as well as a consumer of services, I cannot impress enough the need to strike down the continued stigma related to mental health care that we are allowing health insurance companies to continue in the name of profit.
Who else benefits from keeping this stigma around? Most of us seem to have grown weary of it – especially when the consequences to society cost us billions of dollars and countless lives. Insurance companies, though, need this stigma and the lack of quality services to persist. Now that people are guaranteed coverage, the insurer’s best hope is that people either can’t find services or don’t seek them.
I graduated from Washington University in St. Louis (the #1 ranked school of social work in the country), achieved an advanced credential in substance abuse counseling, and in February 2014 passed the state exam (by a large margin) to become a licensed clinical social worker. I opened an office in the 63118 zip code, which includes several struggling neighborhoods and an underserved population. I can’t get a single insurance company to add me to their network. “We’re sorry, but we have too many of your provider type in that area.” Really? After doing some simple research (I.e. Google), I verified this to basically be a lie.
At first, I was shocked. Why would they deny me access to their network? It doesn’t cost them anything to add….ohhhhh. It does cost them. If they offer quality mental health services, people might actually use them, and insurance companies aren’t in the business of people getting services. Not to mention that this discriminatory practice is preventing me from making a quality living.
This is not a quick fix. However, we have to start somewhere. The government needs to mandate that insurance companies allow mental health providers access to their networks just like for health. We need to fix the issues with supply of services before we can address the demand for them.
It is evident from the recent increase in gun-related tragedies, like the school shooting in Connecticut, that something needs to change. Focusing on gun control is one of the obvious, and needed, choices for change. However, just focusing on gun control is like treating the symptoms of an illness as opposed to the cause.
Over the past 50 years in this country, we have seen a radical reduction in the supply of services for those people in need of mental health care. Most people with mental health disorders (even the most severe) are not violent. However, almost all of the people who commit such a violent and senseless crimes do so because of untreated mental illness. In this "highly-developed" country, people have not had adequate access to physical health care, let alone mental and behavioral healthcare. We have allowed insurance companies and managed care organizations to define mental health care as "optional" and "restricted." We have stood by as legislators that have long mismanaged State budgets cut mental health services in the first round - the "low hanging fruit" so to speak. We have allowed the stigma that people with mental illness are "broken" to continue through a total lack of adequate education and prevention programs.
We need to make sure that this nation's healthcare overhaul includes best-in-class services for mental health. The best evidence-based research supports that mental health disorders are physical illnesses of the brain. It is no longer acceptable to treat individuals with mental illness as second-class citizens (at best). Not only can we afford to make this happen, we can't afford not to.