Health Policy Brief

To: Bill de Blasio

From: Sonam Bhandari

Date: 1/22/2020

Re: Increasing access to Mental Health Care Services.

Statement of Issue:

Nearly 1 in 5 adults in the United states are living with mental illness among which only 43.3% received treatment in 2018 but with a delay of 11 years delay between onset of the symptoms and treatment¹. The national survey of children’s health collected data that showed that among the 7.7 million US children with a treatable mental health disorder, approximately 50% did not get the needed treatment². Almost 65-70% of youth in juvenile justice system have a diagnosable mental health disorder but their needs are not being met³. Proper access to mental health services are needed to insure that the people not receiving care would have the necessary means to receive the care they need.

Lack of Access is the root cause of Mental Health crisis in the US⁴. Some of the barriers to mental health care access are cost, poor insurance coverage, limited options, lack of awareness and social stigma⁴.

According to the WHO, Mental Health Care is a human right⁵. Lack of proper Mental Health Care Services leads to poorer physical health – It is important to emphasize the importance of mental health to have a healthier population.

People with mental illness are not getting adequate care. With almost 49.4% children and 56.7% of adults not receiving the needed treatment from a mental health professional it is quite clear that the US is failing to provide necessary support to those with mental health. Some reasons for not receiving among those who needed care included high cost of care (45.2%), lack of information about treatment centers (29%), thinking that they did not need treatment (29%), and not having the time to go for care (21.3%)⁶. Better access to care needs to be provided to these people in need to ensure all who need mental health services are able to receive it.

Mental illness leads to higher rates of substance Use. Adolescents with major depressive episodes (MDE) are more likely to smoke (6.1% vs 2.1%), binge drink (8.5 vs 4.1%), and use illicit drugs (32.7% vs 14.0%) when compared to adolescents without MDE. Among adolescents with both substance use disorder and mental illness only 5.4% received both mental health care and substance use treatment⁶. Substance use is another challenge in health care, and the lack of resources to help people with mental health care increases this rate of substance use leading to an unhealthier population.

Policy options:

• Increasing federal and state funding to improve Mental Health Services by establishing more mental health clinics, telehealth, and creating more resources that increases community understanding of mental health illnesses and provide information about mental health resources available. These funds can also be used to train mental health professionals from different cultural backgrounds.
  • Advantages: This would increase access by having more mental health clinics leading to reduced wait times and increases options, ensuring that people would have information required should they need care. Telehealth would also allow patients to receive over the phone which would help those who do not have the time to go for care. Increasing mental health awareness and education would also reduce stigma which is another barrier to access.
  • Disadvantages: Even with the establishment of more mental health clinics, there may not be enough mental health care providers to provide quality care. Increasing federal and state funds to increase mental health services may wither increase taxes or reduce funding of some other program – which would face resistance.
• Federal mandate to requiring private insurance companies to provide mental health services with financial incentives provided by the government in order to reduce cost for the patients.
  • Advantages: This requirement to provide mental health services would help those who did not seek mental health care due to the high cost of care. Insurance companies would also be in support of this due to not having to pay extra or charge their customers more -which may have deterred them from using their services.
  • Disadvantages: While this does help increase the access to those who do not seek care due to costs, it still does not help those who do not seek care due to lack of time to go seek care and those who do not know where to seek care.
• Federal Mandate that requires each state to provide mental health education in schools (public and private) with age appropriate information provided at their grade levels. Adding Mental Health education to the curriculum and provided by trained teachers who are taught to identify and provide resources to students when needed.
  • Advantages: With a large number of adolescents facing mental illnesses it would this education would help students identify when they need help and reduce stigmas associated with mental health which is one of the leading cause of people not seeking mental health care. It would help identify the causes of stresses to the students by having classes that would focus solely on mental health.
  • Disadvantages: The cost of training individuals to provide mental health education at age appropriate level may increase state taxes, which a lot of people may be against. While It may decrease stigma against mental health, parents with stigma against mental health may be against having their children expose to issues that they may not necessarily have to deal with.

Policy Recommendation: With increasing rates mental health illnesses and decreased access to mental health care it is imperative that polices that increase access and awareness, reduce stigma, and increase knowledge about resources available be implemented to reduce this mental health crisis in the US. Increasing available funds to increase mental health care access by establishing more mental health clinics, using telehealth to reach more people and having more culturally competent providers would make people more receptive to care provided or to seek care. Although due to its costly it would in the term improve patient health- both mental and physical, leading to a healthier population which would in turn benefit the economy.

 

 

 

 

REFERENCES:

1. https://www.nami.org/learn-more/mental-health-by-the-numbers
2. Whitney, D G., US national and State-Level prevalence of Mental Health Disorders and Disparities of Mental Health Care Use in Children.” JAMA Pediatrics, volume 173, Number 4, April 2019. (389-391). http://web.b.ebscohost.com.york.ezproxy.cuny.edu/ehost/pdfviewer/pdfviewer?vid=1&sid=379c0065-045b-451f-8203-b303ab430bb1%40sessionmgr103
3. https://www.ncmhjj.com/wp-content/uploads/2013/07/2007_Blueprint-for-Change-Full-Report.pdf
4. https://www.thenationalcouncil.org/press-releases/new-study-reveals-lack-of-access-as-root-cause-for-mental-health-crisis-in-america/
5. https://www.apa.org/international/pi/2018/12/mental-health-rights
6. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
7. https://medium.com/@leahharris/why-mandating-mental-health-education-in-schools-is-a-band-aid-on-a-gaping-wound-d72c3e570be2