As a nation, the US has done a terrible job of meeting people’s mental health care needs. Both public and private health insurance cover mental health care, but they pay so little for mental health services that it is often hard to find mental health providers who accept insurance. CNBC reports on mental health care cost and accessibility issues.
Almost 20 percent of Americans have a mental health condition. And, spending on mental health care, including therapy, prescription drugs and inpatient care, is up 52 percent in the last 11 years. But, it’s hard to find mental health providers who take insurance.
Nine in ten physicians providing physical health care take insurance. Fewer than six in ten psychiatrists, 56 percent, take insurance. More than five times as many people are forced to pay out of pocket for the full cost of their mental health care than for their physical health care.
Mental health care tends to cost people a lot more than physical health care. People with depression typically spend $10,836 each year. People with diabetes on insulin spend less than half that, $4,800 a year.
It’s also hard to find mental health care providers in many areas of the country. More than one-third of Americans live in areas where they are scarce.
Between high costs and the difficulty of finding mental health providers, more than half of people who need treatment do not get the treatment they need. And, Black Americans have twice as much difficulty getting mental health care than white Americans.
The US needs to do a far better job of ensuring people access to mental health care for their personal needs as well as for the economic health of the nation. Mental health conditions take a toll on workplace productivity. People miss work or cannot perform at their best level. Reduced productivity is estimated to cost an additional $44 billion a year.
The 2008 Mental Health Parity and Addiction Equity Act improved access to mental health care. It requires insurers to cover access to mental health care on an equal level with physical health care. Put differently, insurers are not allowed to discriminate against people with mental health conditions. But, there are plenty of ways insurers can get around the law.
There are a few ways that people who can’t see a psychiatrist can still get help. For one, their primary care doctors have the opportunity to identify and address their mental health care needs. That’s another reason why having a primary care doctor is so important. Also, at least for now, if you have Medicare or most private health insurance, you could see whether using telehealth services, which are easier to access and cost less, can help.
Medicare coverage of mental health services has improved some, but it is still in need of significant improvement. There is coinsurance parity for outpatient mental health visits. It also now covers depression screenings through the annual wellness visit.
But, more generally, Medicare offers poor coverage for mental health treatments and substance abuse counseling. And, at most, Medicare covers 190 days of inpatient mental health care services in a lifetime. Moreover, fewer than one in four psychiatrists accept Medicare’s rates.
In addition, Medicare does not cover care delivered by mental health counselors. And, people in Medicare Advantage plan have particularly poor access to mental health providers.
Right now, if you need mental health services, NAMI, the National Alliance on Mental Illness, has a free helpline at 1-800-950-6264. And, you can find other lower-cost places to go for treatment through the Substance Abuse and Mental Health Services Administration. If neither of these resources provide you with the information you need, try the National Association of Free & Charitable Clinics or the Open Path Psychotherapy Collective.
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