If navigating the health care system for treatment of physical illness seems like a maze, seeking treatment for mental illness can seem like a black hole. Approximately 1 in 4 Americans experience diagnosable mental health problems each year (with 1 in 17 suffering “serious mental illness”), yet fewer than half are treated. While incidents like the Newtown, Conn., school shooting are rare, they bring media attention to the need for resources that allow individuals to proactively access mental health treatment and support services. As with health care in general, however, the “system” for finding, using and coordinating different mental health services is fragmented at best – and in some cases, nonexistent.
People who seek help for their own or a family member’s mental illness may end up interacting with not only numerous specialists, as a cancer patient might experience, but also social workers, residential treatment centers, counselors, courts and law enforcement agencies – all of whom may or may not be sharing information or coordinating efforts.
The Affordable Care Act (ACA), in conjunction with the 2008 Mental Health Parity and Addiction Equity Act, should improve the insurance picture for those needing mental health care. Although the Mental Health Parity act didn’t require employers to provide benefits for mental conditions, nearly 85 percent of U.S. employers were offering some level of coverage by 2012, according to the Society of Human Resources Management. When the ACA takes effect in 2014, small group and individual health insurance plans will be required to include mental health benefits at a level comparable to physical health benefits. Plans will also be required to offer depression screening for adults without a copayment, co-insurance or deductible.
Despite these coverage improvements, significant barriers persist for those struggling to cope with mental illness and its impacts on economic, physical and emotional well-being. One example is a legal barrier: parents or relatives caring for their mentally ill adult child or relative cannot legally make them take their medication or stay in hospital care. State laws limit caregivers’ ability to involuntarily commit an adult relative, even if they have threatened to harm themselves or others. In my work, I have met families who, for example, cannot receive information from their adult child’s behavioral health providers due to HIPAA restrictions, although they are in the role of primary caregivers.
If you or a loved one struggles with mental health issues, here are some actions to consider:
- Check your coverage – Make sure you are familiar with your current health plan’s mental health coverage, and how it may change next year. Because employers with more than 50 employees are not currently required to provide mental health coverage but will be required to do so in 2014, where you work may make a difference in your benefits now and in the future.
- Identify options for yourself or your adult relative – People with chronic mental conditions often have difficulty maintaining employment and, by association, health benefits. If this is the case for you or your relative, coverage outlook may be improved by the ACA in 2014, which will extend Medicaid to those earning less than 138 percent of the federal poverty level. Visit http://www.healthcare.gov/using-insurance/low-cost-care/medicaid/ to learn if you or your loved one is eligible for these enhanced benefits.
- Record everything – The more you can document visits to and interactions with doctors, psychiatrists, social workers, etc. and changes in or reactions to your prescription protocols, the better able you will be to advocate for yourself or your loved one. Even a simple notebook or journal can be a valuable tool for doctors and care providers.
- Don’t go it alone – Living with mental illness or caring for a mentally ill loved one can be draining and overwhelming. Associations dedicated to mental health awareness and advocacy, such as the National Alliance on Mental Illness (www.nami.org) offer information about resources and host local support groups.
- Consider care management – Depending on your needs, ConciergeCare can assist you by advocating for you during treatment, helping you develop behavioral goals, facilitating good communication with your providers, creating tools for you to monitor the effectiveness of treatment, and assembling a quality support team for you and your family. We will “walk this journey” with you.
If you need help advocating for yourself or a loved one during a behavioral health crisis, or assistance improving your management of a chronic mental condition, call us at (913) 553-6226.