Despite the passage of the mental health parity act a few years ago, and the help that the Patient Protection and Affordable Care Act has also brought, many Americans still fall through the cracks of our disjointed, disorganized public mental health care system.
Unlike public health care, the public mental health system is a patchwork quilt of disparate systems that vary incredibly from state to state. They also rely on significant state funding — funding that’s usually the first to be cut when state budgets are tight.
The U.S. is one of the most wealthy societies in the world who’s standard of living would make people envious. Shouldn’t we do more to ensure that just because you’re poor, you have the same access to treatment as you would if you were poor and had a medical concern?
Andrew Doughman at the Spartanburg Herald-Journal in South Carolina wrote a thoughtful and touching article today shedding light on this ongoing national embarrassment.
Diagnosed with an incurable disease, poor because she no longer was able to work, forced into an early retirement devoid of leisure, unable to sleep regular hours, gaining weight from her medications and severely depressed, she confessed to her health care provider at AccessHealth in Spartanburg that she was suicidal.
“I need help, and I need somebody to talk to who is a professional,” said Moore, 62, who agreed to share her story using her middle name only because of the stigma related to mental illness.
She is like many people in Spartanburg (SC): poor, lacking health insurance and unable to easily find help for a mental illness. Local health experts say the lack of access is a result of a fractured mental health system that strains the community and disproportionately affects the vulnerable among us: children, substance abusers, the poor and the disabled.
People like Moore are commonplace in every community in America. But because they don’t have a huge lobby in Washington or the state capitals, virtually nobody cares about them or stands up for their needs.
While this country continues to give tax breaks to large corporations for every imaginable reason (for instance, The New York Times documents this $3 billion loophole that one company exploits to expand its own profits), it seems unable to understand that millions of Americans are falling through the cracks of our mental health care system. While the politicians dicker, people who need treatment end up getting none at all — and dying because of it. ((Suicide is one of the leading causes of death in the U.S.; suicidal thoughts are most often the result of untreated depression))
Luckily, Moore happens to know a psychologist friend, whom she leans on for support:
“I’m lucky I had a friend who was a psychologist,” she said. “If I didn’t, I would probably be dead. She helped me every time.”
She got a prescription for anti-depressants from her primary care doctor through AccessHealth.
“I can’t say if it’s helping or it’s not helping,” she said. “I’m not going around wanting to kill myself everyday like I was before, so I guess it is helping a little.”
We’re not doing enough as a nation to help people who are poor who have a mental health concern and need treatment. It’s time to open our eyes and fund these treatment programs at the level that’s needed.
Read the full article: Poor, mentally ill in Spartanburg have few options
4 comments
I’m so tired of the lack of resources the mentally ill have in this nation. I feel like we are second class citizens. I’m also disturbed by the lack of major advancements in mentall illness treatments or better medications with fewer side effects. I have type two bipolar disorder. It took me twelve years to get that diagnosis and medication to help. I lost over a decade of living to this illness. I understand that the brain is extremely complex, but more should be done. Research into mental illnesses that garner positive results means fewer people leaving the work force, less money spent on incarceration of those who self-medicate with illicit substances and homelessness. Plus, there is the lack of a higher quality of life. It truly is sad that many more expensive issues could be avoided with upfront research initiatives.
If people are really paying attention to what are the endpoints to PPACA as it now stands, mental health services will be so marginalized and minimized, especially what the IPAB will do as what are the predecessors in most insurance plans now, I actually think psychiatry will be an extinct field by 2016.
But, sensationalism of the few positive points to PPACA, and the sheer denial by partisan hacks who just continue to shout down whatever legitimate complaints are being raised by honest and attentive critics, this country is in real trouble come 2014.
And let me just say this to anyone who is moderate and independent, what kind of landmark legislation is delayed in implementation until 4 years after it is passed? To allow the chief proponent to be reelected and spend two more years fine tuning its full bureaucratic intrusions, and in my opinion, its punishing of any opponents who dare to speak out further. All I have to do to show how history will repeat itself is watch how the VA system is treating active Vets with their mental health services as of today, July of 2012. Drugs and weekly if not less frequent group meetings as psychotherapy. Hey, don’t believe me, talk to the vets getting the services!
It is unfortunate for those who want another crack at crafting real, responsible legislation to impact on health care have to vote for the other party that is equally inept and incompetent at helping the middle class. Heckyl, or Jeckyl. Now that is real representation in a nutshell!
Hey, don’t believe me, let the status woe, er, quo go on. People think it is tough now. Just imagine how invested politicians are as of today in helping the mentally ill. Gifford’s experience had NO impact in change, and that was one of their own!
I am going on vacation, so wanted to offer this addendum after seeing this post got little to no attention since written by Dr G.
How do people expect to be helped by clinicians if they as patients do not want or make little to no effort to help themselves, to accept and enact change? I have worked in community mental health since my third year of residency to now, on my own for almost 20 years post graduation, and I cannot recall a level of dependency, entitlement, and at times brash demand to give the patient what “they want”, which often is NOT what they need as I see nowadays. And, a sizeable percentage of these patients do not vote, so why should politicians prioritize them and the systems they use when the accountability for said politicians is minimal at best?
And, per the way I first heard the story about Mr Holmes in Aurora regarding this notebook yesterday, people sounded quick to try to crucify the psychiatrist or the college system the doctor works in as a cause to the horror to happen (yes, Fox News, thanks for another example of irresponsible “journalism” gone amok again). Gee, you think this motivates pending graduates in mental health care programs to want to work in CMHCs?
