Despite widespread acknowledgement in the medical community that mental health issues are just as serious as any other medical condition, people seeking mental health care often struggle to get access to treatments they need through their health insurance.
It only takes turning on the news to see how impactful mental illness can be on not just an individual, but society at large. Lawmakers debating the future of the health care system should consider taking new steps to limit insurance practices that discriminate against mental illnesses and instead extend the reach of current mental health care.
Huge numbers of people seeking mental health treatment lack access to quality care that is covered by their insurance.
In November 2016, a survey by the National Alliance on Mental Illness found that people with health insurance had more difficulty finding both inpatient and outpatient mental health providers covered by their insurance network in comparison to general medical providers. Patients with mental health concerns are often forced to seek out-of-network providers for behavioral health treatments, resulting in greater out-of-pocket costs.
There are several reasons behind the unmet need for mental health services that are covered by insurance. One is a serious shortage of mental health providers who accept insurance plans in the first place, not because they don’t want to but because they can’t afford to. Because insurers routinely fail to offer adequate reimbursement rates for therapists and psychiatrists, many providers decline to acceptinsurance altogether.
This leaves providers like myself with few options but to work on an out of network basis. This is not only problematic for the patient, but makes it increasingly more difficult for providers to sufficiently sustain their practice through clients who can either afford to pay for their services or are reimbursed adequately by their out of network coverage (if they’re lucky enough to have such coverage). One recent study found that only 55 percent of psychiatrists nationwide accept private insurance plans, compared to 89 percent of doctors in other medical fields.
Along with low reimbursement rates, mental health providers are also discouraged from accepting insurance by the sheer amount of paperwork required to receive payment from insurance companies, which can take up hours every week.
Although filling out insurance forms is a serious time requirement for all medical practices, it is particularly burdensome for smaller offices and sole proprietorships, which are particularly common in the mental health field. Many therapists can’t afford dedicated staff members to do administrative tasks, forcing them to do the work themselves instead of seeing patients.
Even if you are lucky enough to have a mental health provider who accepts your insurance, you might still face unfair obstacles from insurance companies. According to one survey, insurance companies deny coverage for psychiatric medications and treatments at twice the rate of other patients. Despite state and federal laws requiring insurers charge the same co-pays and deductibles for mental health
treatment as they do for other medical care, some patients continue to report being charged higher co-pays for mental health visits than they are for other doctors’ visits.
For patients struggling with mental illness or addiction, being denied treatment by an insurance company can create serious problems. Even being forced to wait a few days or a week to receive approval for medication puts my patients at risk. No therapist wants to take time away from a patient undergoing a psychiatric emergency to haggle with an insurance company.
People suffering from mental illness and addiction already face widespread stigmas associated with their conditions. Many of them are afraid to ask for help until it is too late. The last thing that we need is insurance companies making it more difficult for people to receive the care they need. The impact of this is far reaching in today’s society.
Ms. Carvalho is a therapist in private practice in New York City and a lecturer at the College of Staten Island. She has a master’s degree in psychological counseling from Columbia University.