The Trouble With Mental Health Care

Even with the widespread debate over health care during the past several years and with the implementation of the Affordable Care Act, there still seems to exist a large sector of health care that remains severely problematic.

Prevalence of mental health issues

Most people probably don’t realize the sheer amount of Americans that suffer from some type of mental illness, but it is indeed one of the most common health care issues. In fact, as many as 1 in 4 adults are affected each year. The federal Substance Abuse and Mental Health Services Administration reported that 9.6 million adults reported having a serious mental illness, such as major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, PTSD, panic disorder, and borderline personality disorder. And that is only counting the cases reported.

What’s more disturbing is the severity of the consequences that can occur when mental illness goes untreated. Many untreated patients end up unemployed, homeless, in prison, or even turn to suicide. According the National Alliance on Mental Illness, the economic hit of untreated mental illness is more than $100 billion each year.

The difficulty in coverage

Even if we put aside the stigma that unfortunately still comes with acknowledging a mental illness in our country, there remains a mountain of obstacles.

A recent poll conducted for the California HealthCare Foundation revealed that fewer than 40% of Californians understand that their insurance plans cover mental health issues, even though the Affordable Care Act extended coverage to this area (naming it “behavioral health”). This is also apparent in the fact that the Congressional Budget Office projected that 13 million uninsured Americans would become insured by 2014, yet the demand for mental health care has not increased.

Part of the problem in understanding the coverage are the numerous loopholes, conditions and coverage gaps. Firstly, the law states that the expansion portion of Medicaid was optional for states, and thus far only about half the states have decided to expand. This leaves about 5 million Americans missing an important part of their coverage, and as Medicaid is a program designed to help poor or disabled Americans, experts believe a large portion of this group is in need of some type of medical care.

The second half of the problem with coverage is that in an area like mental health, it is very difficult to discern what type of treatment is medically necessary and for how long. While a treatment like chemotherapy has a very defined treatment program, it is difficult to quantify something like therapy sessions because it can differ so greatly from person to person. So insurance companies tend to put fairly strict limitations on how many sessions they will cover. And because of this, many psychiatrists will not accept private insurance or Medicaid, consequently leaving many patients in need of care unable to afford it. The laws are just too vague in terms of what should be covered under mental health and what is deemed “medically necessary.”

Supply and demand issues

Of course, with the growing number of people obtaining insurance, surely the number of patients seeking mental health care will eventually begin to increase over the coming years. So the next important questions arises: are there enough providers available? And as of today, that answer is no. Historically, this field is understaffed, but with an onslaught of new demand, the gap between supply and demand could widen substantially. According to the Department of Health and Human Services, 55% of U.S. counties do not have a practicing psychiatrist, psychologist or social worker. All of these counties are rural, so patients seeking care oftentimes have to travel great distances to get care and this is after having to wait months for an appointment. This department estimated that there is a shortage of nearly 2,000 psychiatrists and almost 6,000 other professionals in the mental health field.

This area of health care is simply far to important to be so neglected. At the La Jolla Nursing and Rehabilitation Center we take mental health seriously, and will do everything in our power to give you and your loved ones the care they need. For more information please don’t hesitate to contact us at or call us at (858)453-5810.