Think again. The election in November is going to be historic , not for the presidency, but what kind of direction society will travel hereon. Vote democrat and accept dependency and entitlement as our cultural banner, or, vote republican and be abandoned even further if you are not upper class.
Why is it choice in this country is alway either/or? I agree with George Carlin, don’t vote so you have the right to complain. Because there is no choice in politics. Damned if you do or don’t.
By the way, why has the prevalence of anxiety disorder diagnoses dropped these past 10 plus years? Because now anxious people are misdiagnosed bipolar. Otherwise, why aren’t all these “mood stabilizers” fixing everyone on them? Antipsychotics don’t treat anxiety, it just sedates it. Now you know why Pink Floyd wrote “Comfortably Numb”!!!
Hello Joel,
Not everyone has the strength to keep fighting. They get beaten down and give up. I moved to Redding CA in 2006. When I got home from County Mental Health, my mom demanded to go back with me to hear it with her own ears (she’s never trusted me for some reason). Anyway, like the mental health worker told me “If you want a therapist, call out of the phone book, we don’t provide therapy here”.
Shasta County mental health don’t even have their own mental hospital. Patients being admitted are driven 150 miles south to Sacramento CA and then picked up and driven home after their stay. As was the case when my depression got out of control and had to be in the hospital Nov 26-December 6th 2012
I was released on two new medications and was told to get set up with a psychiatrist. So I return to Shasta County Mental Health for the one service they claim to still have. But because I have a medical doctor I was denied a psychiatrist. I was told my medical doctor can handle my psychiatric needs. Apparently medical doctors are psychiatrists now too.
Thankfully I found a therapist and my new psychiatrist. After years of fighting for therapy I found a ad in a online news paper about a town 40 miles away that had gotten a grant and was accepting patients. I got the last PTSD specialist they had, so that was a plus. But it was that very same therapist who told me they had 2 psychiatrists up there.
I now see both the psychiatrist and therapist, and because they accept Medi-cal and medi-care I have a zero co-pay. But because it’s in the mountains, it burns a lot of gas to get up there and a round trip burns a quarter tank of gas. But it’s far better than nothing.
What normally happens is the ER is were I am told to go when suicidal. I am unfairly seen as a attention seeker and treated rather rudely. For example I had called a suicide hotline who sent the police to take me to the ER.
Once at the ER the nurse wanted me to put on a gown. I explained that my PTSD was from abuse in hospital settings and seeing as I was wearing shorts and a t-shirt it would be nothing for me to remove either articles of clothing for the medical exam.
The nurse tells the charge nurse about the PTSD. She walks by my room saying “get the restraints”. The charge nurse comes in with 3 nurses, two security guards and the officer he brought me to the hospital. The charge nurse began putting the restraints on the bed while saying “If you don’t put on the gown, you will be held down, put in restraints, your clothing will be cut from your body, your diaper removed (I’m incontinent) and a cathater put in and if you so much as TOUCH anyone you will be arrested for assult. You have 10 seconds to comply”.
What choice did I have? I put on the gown and shortly after broke down in tears with one flashback after another. When the doctor did come in, he didn’t even do a physical exam, which was the whole reason the gown was forced on me. Instead the doctor tells me “Boy, you must like being treated like this, you keep coming back”. The goal? Make me as uncomfortable or as traumatized as possible so I never come back again.
Problem is, I’m not attention seeking. I was doing something I was told is what your supposed to do when suicidal, to ask for help. But instead I am abused and tormented for choosing life and getting help. If that’s help, I would hate to see what their idea of hate is.
The issue is that those who need the help most often can’t do much for it. Or are tricked out of it. There was a major staff member at mental health the last 5 years who told me mental health only took the medi-cal, but because I had medi-care that medi-care was my primary and since mental health didn’t accept medi-care that they couldn’t see me. The truth was, they bill medi-care and once medi-care denies it, medi-cal takes what medi-care doesn’t.
But how are every day people supposed to know all the coverage laws and such. I begged for therapy for 5 years until I found that place 40 miles away. Then comes to find out the guy at County Mental Health was picking and choosing who HE felt deserved help. When he didn’t feel they deserved the help, he would claim they don’t take their insurance and send them packing. The guys help for me was budgeting. He says out of my SSI benifits, the only things that should come out of it is rent, food and electric. And that by his figures left me with a couple hundred in cash benifits to spend on therapy. Never minding I have two insurances.
Talking to a woman at social services told me she had been hearing about this going on at county mental health. And that I get medi-cal/medi-care, that my insurance should cover the costs and shouldn’t be coming out of cash benifits (accept for medication co-pays for example).
There was tons of time I had nothing BUT the ER to live through the night due to being so suicidal at $6,000.00 per visit with a average of 2-3 visits per week. Not really resolving the issue, but more of managing the wave of wanting to die to pass until the next time. Basically, a band aid. I got lucky finding a therapist. Most are regular visitors to the ER’s dual psych hold rooms. Yep, they actually have 2 dedicated isolation rooms for the mental health patients, and two others if it’s a busy night.
What really sucks is you can be in the ER for 8-24 hours for a bed to open, sometimes longer. My room mate had been there for 2 days. And it sucks because your 72 hour hold doesn’t officially start till you are signed into the psych ward. So your REAL stay is 72 hours PLUS how ever long you were in the ER waiting to find a bed in some other county that’s willing to transport you. VERY broken system.