“Has the world changed since the tragedies of Newtown and the other tragedies? Sadly, little has been done to get those who need help the help they need,” U.S. Rep. Tim Murphy, a clinical psychologist from the Pittsburgh area, recently told The Columbus Dispatch. “Those who need help the most are getting it the least because the nation’s mental health system is broken.”
Mental Health Laws that are still waiting
The news source explained that there have been many proposed mental health policy changes in the past few years, but many have not been adopted. For example, earlier in 2013, President Obama proposed that Congress allocate an additional $130 million to help educate teachers on how to recognize mental health problems in the young. However, that money has yet to be distributed.
Furthermore, a major piece of bi-partisan legislation called The Excellence in Mental Health Act was proposed this year, but it was only able to pass when it was cut down considerably and tacked on as an amendment to a Medicare law. The Columbus Dispatch quoted Sen. Debbie Stabenow, D-Mich., a major sponsor of the act, who said that she hopes the law will pass in 2014. It’ll allow people to use Medicaid to pay for the use of community health centers.
Not all bad news
However, this is not to suggest that nothing has changed during 2013 in regards to mental health legislation. For example, the news source pointed out that measures were finally taken to fully implement the Mental Health Parity Act, a law passed in 2008. This act requires insurers that offer mental health benefits to ensure these benefits are equal to the physical health one offered. This means more mental health benefit packages must cover inpatient, outpatient and emergency services, as well as medication.
Furthermore, Vice President Joe Biden recently announced that the government is dedicating an extra $100 million to mental health services. Half of these funds will go to the U.S. Department of Health and Human Services to help it empower community health centers to hire more mental health staff, while the other half will be dedicated to providing more mental health services in rural parts of the U.S.
“It’s a good start, don’t get me wrong,” said John Grohol, Psy.D., founder and CEO of Psych Central, in an online column quoted by The Columbus Dispatch. “But it’s a drop in the bucket compared to the $4.35 billion taken out of the mental-health treatment economy since 2009.”
Terry Russell, executive director of the National Alliance on Mental Illness-Ohio, added that she believes not enough has been done since the Sandy Hook School shootings in Newtown, Conn., to make sure that a tragedy like that will not occur again simply because the perpetrator has not gotten the mental health care he or she needed.
The ACA may not bring necessary change
The U.S. Patient Protection and Affordable Care Act declared that insurers can no longer declare that people have spent their lifetime dollar limits on essential services, and this includes mental health services. While this is good news for many in the industry, it may not be enough.
According to an article published by USA Today, while the ACA will require insurers to cover mental health issues the same way they do physical problems, a recent study has shown that only half of psychiatrists accept insurance. The news source spoke to Tara Bishop, associate professor of public health and medicine at Cornell Medical College, who explained that she and her colleagues discovered that between 2009 and 2010, only 53 percent of psychiatrists took insurance. This is a stark contrast to the 89 percent of other physicians who accepted insurance between 2009 and 2010.
Furthermore, the difference between physicians and psychiatrists did not end there.
“It seemed to be getting worse in more recent years,” Bishop told USA Today. “We saw similar things for Medicare: 54.8 percent of psychiatrists took Medicare, as opposed to 86 percent of other physicians.”
The news source explained that there is no provision in the ACA that requires psychiatrists to take insurance. This is a problem, since Bishop believes that many people who can’t afford a psychiatrist may end up in the emergency room due to a mental health problem that could have been detected and treated earlier by a psychiatrist.
Unnecessary trips to the ER drive up health care costs in the U.S. dramatically. Reducing them is one of the main goals of health care reform in the coming years, which is why it’s important to find ways to steer people toward using psychiatric services rather than simply going to the hospital.
Bishop added that fewer medical residents seem to be choosing psychiatry, which could be adding to this problem. This is something Rep. Murphy pointed out when he first introduced legislation designed to encourage the mental health industry to focus most of its resources on treating the most seriously mentally ill.
“We have fewer psychiatric hospital beds, fewer outpatient-treatment options, restrictions on the use of medications that can and do help those who are mentally ill, too few psychiatrists and psychologists and clinical social workers, especially child and adolescent specialists, and especially ones who are trained and specialize in treating the seriously mentally ill,” said Murphy, quoted by The Columbus Dispatch. “We have too many barriers that prevent doctors from communicating with parents of the sons and daughters with persistent serious mental illness. We have federal barriers that block treatment, federal dollars that go to grants for programs that do not work.”
All of this suggests that more may need to be done to ensure people have access to the mental health care they need.