It's Time to Close the Gaps in Mental Health Treatment

In a presidential election year, there are lots of speeches about improving the path for America and its citizens, but words are meaningless unless we fully address the massive gaps in mental health care for our most vulnerable communities.
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Scholars will record the United States as one of the strongest and most prosperous nations in all history. The capacity of Americans to achieve is a part of our country's legacy. Yet according to a study conducted by the Substance Abuse and Mental Health Services Administration, over 43 million adults in the U.S. suffered from some type of mental illness in 2014. And that number is growing. On average, 9.8 million adults have a serious mental illness. The passage of the Affordable Care Act makes access to mental health care easier but many mental health patients go untreated even though effective treatments exist. There are many reasons for this. Stigma discourages people to seek treatment and the cost of effective medications puts care out of reach for many. Many who suffer under the weight of mental illness lack the support that would otherwise encourage them from friends and family. There is also lack of cultural support in keeping appointments and taking medication. In addition, there are many gaps in the treatment and the availability of mental healthcare.

It is estimated that in 2015, there were 564,708 homeless people in the U.S. on any given day. Compared to the rest of the people in the U.S., the homeless have higher rates of substance abuse, hospitalization and mental illness. In fact, the rate of mental illness is two times the rate of the rest of the population. Unfortunately, consistent medical and mental health care is often very hard for the homeless to find. A study of 966 homeless adults found that 21 percent had unmet mental healthcare needs. When they seek treatment, it is usually at a Community Health Center. These centers are severely understaffed so services are limited. Since the Affordable Care Act provides health insurance to all Americans, it will likely double the patient-load of the already overwhelmed Community Health Centers.

Our children also suffer from the mental health care gap. A national survey of 2,311 people in the U.S. found only 30 percent believed there was "lots of availability" of mental health care for teens in their community. The availability for children was about the same. Another study found that of 1,301 children with emotional, developmental or behavioral problems, 18 percent did not receive care. Parents reported the number one reason their children didn't receive care was because of the cost or problems with insurance coverage. Again, the Affordable Care Act should reduce or end this obstacle. However, the national shortage of mental health services for youth remains. It has been estimated that only 63 percent of counties have a place that can provide mental health services for youth and less than half of counties have programs able to provide care to severely emotionally disturbed youth. The treatment gap is even bigger in rural counties.

There is a myriad of gaps in receiving mental healthcare. Racial minorities continue to be underserved. Senior citizens often go without needed care. Undocumented immigrants are ignored because we have politicized humane treatment of this group of people. There are things that can be done to reduce the treatment and services gap. Overcoming the stigma of mental illness increases the likelihood of community and local government support for providing mental health services. Cost and insurance problems are most often reported as the number one roadblock to receiving care. The Affordable Care Act is a major step in removing the roadblock, establishing that all Americans have a right to receiving needed healthcare, regardless of cost.

In a presidential election year, there are lots of speeches about improving the path for America and its citizens, but words are meaningless unless we fully address the massive gaps in mental health care for our most vulnerable communities. Our global reputation for advancement will be in jeopardy if we don't.

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If you -- or someone you know -- need help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the U.S., please visit the International Association for Suicide Prevention for a database of international resources.

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