Healthcare, Mental Health

Is the US mental health care system in crisis?

system_in_crisis health-facts

When we want talk about mental health in the united states, there’s a lot of talk and little action. Many fault mental illness for things like mass shootings even though most mentally ill are not violent but few point out that every year close to 44 million adults will experience a mental illness and less than half will receive care and 40% of those with severe mental illnesses like schizophrenia or bipolar disorder won’t get the help they need.

Here are 5 ways the mental health care system is in crisis :

  1. Institutions

Compared to 50 years ago there are far fewer people in mental institutions today which sounds like a good thing.

When you think about mental institutions you think about : « Girl, Interrupted » (American psychological drama film, 1999) or « One Flew Over the Cuckoo’s Nest » (American film, 1975)… scary places with mean staff and catatonic patients unsanitary inhumane lobotomies… which was true according to a bunch of expose on mental hospitals back in the day, public outrage combined with the first effective anti-psychotic drug put politicians on a path of reform.

So in 1963, John Kennedy signed the Community Mental Health Act which accelerated what’s known as deinstitutionalization, that means institutions were closed and patients move back into their communities. There they were supposed to get care in newly funded community mental health centers. The idea was to create a less restrictive setting and protect patients civil rights, good plan! but after all these years these community mental health centers still have never been fully funded and the program has fallen by the wayside and many of those released have not received the services they need.

Then in 1988 President Reagan’s slashe federal mental health spending by 25 percent.

  1. Jails and prisons

So where do people end up ? for a lot of them… in jail !!! In 2012, there were 10 times as many mentally ill people in prisons and jails than in state hospitals (source : Treatment Advocacy Center) and close to 400,000 adults with untreated mental illness are in jails (source : National Institutes of Health).

In effect prisons are the new mental institutions which according to the National Alliance on Mental Illness : wouldn’t be the case if there were better services ?.

  1. Access

There also aren’t enough people to help, there are fewer psychiatric professionals to go around compared to other healthcare professionals (source : BLS : Bureau of labor Statistics). Close to 90 million Americans live in areas with a shortage of mental health care providers (source : BLS) which can mean long waits for treatment or long distances to travel or there just are no options period, because if you really needed help and inpatient care ! the US has only 28% of the beds needed, and even if you find the perfect doctor ! your insurance might not cover your treatment plan.

  1. Costs

insurance companies used to be able to charge higher co-pays for psychiatric care than for other medical treatments and limit the number of visits. All the way up until 2008 when the mental health parity and addiction Act forced insurers to cover mental illness equally, but experts say insurers are still finding loopholes, and what about all those people who didn’t get access before the law changed ?

 You might go see your doctor once a year ! but if you need to see a psychiatrist once a week !! those co-pays add up, especially when you’re on a tight budget. New rules are not, cost is a real barrier and non-traditional treatments like acupuncture often aren’t covered.

  1. Stigma

Of course, in order for any treatment to work patients have to seek it out, and the stigma against mental illness can hold people back, we often treat mental illness as dangerous or as a character flaw and the fear of being ostracized or institutionalized is real. That’s why admitting you need help is the first challenge and the second is actually getting it.

 So isn’t it time we have a conversation about mental health that actually leads somewhere instead of just throwing up our hands ?