By On December 3rd, 2018

Lack of insurance acceptance is driving America’s mental health problems

It is all but undeniable that America has a growing issue with mental health and lack of treatment. The latest estimates suggest that nearly one-in-five Americans live with some form of diagnosable mental illness, however, less than half receive regular treatment.

There are a number of factors that contribute to the low rates of mental health treatment, but the biggest may be the most obvious. There simply are not enough mental health professionals available. Those who are working in the field often make matters worse by not accepting insurance, severely limiting who they treat.

As a new study shows, the practice of not accepting insurance has another serious side effect. Those with more serious mental illnesses such as schizophrenia or bipolar disorder are less likely to receive treatment, compared to those with relatively less disruptive forms of mental illness like ADHD, depression, and anxiety.

Researchers at NYU School of Medicine and Yale School of Public Health found that office-based psychiatrists who did not accept private insurance were significantly less likely to involve patients with serious mental illness compared to psychiatrists that do (42% compared to 53%).

“This may indicate that patients who anticipate needing more services prefer to use a psychiatrist who accepts their insurance because going out-of-network may just be too expensive,” explain study authors Dr. Kelly A. Kyanyo and Susan H. Busch in an op-ed for The Hill.

“It may also indicate that psychiatrists who choose not to accept insurance are opting to see less complex patients. Either way, the shortage of psychiatrists that accept insurance may impact those that need it the most.”

The issue isn’t a simple case of greed or bureaucratic hang-ups preventing psychiatrists from accepting private insurance, either. The researchers offer an anecdote to describe the conundrum faced by many psychiatrists.

“A friend of mine, James, is a psychiatrist who started his career at a clinic that mainly served a Medicaid population, but recently left for private practice. He related to me that after years of frustration with limits on the amount of time he could see a patient, administrative hassles and low reimbursement, he decided to branch out on his own. He debated taking insurance in his new practice, but had heard that psychiatrists who relied on insurance could only make a living by seeing patients for 15 minutes at a time. He felt this was a disservice to his patients and undermined his ability to provide good care and ultimately, he decided not to accept insurance.”

There is a widespread belief that private insurance companies limit the time psychiatrists can afford to spend with each patient, providing sub-par treatment. For those with more serious mental illness, this truncated form of treatment would likely be ineffective at best.

“In an ideal world, psychiatrists would serve the most psychiatrically and medically complex patients, be easily accessible across the country and take insurance,” Kyanyo and Busch say. “We need policies that will encourage psychiatrists like my friend James to take insurance – policies that improve reimbursement and reduce the headache of taking insurance.”

If you believe you or someone you love may be living with a mental illness, please call Brookhaven for help at 888-298-HOPE (4673). We accept a wide range of insurance options, as well as VA, Tricare, and other forms of Government funding.

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