“We are going to need to work on making access to mental health care as easy as access to a gun.” President Obama
According to a survey by the federal Substance Abuse and Mental Health Services Administration, more than 45 million adults nationwide suffered from some mental illness in 2011. About 11 million had a serious illness and of those more than 40% did not get care. Among the biggest barriers to treatment have been cost and limits placed on care by insurance companies.
Unfortunately, even with private insurance coverage, many patients do not get the care they need. My son was repeatedly discharged from various hospitals in San Francisco within 24 hours after a serious mental illness crisis with the discharge order stating he no longer needed treatment because he was not a harm to himself or others. That did not mean he was stabilized. It only meant that the hospital was no longer required to treat him under the law. One time in particular he was discharged from the University of California San Francisco Hospital in the middle of winter without his clothes or shoes. The admitting psychiatrist had assured me he would be held for 72 hours for observation and treatment and trusting his word, I took my son’s clothes and shoes home. Instead, he was discharged first thing in the morning in green hospital scrubs and cloth slippers. The police picked him up wandering in the rain.
My hope is that President Obama’s plan focusing on mental health will mean that the millions of adults who suffer from a mental illness will get the sustained treatment they need and not be dumped out in the street like garbage.
The following is an outline of President Obama’s plan:
Make Sure Students and Young Adults Get Treatment for Mental Health Issues: Three-quarters of mental illnesses appear by the age of 24, yet less than half of children with diagnosable mental health problems receive treatment. And several recent mass shootings, including those at Newtown, Tucson, Aurora, and Virginia Tech, were perpetrated by students or other young people.
The Administration is calling for a new initiative, Project AWARE (Advancing Wellness and Resilience in Education), to provide training and set up systems to provide referrals. This initiative, which would reach 750,000 young people, has several parts:
1. Provide “Mental Health First Aid” training for teachers
2. Make sure students with signs of mental illness get referred to treatment
3. Support individuals ages 16 to 25 who are at high risk for mental illness. Efforts to prevent school shootings and other gun violence can’t end when a student leaves high school. Individuals ages 16 to 25 are at high risk for mental illness, substance abuse, and suicide, but they are among the least likely to seek help.
4. Help schools address pervasive violence: 22% of 14 to 17 year olds have witnessed a shooting in their lifetime. Exposure to community violence can impact children’s mental health and development and can substantially increase the likelihood that these children will later commit violent acts themselves.
5. Encourage Congress to provide $25 million to offer students mental health services for trauma or anxiety, conflict resolution programs, and other school-based violence prevention strategies.
6. Train more than 5,000 additional mental health professionals to serve students and young adults. Experts often cite the shortage of mental health service providers as one reason it can be hard to access treatment.
Launch a national conversation to increase understanding about mental health: The sense of shame and secrecy associated with mental illness prevents too many people from seeking help.
Ensure Coverage of Mental Health Treatment: The Affordable Care Act will also make sure that Americans can get the mental health treatment they need by ensuring that insurance plans cover mental health benefits at parity with other benefits.
Finalize requirements for private health insurance plans to cover mental health services
Make sure millions of Americans covered by Medicaid get quality mental health coverage: Medicaid is already the biggest funder of mental health services, and the Affordable Care Act will extend Medicaid coverage to as many as 17 million hardworking Americans. If you are interested in more details about President Obama’s plan go to www.namicalifornia.org.
Finally, President Obama has not suggested the re-establishment of involuntary treatment but it is an option that warrants serious research and discussion. But I’ll leave that for another blog.