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People often talk about how mental illness is something that affects a lot of us, with the statistics usually coming in at around 1 in 5 adults who will experience it in their lifetime. Yet, our approach to addressing this is still relatively casual. While it’s important to normalize the presence of mental illness to reduce the stigma attached to it, it’s just as vital to accept that it is a serious societal issue of epidemic proportions in the U.S.
The truth is that mental illness can detrimentally disrupt lives, and there is a medical and ethical responsibility to make certain that everyone who needs treatment to improve the quality of their existence has access to it. Unfortunately, the healthcare system in the U.S. is not designed to provide this. Rather, we have cultivated an approach in which help is not provided to those who need it but to those who can afford it. There is no possible way for this commercially-focused method to come close to adequately addressing a mental health epidemic.
Let’s take a look at a few areas where mental health treatment needs to be improved for those low-income individuals in particular.
Access to Information
One of the most important elements in improving mental health treatment doesn’t necessarily begin with the treatment itself. Rather, there is a need to make sure that those experiencing mental illness or its symptoms have access to adequate informational resources. Those in higher income brackets tend to have greater access to information and advice than people who are on the lower end of the socio-economic scale or who are experiencing poverty. As such, the quality of treatment and indeed their wellness is impacted accordingly.
Medicare is, of course, a vital aspect in making sure people with lower incomes have access to healthcare and health education. However, even when they do qualify for this service, patients can still have difficulty with navigating its use. There needs to be greater emphasis placed on helping these service users to understand what coverage their Medicare provides for mental health, what services they have access to as a result, and even the extent to which medications might be covered. When the healthcare system is built on an insurance process, there needs to be focus placed on making sure there is clarity in its use.
More importantly, though, public health departments need to be able to undertake mental health educational outreach in their lower-income communities. Many people don’t fully understand how mental illness can present, how it can impact their lives, and what they can do about it. Health departments should be connecting with schools, universities, workplaces, and community leaders to identify where education is most needed. This way, relevant literature and visiting nurse practitioners trained in public health education can be deployed effectively.
In an ideal world, there would be a system of universal healthcare in which the subject of whether patients could afford therapy wasn’t an issue. It’s still a goal that it’s important to push toward, as one of the tragedies of the society we live in is that we are allowing people to suffer intensely — and at times even die — because they are unable to pay for the treatment that could help them. In the meantime, we need to also identify and expand more affordable access to long and short-term therapies.
To some extent, the regular Medicare program allows for therapeutic services. However, patients must understand that the area can be quite nuanced — there are differences between mental health therapy and counseling, and there are limitations to coverage for each, including potential deductibles. For instance, while Medicare B covers visits to therapists’ offices for individual treatment, non-psychotherapy support groups that can be a vital tool in mental health therapy are not covered. This creates a gap for service users, and rather than simply stating what is not covered, there needs to be a system that directs them toward other affordable options.
Telemedicine, for instance, has become an important tool in more affordable mental health services. As doctors aren’t subject to as many overheads as in-person practices, there are opportunities to offer therapeutic appointments both at lower prices and taking place in an accessible form for the user. Indeed, some private services such as BetterHelp offer a sliding scale pricing program based on income. Raising awareness of these types of alternatives can be valuable on the path to securing improved Medicare for all.
Better Research for Intervention
There is undoubtedly a connection between poverty and mental illness. However, there is unlikely any time soon to be any kind of intervention that would solve either of those problems, let alone both. In the meantime, our society needs to use smarter methods to identify those in need and place resources where they are most needed.
This is where using the tools of our contemporary digital landscape can be effective. We live in an increasingly data-rich world. We often hear about how this is detrimental to privacy, but it can also be a positive route to better understanding the changing needs for affordable mental health services. Data science is already being used to assist diagnoses and in suicide prevention following outpatient treatment. But it can also be employed to analyze the raw information about populations, including trends in therapeutic service requests, and other patterns that would otherwise be difficult to detect. Professionals can then create predictive models about where gaps in care are likely to exist and make recommendations to public health authorities.
It’s a frustrating truth that there is a solution to better mental health treatment for low-income individuals — universal healthcare — but it is not being employed. In the meantime, it’s important to utilize alternative methods that can help bridge the gap. As a community, we must work to provide quality health education, highlight affordable therapy options, and utilize data to more efficiently identify areas of need.