Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A consistent and clear picture of significant barriers to mental health care

Peggy A. Rothbaum, PhD
Policy
March 2, 2018
52 Shares
Share
Tweet
Share

As part of the interview for my book, I asked about the role that mental health plays in healthcare. Responses were unequivocal: It plays a vital role. All of these doctors have patients who are depressed, anxious, traumatized, or otherwise in need of mental health services. My doctor interviewees frequently added comments about lack of access to mental health services and insurance interference.

Refusal to pay is a big problem, according to my doctor interviewees. One doctor said,  “You can’t get an appointment with a psychiatrist. I try and make referrals. Insurance won’t cover it, you can’t find someone to see, and there is a stigma.” Another one said,  “It’s hard to find good therapists, and no one is in-network.” (Recent news is that only about 11 percent of all psychotherapists are in-network.) Another agreed,  “Drugs have limited value. Therapy is of value. But it is an unreimbursable commodity as insurance does not cover it.”

It’s a lot to manage in medical practice. One doctor explained, “We don’t have the resources in the practices to handle it. We have generalists who don’t have the training. To manage the amount of bipolar, ADD, ADHD, OCD, PDD, depression and you can’t get the insurance to pay.” Another one said, “It’s another area of great need and broken-ness. It is hard to find good care. Reimbursements are low. Licensing and preparation to reach to that point where you are qualified is a very difficult task. So we rely on church, family, counseling.” Another doctor said, ” How do you do this with 9 minutes allowed per visit?”

Prior to writing my book, I participated in two data-based research projects, which were published, with the New Jersey Psychological Association, investigating insurance and mental health care. In the first project, psychologists reported, among other findings, pressure to change quality of care and compromise ethics based on patient protection. A “treatment concern cluster emerged,” which included the items, being unable to get on the panel, having to go through lengthy precertification, having to fulfill lengthy screening requirements, being forced to discharge before the patient is clinically ready, having untrained personnel making patient care decisions, dealing with slow response from the company to requests for approval of sessions, having a clinically inadequate number of sessions and dealing with increased paperwork.

A decade after the first project, I co-authored another article with the New Jersey Psychological Association, based on data collected in an Insurance Complaint Registry, which documents insurance abuses in denying mental health care. Complaints were collected from psychologists and summarized into general categories: denying coverage for treatment, difficulties with treatment authorization, miscellaneous actions resulting in negative impact on patient, network issues, insurance company provided misinformation or was unresponsive to inquiries, and payment difficulties due to insurance company errors. The list of actual items in each category is in the article. Some of them are just absurd. As the saying goes, “You can’t make this stuff up.”

These three data sets, two reporting responses by psychologists and one reporting responses by physicians, reveal a consistent and clear picture of significant barriers to mental health care in our state. Inadequate mental health services drives up medical care costs and decreases workplace productivity, as unequivocally documented by research. What is the point of having mental health parity laws, where mental health care benefits are comparable with medical health care benefits, if the insurance companies deny and refuse to honor existing coverage? The insurance companies need to be reined in and forced to honor mental health coverage. Our well-being depends on it.

Peggy A. Rothbaum is a psychologist and can be reached at her self-titled site, Dr. Peggy Rothbaum.  She is the author of I Have Been Talking with Your Doctor: Fifty doctors talk about the healthcare crisis and the doctor-patient relationship.

Image credit: Shutterstock.com

Prev

Physician burnout: When work is not the cause

March 2, 2018 Kevin 7
…
Next

Is apathy needed to survive medical school?

March 2, 2018 Kevin 4
…

Tagged as: Psychiatry, Public Health & Policy

Post navigation

< Previous Post
Physician burnout: When work is not the cause
Next Post >
Is apathy needed to survive medical school?

More by Peggy A. Rothbaum, PhD

  • Trying to bury trauma does not work

    Peggy A. Rothbaum, PhD
  • Yet another injury to our doctors and our health care system

    Peggy A. Rothbaum, PhD
  • We must care about our doctors. Especially now.

    Peggy A. Rothbaum, PhD

Related Posts

  • Sharing mental health issues on social media

    Tarena Lofton
  • How social media can help or hurt your health care career

    Health eCareers
  • Improve mental health by improving how we finance health care

    Steven Siegel, MD, PhD
  • A step forward: a way to advance the mental health of health care professionals

    Mattie Renn, Thomas Pak, and Corey Feist, JD, MBA
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • The promise and challenge of integrating primary care into community-based mental health centers

    Betty Rabinowitz, MD

More in Policy

  • The realities of immigrant health care served hot from America’s melting pot

    Stella Cho
  • Healing the damaged nurse-physician dynamic

    Angel J. Mena, MD and Ali Morin, MSN, RN
  • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

    Mohammed Umer Waris, MD
  • Breaking down the barriers to effective bar-code medication administration

    Amy Dang Craft
  • The locums industry has a beef problem

    Aaron Morgenstein, MD
  • Canada’s health workers are sounding the alarm. We must act, now.

    Ivy Lynn Bourgeault, PhD
  • Most Popular

  • Past Week

    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
  • Recent Posts

    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Maximizing physician potential: How coaching can aid in conflict resolution, enhance health care leadership and build stronger teams

      Asha Padmanabhan, MD | Physician
    • The future of education: AI empowerment, YouTube college credits, and the impact on traditional colleges

      Harvey Castro, MD, MBA | Tech
    • The beauty of a patient’s gratitude

      Dr. Damane Zehra | Conditions
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Moderna's Steep COVID Vaccine Price: Corporate Greed or Capitalism?
  • House Republican Argues Against FDA Budget Increase
  • Prescriptions for Stimulants Jumped During the Pandemic
  • Federal Judge Strikes Down ACA's Preventive Care Coverage Requirements
  • Pandemic Jump in ED Visits for Firearm Injuries Continued Into 2022

Meeting Coverage

  • VTE Risk in Recurrent Ovarian Cancer Increases With More Lines of Chemotherapy
  • Obesity's Impact on Uterine Cancer Risk Greater in Younger Age Groups
  • Oral Roflumilast Effective in the Treatment of Plaque Psoriasis
  • Phase III Trials 'Hit a Home Run' in Advanced Endometrial Cancer
  • Cannabis Use Common in Post-Surgery Patients on Opioid Tapering
  • Most Popular

  • Past Week

    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
  • Recent Posts

    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Maximizing physician potential: How coaching can aid in conflict resolution, enhance health care leadership and build stronger teams

      Asha Padmanabhan, MD | Physician
    • The future of education: AI empowerment, YouTube college credits, and the impact on traditional colleges

      Harvey Castro, MD, MBA | Tech
    • The beauty of a patient’s gratitude

      Dr. Damane Zehra | Conditions
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A consistent and clear picture of significant barriers to mental health care
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...