We’ve all seen so many slogans telling us: don’t give up, you’re not alone, you matter!
Media and mental health workers are all trying to raise awareness about mental health, its importance, and the stigma involved. Don’t get me wrong, I support their work and find it very important, but what comes to my mind (considering some experiences from my friends) is that first of all, we kind of are often left alone and we kind of tend to give up because we are so fragile. It doesn’t take much to knock us down, and as much as those slogans and billboards tell us that we matter, we don’t feel like that when we enter into the health care system seeking help.
Getting help from a therapist, psychologist or psychiatrist is one long hurdle race.
First and foremost, there aren’t enough mental health professionals, whether in the network or out-of-network services. Reports reveal that people with insurance had more difficulty finding mental health professionals compared to general or specialty medical care. As if having a health problem isn’t already enough, when you go looking for help, you encounter your first obstacle–scheduling a session. Waiting time can be between one or two, sometimes three months, depending on the dates available. In the meantime, you struggle on your own, trying to get through the days hoping that somebody will be willing to help you after a few months. The system often fails to remember that: “To prevent mental illnesses from worsening or becoming chronic, it is important to start treatment as soon as possible,” as the spokesperson for the Federal Chamber of Psychotherapists in Germany said. We seem to forget that many people can get lost in that waiting corridor–some to suicide, some may continue or begin substance abuse, and some experience deterioration of their health.
Finding a session date is one thing but choosing the right therapist is another. It’s an intimate relationship, and you really need to click with your therapist. Certain professionals just don’t have the right approach to help you overcome your issues, or you may feel they are not the right therapist for you.
The second hurdle is treatment costs. If you cannot find a doctor covered by your insurance in a reasonable time or in a moment of urgent need, you can look for a private therapist. That is if you happen to have enough money to afford expensive rates, but many don’t. This results in people facing high out-of-pocket costs, leading them to seek less care or go without care at all.
Not to mention one more aspect often forgotten. Mental health patients need more frequent subsequent check-ups and more hours in care compared to other specialties. You may visit your dentist or your ophthalmologist two or three times a year, but mental health care implies more sessions and hours spent in the ambulance room. This also is one of the many reasons why we need more mental health care professionals.
So, what can be done to improve this situation?
Increase reimbursement rates and other incentives for psychiatrists and other mental health care professionals. Recruit and contract with a broader range of providers. Doctors are also overwhelmed with a huge number of patients, which leaves them drained personally and professionally and unable to give their patients the needed focus and attention.
Stimulating medical students through scholarships in specializing in psychiatry. Also giving stimulation to other profiles included in this process like social workers, psychologists etc.
Or maybe try different models like the Italian one known as the Trieste model. Everyone, etc is allowed access to treatment without making an appointment because of the 24-hour walk-in-service. The results are impressive: besides non-existent waiting lists; they have much lower suicide rates and fewer hospitalizations.
Even before the pandemic, there was an urgency for more mental health providers. According to the Steinberg Institute in California, two-thirds of all primary care providers in the US have problems finding specialists to refer their patients to.
Imagine if two of the three patients with heart problems couldn’t find a cardiologist? Or if two of the three asthmatic patients couldn’t find a pulmonary specialist.
The ongoing pandemic will leave even more people (among them many children and young adults) suffering from psychiatric disorders untreated and unable to live their life fully and contribute to their community as well. That is why we need to address this problem as soon as possible.