Advocating For Access To Mental Health Care . . . It Is Time For Us To Stand Up For What Is Right

I am encouraging you to go to Philmont Guidance Center’s Facebook page and listen to a 6-minute video I uploaded there.  Get past the boring talking head thing (psychiatrists tend to be a bit dry sometimes) and LISTEN to what he is saying and THINK about what this will mean if the trend is generalized to society as a whole.  In a nutshell, Cedars-Sinai medical center, one of the premier care facilities in southern California, is closing it’s inpatient psychiatric facility because it is not profitable enough. This is far beyond an isolated incident, and represents a society-wide trend toward marginalizing the care of patients with brain dysfunction that manifests as behavioral or emotional disturbance.

If you think I am over reacting, consider this . . .

Access to out-patient mental health services in the Philadelphia area (my geographic home base for those of you who don’t know), has shown a gradual erosion over the last 5-10 years.  As with all care, the cost of copay’s and out-of-pocket expenses has increased.  A patient’s cost to access mental health services has risen disproportionately, however, resulting in a greater financial burden.  This extra burden often comes at a time of reduced emotional resources (from the mental health issue) and can significantly limit a patient’s ability to get the treatment that is needed to restore full functioning.  The latest maneuver that I have seen the insurance industry do is to write health care policies for people that EXCLUDE access to mental health care.  Yes . . . EXCLUDE access to mental health care services.  Repeatedly, I have run into the situation where a patient comes for treatment only to find out THEN that he or she has NO MENTAL HEALTH CARE COVERAGE.  Somehow, that detail was left out of the information when the “choice” of coverage was reviewed.

Consider the statistics.  It is estimated that 47% of the population in the United States will meet criteria for a mental illness at some point in their life.  The lifetime risk of Depression is 17%.  An anxiety disorder is present in 51% of patients with Depression.  Lifetime risk of Bipolar Disorder is 4%.  Lifetime risk of Schizophrenia is 0.7%.

In comparison, 26 million people in the US have been diagnosed with Diabetes (8.4%).  Epilepsy will be diagnosed in 3% of the population at some point in their lives. Chronic kidney disease will effect 16.8% of the population at some point during their lives.

How do you think it would go over if Aetna started writing policies that restrict access to Diabetes care??  What if a patient with Grand Mal seizures was not covered??

The exclusion of mental health care coverage is blatant discrimination against a substantial portion of our community that remains largely anonymous because of fear of discrimination or ridicule.  But let’s face it . . . everyone of us knows someone who has had to deal with a significant mental health care issue.  EVERY ONE OF US.  I dare you to go eyeball to eyeball with that person and tell them that you support the exclusion of mental health care coverage that they need to get treatment for their issues.  I DARE YOU!!!!

Can’t do it or don’t want to do it??

Well, that is what you do when you remain silent.

I challenge all of you to contact your employer and/or the human resource department at work and make a stink if mental health care is excluded from coverage in any of the benefits offered there.  I challenge you to contact your federal, state and local representatives and demand an end to discrimination against your family, friends and neighbors with mental health care issues. Share this blog with everyone you know and ask them to speak up as well.

If you are not sure how to contact your congress persons, go to and put in your zip code. Send them an email.  Give them a call. Don’t remain silent.

The government and the insurance industry will listen if enough of us speak up for what is right.  If you don’t do this now, you may find yourself without the resources YOU need when it is time for you or a loved one to get help.

–Dan Hartman, MD

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