We’ve come a long way from electric shock therapy, lobotomies and whispered comments about psychological conditions. The past century has witnessed substantial strides toward erasing the taboos and stigma surrounding psychological problems and disorders. When someone mentions mental health issues these days, we no longer conjure up an image of straitjackets and asylums. Instead, we picture more nuanced care such as cognitive behavioral therapy, mental health education, or even medication.
But while society views psychological problems as similar to physical ailments and diseases, it seems as though the healthcare industry hasn’t quite caught up. According to the National Institute of Mental Health, about one in five adults in the United States lives with mental illness. In 2017, this accounted for approximately 46.6 million people. Considering the pervasiveness of mental health issues, it would be fair to assume the insurance industry typically offers robust opportunities and coverage for access to care, yet this doesn’t always seem to be the case.
A study conducted by the American Psychological Association identified positive attitudes regarding the importance of mental health and seeking treatment. In a poll of 1,000 randomly selected Americans, “91 percent said they would likely consult or recommend a mental health professional if they or a family member were experiencing a problem.” The disparity between mental health awareness and procuring care seems to stem not from social attitudes about mental health, but the coverage and cost of care. In this same study, 87% of participants identified a lack of insurance as a barrier to seeking treatment, while another 81% cited cost concerns as a deterrent.
Viewpoints from Rachel Gerard
Even those who have comprehensive medical coverage often find gaps within their mental health care and limitations to their benefits. Limitations on counseling sessions, psychiatric evaluations and other forms of mental health intervention can often prevent the average American from receiving treatment, even with the advent of the Mental Health Parity and Addiction Equity Act.
According to a 2015 survey by the National Alliance on Mental Illness, 29% of those enrolled in Affordable Care Act (ACA) coverage reported that either themselves or a family member were denied coverage for mental health care. This number is more than double the proportion of patients denied general medical care. Because insurance companies are incented to keep costs low, mental health coverage is often an area where corners are cut.
There is a slew of reasons why mental health care is more difficult to access than other types of medical care and it is apparent that this is a broken system in the U.S. – fundamentally, something needs to change.
One solution that could potentially bridge the gaps in coverage is implementing Integrated Care, or the holistic assessment of one’s mental health in tandem with one’s physical health. Integrated Care (for example, a preliminary evaluation of mental health status while receiving a yearly physical exam) is a way to include mental health care in the same facility at the same time as other health concerns rather than isolate it and its costs. This integration would allow for mental health care to follow social attitudes in normalizing mental health care and make it more accessible and affordable. It’s important that employers are cognizant of these issues when developing their benefits strategy.