“Why don’t you get treatment?”
“Why don’t you take meds?”
“Why don’t you see a therapist?”
“Why not get insurance?”
These are common questions that people who are mentally ill get asked when they are not being treated for their condition. Many people who ask them have good intentions, but what they don’t understand is: Getting treatment is not always easy. In fact, insurance companies often make it unaffordable and complicated.
When asked about whether or not they have encountered complications in getting treatment, a Twitter commenter said:
“I think it will likely vary a lot for everyone ‘cause the MH (mental health) resources are dependent on the country! I live in Canada so I have had free access to some mental health services, but that meant SUPER long waits for appointments & halfassed MH (mental health) workers that were always hours late.”
A friend of mine, a blogger on the site The Sound Mama, writes about her journey with anxiety and includes a section about battling with the health care system. You can read about it here.
Seriously, so many people experience these issues!
It varies depending on where you live, the health insurance provider you have, and what doctor you opt to see. Common issues people face are:
- Long wait to get appointments
- Expensive medicines
- Poor provider selection
- Expensive premiums/high deductible
I am going to talk about these 4 issues, trying to go in depth as to how they affect people who suffer from mental health issues, and what we can do to help.
Common issues in getting treatment
#1 Long wait to get appointments
CNNMoney lists the average wait time to get in to see the doctor and get treatment in several major cities. Here are the longest wait times:
- Boston: 66 days
- New York: 26 days
- Seattle: 23 days
- Los Angeles: 20 days
This is problematic because many people seeking psychiatric help are in a state of crisis. They have possibly thought about hurting themselves or someone else. They want to be able to get in quickly, and in these major cities, that is simply not possible.
What is their alternative? If their condition is an emergency, they can always go to the emergency room. The problem with that is the difference in cost. For instance, on my insurance, which is, thankfully, really great, I can see a specialist like a psychiatrist for $20. Pretty inexpensive co-pay! But if I am unable to get in to see them, and my situation becomes critical, I will face a co-pay of $150 for going to the emergency room. And does not include any testing or medication I would stand to receive. That is a vast difference!
That is a huge issue for many who suffer from mental health issues, when mental health can be so expensive to treat as it is. In my case, if I cannot get in to see my normal doctor in a timely fashion, I face paying at least 7x as much to go to the emergency room. That is unacceptable.
#2 Expensive medicines
This category especially makes me so thankful for my good insurance. I am able to get my three maintenance medications for about $50 a month total. For many, though, the costs of medications that are life-changing, and life-saving, are more than they can afford.
Using my medication as an example, these are some costs people might expect to face (estimated retail prices according to GoodRX) if they do not have insurance:
- 60mg Cymbalta: $249.70 (for the generic version)
- 40mg Latuda: $1489.55 (no generic available to my knowledge)
- 300mg of Neurontin: $79.48 (for the generic version)
So, as you can see, if not for my excellent unicorn insurance, I would pay approximately $1800 for meds I need to stay emotionally stable and be there for my kids. Why not just get insurance, you ask? I will get to that.
#3 Poor provider selection
A lot of times, insurance plans make it hard to select the doctor best suited to treat you. There are the previously mentioned long wait times, but there are other factors too.
- Too far from home or work
- Do not accept your insurance in the first place
- Not taking new patients
There are various reasons why a person might have a hard time finding a doctor that is covered by their insurance, and that is important to remember when asking someone why they don’t just go to a doctor. Also, many single parents might have a hard time finding child care during appointment times, although that is not insurance related.
#4 Expensive premiums/high deductible
Two factors to keep in mind when discussing treatment and frustrations with insurance companies are:
- How much do you stand to pay a month in premiums?
- What is the annual deductible that needs to be met?
For the first question, I went on the BCBS website (a common American insurance company), and their rates for California are as follows for an HMO plan:
- Monthly: Between $232 and $655 (depending on if it’s biweekly or monthly, and if you have dependents)
Obviously, it will vary by state. But if you factor this in with whatever you pay for medication, the costs are daunting. Many mentally unwell people are in partnerships and have children. If a person cannot, for whatever reason, get on their partner’s insurance, they might have to provide it for the family themselves. That could run them several hundred dollars per month!
The second question that needs to be asked is, what is the annual deductible that needs to be met? Simply put, a deductible is what you have to pay out of pocket before getting benefits of coverage from your insurance provider.
For example, our deductible is $750. That means that we have to pay that amount in a year before insurance will cover things like X-rays and surgeries. That deductible is not too horrible, but some people have a deductible in the thousands. So, even though a person might have insurance, it does not mean treatment is cheap!
To sum up
These are just a few reasons why dealing with insurance companies is such a hassle! That is a major reason why many people who have mental illness do not get treated. Between the costs of medication they need, to the inconvenience of waiting to see the doctor, to high insurance deductibles, these are hassles that nobody needs, especially those suffering from mental illness.
What can you do?
It also never hurts to start a petition. Create an account on Change.org and start a petition that you can easily share on social media.
Every voice matters. Some of those with mental illness are estranged from family and friends and do not have people to speak for them, and often, they cannot speak for themselves. Be their voice. It really, really matters.
Have you ever had an issue with your insurance company? How did you resolve it?