Hello kittens~ Hope your weekends went well, and if not, I hope this week looks up for you. The topic for today was actually inspired by a comment from my last blog. Jennifer A. commented:

“Hay Kat,

This was a great post! I remember when I started taking my psych meds around friends and non-immediate family members and how judged I felt. While I’m happy to say that I no longer feel ashamed of taking medications, it is still an issue facing others. One main issue I have with taking my meds is insurance – which doctors take my current insurance, what my insurance will cover monetarily, and how many Psychiatric doctors don’t take any insurance what so ever.”

What Jennifer brings up at the end of her comment is definitely a common problem in the mental health community. We have to face the scary reality of being denied medications and services like therapy that may be essential to the general stability and well-being of our overall health and daily function. Imagine taking the same prescription of pills for several years and having this expectation that it will always be covered completely then, boom, a copay. For those that don’t know, a copay is an additional cost that you pay out of pocket on top of what’s paid by your insurance company. I personally sometimes have to pay a few dollars or less, but for some others, like some of my family and friends, they have to pay unreasonable out of pocket costs. This is a problem. Having a clear need—not want, need— for medical reasons then being either denied, charged, or not being eligible is a problem. These are clear roadblocks for anyone with a mental disability and especially those who are coming from low-income households. 

Someone I know was in dire need of a therapist and psychiatrist, so they could be properly diagnosed then treated for their debilitating depression, anxiety, and panic attacks with therapy and medication, but they kept facing roadblocks. They would go on Google, search up therapists, and go to their appointments. It seemed like it was fine at first and just to make sure they asked the receptionists at these appointments if they were covered. The receptionists all assured them they were. But then lo and behold, they received bills for appointments in the mail. It was already a handful getting health insurance, but now these new problems were arising. According to an article from NPR entitled “ ‘Mental Health Parity’ Is Still An Elusive Goal In U.S. Insurance Coverage” by Graison Dangor, “… a 2017 report by the actuarial firm Milliman found that an office visit with a therapist is five times as likely to be out-of-network, and thus more expensive, than a primary care appointment.” Therapy for many mentally disabled folks is a very integral lifeline and support system, but it’s out of their grasp when they can’t afford it. I’ve come close to dealing with this myself, when I once arrived late to my therapy appointment and I was about to be charged several hundreds of dollars had it not been for the leniency of my therapist, who later warned me kindly that if I were to come late again she would have to unfortunately charge me. I wouldn’t be able to afford that, especially since at that time I was unemployed and also, coming from a low-income family, that would’ve been a big hit on us financially. This creates an unstable environment for those ranging from severely mentally disabled to mentally disabled because how will you be able to be treated if:

1. You don’t know who accepts your insurance

2. You have an insurance that most don’t accept

3. You are covered but only partially and what you do have to pay you can’t afford

In an article entitled “Access And Cost Barriers To Mental Health Care, By Insurance Status, 1999–2010” by Kathleen Rowan, Donna D. McAlpine, and Lynn A. Blewett, it is stated that, “Even among the insured, costs may be a barrier to getting needed mental health care. Cost sharing may disproportionately affect people with mental illnesses, who have lower family incomes and are more likely to be living in poverty than those without mental illnesses.” The biggest problem the mental health community is facing, concerning medical insurance, affects low-income folks, because if you don’t know who accepts your insurance, you don’t have an insurance most accept, and/or you have to pay copays, as a person who hardly makes enough to get their necessities, how is it possible to get your mental health care on top of food, shelter, and other expenses? It just doesn’t seem feasible.

In the article, “Insurance Status, Use of Mental Health Services, and Unmet Need for Mental Health Care in the United States by Elizabeth Reisinger Walker, Ph.D., M.P.H., Janet R. Cummings, Ph.D., Jason M. Hockenberry, Ph.D., Benjamin G. Druss, M.D., M.P.H. a study was done that concluded, “Efforts to improve access to mental health care will need to address structural barriers, such as cost and uninsurance, as well as attitudinal barriers, such as stigma about mental disorders and their treatment and misconceptions about the effectiveness of treatments. Additional attention will also be needed to ensure quality of care among individuals once they enter the mental health treatment system.” These are the things that need to be addressed first before real change can be made to this unfair system that is preventing those who need health care as a part of healthy daily living. I hope these systems can see reform and improvement so that those I love and all folks in the mental health community can receive the care they deserve. Let’s hope we see it happen in the near future. 

See you next week, kittens, and stay safe~

Resources:

1. https://www.npr.org/sections/health-shots/2019/06/07/730404539/mental-health-parity-is-still-an-elusive-goal-in-u-s-insurance-coverage  

2. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2013.0133 

3. https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201400248