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OP-ED | It’s Past Time to Fix Our Broken Mental Health Care System

by Sarah Darer Littman | Jun 20, 2014 8:00am
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Posted to: Corporate Watch, Health Care, Mental Health Care, Opinion, Health Care Opinion, Newtown

The Task Force to Study the Provision of Behavioral Health Services for Young Adults released its report earlier this week. I underlined one sentence on page iii, several times in red: “The behavioral health care system is not user-friendly for those in need.”

That has got to be the understatement of the year, if not the decade.

I know this from bitter experience, having dealt with it when confronting my own mental health issues. And I know other people who have dealt with it and who fall within the report’s statistic of “10 percent of adolescents and young adults ages 16 to 25 [who] have experienced at least one episode of a major depressive disorder in the past year.”

During this person’s major depressive episode last year, I emailed my state representative, Fred Camillo, to tell him about the difficulties people are having in finding an intensive outpatient treatment placement in a timely fashion, even with private insurance.

“The health care system is BROKEN, my friend, especially when it comes to mental health . . . Tell me when I should come to Hartford to testify, because I will be happy to tell them from first-hand experience just how @#$@$ up this system is, and how it makes an already bad, stressful, unbearably painful situation worse.”

As a self-employed person who, until the passage of ACA, lived with the fear of rescission every year at renewal, I also faced premium increases well over the rate of inflation throughout the last decade, some years with rate hikes as high as 18 percent for a policy covering my family. Despite these huge premium increases, I’ve become accustomed to having to fight with my insurer — sometimes up to second level appeal going psychiatrist vs. psychiatrist — for fewer and fewer services on the mental health front.

Mental health parity? Don’t make me laugh.

Here’s another example: A child who has Type 1 diabetes receives services from a doctor without question, but then faces incremental resistance to coverage, such as when a particular insulin pump is discontinued. This forces the patient to switch to a different pump, but then the insurer decides that the insulin pods for the new pump are no longer deemed “supplies” (reimbursed at 70 percent), but instead they are categorized as “medical devices” (reimbursed at 50 percent).

Meanwhile, chief executives at the big five insurance companies are taking home huge salaries and their companies are making massive profits.

So I particularly applaud the task force for their recommendation that there should be an independent office within the Office of The Healthcare Advocate to monitor compliance with federal mental health parity laws, and to gather timely, transparent data on how commercial insurance companies are providing mental health care.

Trust me, they leave a lot to be desired. I’ve often asked myself — and others — how my family would have fared through the difficulties we faced if we didn’t have the financial resources we do, and I thank the Lord every single day that we haven’t had to find out. But I worry, deeply, about others who aren’t as fortunate.

I am living proof that if one has access to the right treatment and medication, it is possible to live a productive, purposeful, and yes, taxpaying life. Neither treatment nor medication is necessarily straightforward — there’s much we still don’t know about the human brain. But we’re seeing new advances in medication and treatment all the time.

Would any of the panel’s recommendations have helped prevent the Newtown shootings if they’d been implemented beforehand? That I don’t know.

As I wrote after reading last year the Summary of the Final Report on the Sandy Hook shooting by Stephen J, Sendensky III, State Attorney for the Judicial District of Danbury, I was overwhelmingly struck by one thing — the degree to which Nancy Lanza enabled her son.

Parenting is hard work at the best of times. It’s a constant balancing act between giving your kids the unconditional love and support they need, while still providing consistent discipline so they know that there are limits and values by which they are expected to conduct themselves in the family and in wider society.

As the Talmud advises: “Push away with the left hand while drawing closer with the right hand.” (BT Sanhedrin 107b).

When you’re parenting a child with any kind of special needs, that balancing act is even harder.

We can’t legislate for parenting problems. But we can legislate to make the mental healthcare system more transparent, easier for parents to navigate, and to provide support to families so that maybe we can help to alleviate the problems parents and children face.

Sarah Darer Littman is an award-winning columnist and novelist of books for teens. A former securities analyst, she’s now an adjunct in the MFA program at WCSU, and enjoys helping young people discover the power of finding their voice as an instructor at the Writopia Lab.

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