Thursday, November 23, 2017

When the System Fails You

Living with mental illness is a challenge in and of itself. Struggling through the different disorders and all the symptoms that come with it is a daily battle. Some days you win and some days you lose. One of the battles that comes with living with mental illness is learning to fight through the mental health system. While no system is ever perfect, the mental health system is clearly broken and in need of some major help. There are many areas in which it is lacking.
The first major area that it is lacking in is simply the number of professionals available to treat mental illness. There is currently a national shortage of psychiatrists. A study commissioned by the U.S. Department of Health and Human Services concluded that there is at least a 6% shortage throughout the country and that this deficit would continue to rise as time went on if something isn't changed. While this doesn't seem like much, spread that around the country and there are many counties that don't have a psychiatrist at all and some that have one to service an entire county. Additionally, there is also a pooling of doctors around schools so there are more psychiatrists in certain areas than others which makes it harder to get treatment if you don't live in one of those areas. The national shortage is the first thing that needs to be corrected in the mental health system because we need the professionals to help the people who struggle with mental illness. We need to get people trained to help those who are struggling.
The second area that the system needs to fix is the differences in cost and coverage. First I will give a disclaimer that we have come a long way in the past few years and it has gotten better but we still have a long way to go. Currently, Medicare only gives a limited of lifetime psychiatric hospitalization days and once they are used up the only way to get more is to get another plan and that plan also has limited days. Many insurance companies consider therapy to be a specialist service and charge higher copays for it which makes it difficult to do on a weekly or bi-weekly basis for people who really need counseling that often. There is a considerable cost difference between going to a regular doctor and going to a therapist or psychiatrist, simply because it is mental health and not physical health. Another part of this that comes into play is that many providers do not take insurance at all. They are self pay only which makes it even more challenging for people to get the care they need and leaves even fewer people to see who do take insurance. If people cannot get access to the care they need, simply because of funds, how are they supposed to get better?
The third thing that the system needs to correct is making sure they do not turn people away who need the help. I won't spend too much time on this point because I have an entire post about it (see When You're Turned Away). Simply, there are many people who various professionals and hospitals turn away simply because they are "too sick" and they don't know what to do to help them. They give various reason for this but ultimately it doesn't make sense why they would turn someone who needs help away. However, it does happen, and it does need to be fixed. Everyone deserves help, no matter how sick they are.
The fourth thing that the system needs to change is the number of long term facilities that are available. There are many long term facilities available throughout the country but most of those facilities however do not take insurance and require a massive down payment of thousands of dollars. There are close to no facilities that take insurance that are available to help people with real issues. This needs to be corrected. There are many people that are stuck in state hospitals for months, even years who could benefit from a long term facility if one was available. Long term facilities need to be created to help those who need them and need to be focused on the help, not the money.
Overall, these four things are major problems that need to be corrected in the mental health system. Of course, there are many other things as well that need work. Every system has room of improvement and the mental health system is no exception. With these improvements, many more people would benefit and would be able to get the help they so desperately need. It would make a world of difference in our country.