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The Urgency of Mental Health Care Inaccessibility

By Niku Sedarat

 

In the realms of healthcare, mental health care has long been the overlooked facet of our well-being. Despite growing awareness and advocacy, a stark reality persists: mental health services remain woefully inaccessible for millions worldwide, exacerbating an already burgeoning crisis.


In 2018, the Cohen Veterans Network (CVN) and the National Council for Mental Wellbeing jointly presented the inaugural "America's Mental Health 2018" study at the Cohen Veterans Care Summit in Washington D.C. This groundbreaking study provided a comprehensive examination of Americans' access to and perceptions of mental health services, shedding light on a critical issue plaguing the nation: mental healthcare inaccessibility.


The study's findings painted a stark picture of the state of mental health care in the United States. A staggering 56% of Americans expressed a desire to seek mental health services for themselves or their loved ones, with the need being even more pronounced for youth, low-income communities, and people with military backgrounds. Yet, the question remains: are we fulfilling this need?


Despite the clear demand for mental health services, the study highlighted a pervasive sense of inaccessibility among Americans. A staggering 74% of respondents believed that mental health services were not accessible to everyone, with nearly half (47%) citing limited options for care as a significant concern.


Clearly, there is an unmet need, but why is this occurring in the first place? High costs and low insurance coverage are direct barriers that create financial constraints for many individuals seeking mental health care. Often, insurance companies can determine medical necessity for mental health challenges on a case-by-case basis. Ultimately, because mental health has been highly stigmatized, insurers yield great leverage in determining whether there is a medical necessity through the stigmatized approach of differentiating which mental health challenges are "necessities" versus "choices." While no mental health challenge is a deliberate choice, stigma held by insurance companies can cause them to limit reimbursement rates, thus heightening the cost of mental health services. Long wait times for mental health services can also increase the accessibility gap. In the study by the National Council of Mental Wellbeing, it was found that "ninety-six million Americans, or 38%, have had to wait longer than one week for mental health treatments."


Beyond these explicit barriers to mental healthcare availability, there is also a range of indirect barriers, like stigma and lack of awareness, that make mental health resources all the more inaccessible. Due to mistrust and lack of awareness about factual information about mental health and healthcare, compared to older generations, younger Americans (i.e., Gen Z and Millennials) are less sure about resources for mental health services. Beyond the stigma held by insurance companies, many individuals are well aware of stigma and have internalized many of the stigmatizing ideas around mental health themselves. 49% of Gen Z are worried about others judging them when they say they have sought mental health services. For marginalized social groups, like the LGBTQ+ community, factors such as stigma awareness—the fear that you may be stigmatized for your unique challenges—may perpetuate a sense of fear of judgment from the general public and even mental health professionals, thus furthering mental healthcare inaccessibility.


While it is certainly critical that we understand the intricacies of these barriers and how they compound the youth mental health crisis, there is also an abundance of hope. To combat some of the direct barriers to mental healthcare, options such as telehealth and low-cost, community-based services can be channeled to bridge the accessibility gap. Approximately 45% of Americans who had not yet tried telehealth expressed openness to utilizing such services for addressing current or future mental health needs, revealing a potential to channel technology as a medium of increasing access. We must note that many historically low-income, marginalized communities may not have access to quality internet access and devices to utilize telehealth, making it all the more important that we lean on community mental health support systems. Organizations such as the Depression Bipolar Support Alliance provide a range of both online and in-person support groups for individuals grappling with mental health challenges (Support Group Registration link by DBSA California: https://mailchi.mp/dbsacalifornia/supportgroups). Moreover, peer support specialists are trained and statewide certified services that can be a more cost-friendly form of care. In California, an in-person community center such as Allcove (https://allcove.org/) provides such resources. Worldwide, there are a variety of online mediums for peer support (www.uniteyouthmentalhealth.com/resources).


Beyond finding more accessible forms of support, addressing the crisis of mental health inaccessibility demands a concerted effort from policymakers, healthcare providers, and society at large. Policy reforms and community-based advocacy aimed at improving insurance coverage, reducing wait times, and increasing funding for mental health services are critical. Remember, you have the power to be the change you want to see. If you're interested in fostering more awareness, reducing stigma, and taking action toward improving the state of mental health in your community, get involved at Unité (https://forms.gle/uJBUbp1EfEjMPbNo6).


Mental health inaccessibility is undeniably a challenge in the United States and beyond. However, by prioritizing mental health and dismantling barriers to care, we can forge a path toward a more equitable and compassionate society where every individual has the opportunity to receive the support they need to thrive.

































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