Why Mental Health Services Should Be Free
One of the biggest barriers to getting treatment is cost. Many health insurers refuse to pay mental health providers, leaving patients without access to care.
This is especially true in communities where there are no local clinics or psychiatrists. This means people must travel long distances to get help and may not find it affordable or accessible.
Cost
The cost of mental health services is a big concern for many people, including those without insurance. Even those who do have insurance may struggle to cover the high costs of outpatient therapy and in-patient residential treatment.
A lack of parity between the reimbursement rates paid by insurers for mental and physical health providers can lead to a huge disparity in access to care, says Lisa Yeboah-Sampong, senior health policy analyst at Milliman, a risk management firm. Moreover, in-network lists of therapists are narrow, she adds.
However, a growing number of nonprofit organizations are working to make mental health services more affordable. For example, Open Path Psychotherapy Collective matches patients with therapists at rates that range from $30 to $60 per hour.
Access
Mental health conditions have a significant impact on quality of life and contribute to premature death. However, most countries have inadequate mental health services, inequitable distribution of resources, and lack of knowledge about how to deliver effective care.
In addition to cost, access is limited by social and cultural barriers. For instance, stigma and discrimination against those with mental illnesses have a significant impact on their ability to seek mental health treatment.
These barriers have real-world consequences, explains Sarah Alter, senior policy analyst with RAND Corporation. As a result, fewer than half of those in need of mental healthcare actually seek it.
One strategy for increasing access is Behavioral Health Integration, in which primary medical care practices partner with mental health specialists to offer integrated services. The results have been promising. Another approach is to establish free community-based care, which can overcome social and economic barriers to access. In addition to reducing the stigma and increasing accessibility of mental healthcare, free community-based care can also help people learn how to manage their own illness.
Stigma
Stigma is a barrier to receiving mental health services. It is a combination of ignorance, fear and prejudice. It can affect people who are diagnosed with a mental illness and those who support them.
It is rooted in medical and social structures that perpetuate discrimination and fear. This can prevent people with mental illness from securing housing, a job or adequate medical care.
A stigmatized person is more likely to seek less effective treatment for their condition and may suffer more distress, depression or worsening symptoms. They are also more likely to drop out of treatment or stop seeking help for their condition altogether, which can be harmful.
There are two main types of stigma: public and self-stigma. Public stigma is caused by negative stereotypes of people with mental illness or their family members. This is often influenced by media representations of these individuals. Self-stigma, on the other hand, is caused by negative attitudes and beliefs about one’s own mental illness.
Equity
Health equity is the “attainment of the highest level of health for all people, as attainable and desirable within the context of society.”
Mental health equity means addressing mental health disparities by promoting access to care, treatment, and recovery services that are culturally responsive. It also addresses social determinants of health and the role that social and economic factors play in behavioral health outcomes (e.g., employment and housing stability, insurance status, proximity to services).
While many organizations have made important progress towards parity in mental health access and care, there is much work left to do. The problem of inequity is bigger than any one organization or provider, and we need a new way of thinking about our health system.
We need to move away from the idea of “one size fits all” mental health services and focus on providing services that are tailored to individual needs. This will require a different value and belief system, as well as a change in how we approach health and wealth.
