By Consumers For Quality Care, on October 1, 2019
Despite federal laws in place to ensure Americans have access to mental health care, many face obstacles when trying to access therapists and other psychiatric services. According to the 2008 Mental Health Parity and Addiction Equality Act and provisions in the Affordable Care, it should be no more difficult for consumers to visit a mental health professional than any other type of doctor. However, consumers across the country continue to see mental health professionals at lower rates and many view these services as out-of-reach. Lack of access to mental health care is especially an issue for consumers in Nevada, according to Reno News & Review.
A 2015 survey produced by the Anxiety and Depression Association of America, the American Foundation for Suicide Prevention and the National Action Alliance for Suicide Prevention found that fewer than 40 percent of Americans have seen a mental health professional. A third of consumers believe that mental health care is inaccessible mainly because the cost is often not absorbed by insurance the way that other care is.
The problem is especially acute in Nevada. In 2013, Las Vegas’ Rawson-Neal Psychiatric Hospital came under fire for placing more than 1,500 mental health care patients on buses and sending them out of state to receive care. Advocates say that the situation has not improved much for consumers since then.
Caitlyn Wallace works as a licensed clinical social worker at Renown Behavioral Health, which specializes in maternal mental health care. Wallace says that private insurance companies have purposefully carved out mental health care in a way that makes it less affordable for consumers.
Those who have insurance with Medicare or Medicaid usually fare no better. It can be difficult for consumers to find practitioners or clinics that accept their insurance plans at all.
“A lot of private practice therapists don’t take either because the reimbursement rates are not sustainable,” Wallace said.
Moreover, the state lacks funding that would bring consumers greater access to mental health services.
“Nevada is hard because other states have a lot more public funding for those sorts of things, whereas Nevada doesn’t have public funding,” Wallace said.
Beyond health insurance woes, it can be difficult to find professionals who are accepting new clients.
“In maternal mental health, for example, there’s no one who regularly takes Medicaid right now—they’re both out on maternity leave,” Wallace said. “And no one who takes UHC. And in terms of Cigna and Aetna, I’m the only one who takes them. But it’s a two-and-a-half-month wait list for me, and for a postpartum mom, that doesn’t work. They need help immediately because they’re at high risk. So there’s a therapist in town who doesn’t normally take those but because they’re at-risk, high-need postpartum moms, she will write up the case agreement and submit it.”
In areas around the state, like Reno, the growth in population is outpacing the number of specialists there to help.
Therapists often have to identify a specific diagnosis for insurance to agree to cover consumers’ care. Wallace say that, in instances like couples-therapy, this diagnosis can drive the substance of the sessions in counter-productive ways.
In other words, the billing needs of the insurance companies dictate the focus point of treatment—not the needs of the patients or the assessment of the therapist. And insurance companies don’t place any value on the mental health care equivalent of preventative care.
Wallace believes that insurance companies should make changes so the substance of mental health care outweighs the billing requirements. She suggests that insurance companies allow consumers to receive somewhere between eight and 12 sessions annual without a diagnosis. She believes that this could help consumers who may be suffering from symptoms of a disorder but who may not meet the full diagnosis, allowing for more consumers to receive quality care.