By Consumers For Quality Care, on May 28, 2019
May is Mental Health Month and with it has come a number of stories and studies highlighting the rising need for mental health care. Alongside this increased need is a lack of access to the care Americans need and the challenges many face in getting insurance to cover mental health care.
According to STAT, new data suggests higher concentrations of consumers are seeking out mental health treatment. The study found that insurance claims for treatment of depression and anxiety, amongst other conditions, are on the rise, especially for young people. In all, the report found that between 2007 and 2017 claims for behavioral health diagnoses rose 108 percent. While the study showed a clear increase in the number of claims, it was unable to identify what kinds of physicians were making the claims or if the consumers were receiving the long-term care they need.
“Even if someone accesses an initial appointment, that doesn’t mean they’re getting adequate treatment. They might go to one therapy appointment, or fill an antidepressant prescription once,” said Dr. Ana Radovic, an adolescent medicine specialist at UPMC Children’s Hospital of Pittsburgh who wasn’t involved in the report.
The National Alliance on Mental Illness estimates that 60 percent of the over 45 million American adults who experience mental illness do not receive treatment. Data from Florida shows an increase in the need for the mental health care for young people coupled with a lack of access, according to Vice News. Between 2011 and 2016, the number of young people put on temporary voluntary or involuntary holds after threatening to harm themselves or others, referred to as Baker Acting, rose by close to 50 percent. Unfortunately, this gets them help for a short-term crisis, but accessing longer-term care is challenging as evidenced by Edith Ortiz’s 16-year-old daughter who was unable to access mental health treatment for two days following a suicide attempt, as reported by the News-Press. When a bed did open up, it was in a treatment center more than 100 miles away from her home.
There are about 8,300 practicing child and adolescent psychiatrists in the United States to serve more than 15 million children in need, [the American Academy of Child & Adolescent Psychiatry] notes. The academy points to factors swaying medical students from the path, including educational debt, long training requirements, and insurance reimbursement hassles.
When consumers do try to receive care for their mental illness, the process is often riddled with complications and roadblocks. Although mental health parity laws have been in place since 2008, many consumers still face limited coverage options and denials, according to Becker’s Hospital Review. Consumers who seek treatment often find less than adequate treatment options in their networks, whether it is due to the difficulty of finding a qualified provider, finding a provider who accepts their insurance, or finding a provider located within a reasonable distance. In December of last year, Aetna was required by a Massachusetts settlement to improve the quality of its provider directories.
[W]hen members called mental health physicians listed in Aetna’s directory, they learned the phone number was incorrect or that the provider had moved, was not accepting new patients or had retired.
Insurance issues do not stop once consumers begin receiving treatment. Just this March, a judge ruled that UnitedHealth Group was discriminating against those seeking mental health care through denials. In Minnesota, patients and their families have complained of seemingly arbitrary ends to their mental health care, sparking an investigation. For many, obtaining long-term mental health care continues to be an issue.