Why is Gaining Access to Mental Health Treatment So Difficult?
Image Credit @jeremyperkins
The need for effective and accessible mental health services has grown substantially nationwide.
According to the National Alliance on Mental Illness (NAMI), 20.6% of U.S. adults (approximately 51.5 million or 1 in 5 individuals) experienced mental illness in 2019.
But while the need for sufficient mental health treatment exists for individuals of all ages, many are unable to receive the care necessary to properly treat and manage their symptoms. There’s also an overwhelming amount of the population who are unable to access any care at all—and not because of a lack of interest or motivation.
In 2019, 10.9% of adults with mental illness had no insurance coverage for mental health services. And even with insurance, many U.S. states typically place individuals on a long waiting list before an initial visit; provide scarce or fragmented services following the intake process; and with 55% of U.S. counties devoid of a practicing Psychiatrist, are unable to provide the collaborative care required to treat co-occurring illnesses.
Though these statistics showcase an array of obstacles concerning the mental health infrastructure in the U.S., there remains extensive, long lasting barriers in accessing sufficient mental health treatment for those who are less privileged and/or who have been subject to oppression and inequality.
Barriers to Mental Health Treatment Nationwide
Let’s dive in deeper to the barriers that many individuals experience on their journey to health and wellness.
Out-of-network costs and Lack of Insurance
For individuals who may be without insurance, finding a mental healthcare provider that doesn’t break the bank can be few and far between.
While some providers will offer self-pay and sliding scale options to clients, these rates can be hard to afford, and to justify, if stuck between receiving therapeutic services and putting food on the table.
When unable to schedule an appointment with an in-network provider, it’s common to see an individual book with an out-of-network provider—only to be shocked by the out-of-pocket expenses left inside their mailbox a few weeks later. Oftentimes, clients will terminate treatment as soon as it begins due to these unforeseen and high costs.
Limited Availability and Clinician Shortages
Say you’re one of the lucky few that locate an in-network provider, in your area, with availability for new clients. A rarity to say the least. Next thing you know, there’s a 90-day waiting period before you can even see a clinician. Unfortunately, this happens more times than not and in that moment it’s easy to feel like all hope is lost.
While it’s best to keep the appointment and still look for openings elsewhere, such a delay for care can increase stress and anxiety, often leading an individual to put their health and well-being on the backburner.
Inadequate or Fragmented Care
It’s not so unexpected to learn that many individuals who are receiving mental health services can attest to the sporadic nature of scheduling for weekly, bi-weekly, or even monthly appointments. Clients may have a productive session one week, where they begin forming a strong therapeutic alliance with the clinician, then find they’re booked straight through next month.
Disruptions like such can be counterproductive for individuals’ mental health and can significantly delay, or potentially cause a regression in, treatment progress. Still, the delivery of inadequate or fragmented care is only the result of the larger problem: We have an increase in demand for mental health treatment but a lack of resources for meeting those demands.
Societal Stigma
The stigma surrounding mental health and mental health treatment is still prevalent in many areas and within many cultures. As a result of these driving attitudes and beliefs, an individual may feel reluctant to seek mental health treatment even if they know it could prove helpful to them.
Additionally, because of a lack of awareness on the topic, much of the population is not versed in locating appropriate mental health treatment for themselves or for another trusted party if desired.
Collaborative Efforts for Change
In order to increase access to mental health treatment, society as a whole must work together to address the limiting barriers. While the State and Federal government have a significant role and responsibility in strengthening our mental health infrastructure, insurance companies, physicians, mental health professionals, and members of society alike must join forces to ensure the needs of communities and all residing there are able to be met.
We do this by: Utilizing community-based surveys and assessment tools; spreading awareness and education about mental health and the healthcare system; examining costs of services for the insured and uninsured; holding mental healthcare in the same esteem as we do physical healthcare.
References
Mental health by the numbers. NAMI. (2021, March). https://www.nami.org/mhstats.
Mental health disparities: Diverse populations. American Psychiatric Association. (n.d.). https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts.