Barriers and Disparities for Patients Seeking Mental Health Care

The lack of treatment for mental illnesses — due partly from the stigma with which it is associated with — comes with a number of public issues: economically,

Mental Health coverage prior to the Affordable Care Act was far to none. With about nearly one-third of currently covered individuals having no coverage for substance abuse disorder services and approximately 20% having no coverage for mental health services. Services such as outpatient therapy visits, impatient crisis intervention and stabilization were among many that were not offered. Since the Affordable Health Care Act has been passed more individuals are able to afford health insurance that were once uninsured. It has helped many individuals in being able to obtain medical services that were once inaccessible.

One of the biggest contributors for poor healthcare is the stigma against mental health. This stigma allows healthcare providers to view those with a mental illness as having low relevance, thus creating disinclination towards providing adequate resources and/or care. This negative stance, based on misinformation and prejudice creates those that have a mental illness to lose their self confidence. Because of this loss, people with mental illness decide not to contribute to their health or livelihood. In the past fifty years, many advances have been made in mental healthcare. However, with the attached stigma, many people choose to not seek out treatment.

Self-pity and pessimistic attitudes remain a topic of discussion with a mentally ill patient, however the more valuable picture revolves around the stigma that the public holds towards those with a mental illness. Unrun Ozer, member of International Committee of National Journal Editors, acknowledges that, “Stigmatization is described as attributing someone in a way that would decrease the person’s reputation because the individual strays away from the general norms of the society” ( 225). Ozer clarifies that a stigma is an unfavorable viewpoint that society has on someone that is perceived as different. Those with a mental illness are susceptible to vulnerability because they are at a small disadvantage than the normal person. Negative connotations, such as adverse viewpoints and perplexing labels, affect the care and treatment process of those suffering because their compliance to treatment decreases. Society is too quick to judge and be ignorant if someone isn’t in perfect form, and Ozer reports, “ It has been reported that individuals with mental illnesses are seen by the society as dangerous, frightening, unstable, irresponsible, unpredictable, and having communication problems” (Ozer 225). Ozer declares that these labels are degrading to an individual with a mental illness, and cause feelings of introversion, decreased self-confidence, worthlessness, shame and despair. If we want happiness to be achievable for all, then criticizing individuals is a step in the wrong

Across the country, a steady increase has been noted in the number of patients presenting to emergency departments for psychiatric complaints (Zun, 2014). Patients also attempt to use their primary care doctors to treat their mental illnesses. The mental health care options for these patients are extremely limited, especially for minority populations such as African Americans and Hispanics. One out of four adults in America suffers from some form of mental illness, yet only one out of three of those affected receives treatment (Safran, 2009). Furthermore, patients are routinely misdiagnosed, receive poor quality of care, receive care from providers who have no understanding of their cultures and values, or are not even able to receive care in the first place (Sanchez, 2012).

According to the World Health Organization, mental illness will affect approximately 25% of people at some point in their life (“WHO Qualityrights”, n.d.). Despite that, the current mental health care system in the United States is inadequate. Many aspects of the system need improving, especially the barriers to service. In fact, approximately 20% of individuals are left without necessary treatment for their mental health disorder (“Mental Health”, 2016). Mentally ill individuals have difficulty accessing necessary mental health care services for various reasons; insurance, socioeconomic status, and mental health stigma can all function as barriers to treatment. Insurance discrimination can make it difficult for individuals to find treatment (Han, Call, Pintor, Alarcon-Espinoza, & Simon, 2015). Gaps in insurance coverage can also be a barrier, as they disrupt the long-term treatment process (Gulley, Rasch, & Chan 2011). Socioeconomic status has been found to negatively affect appointment scheduling (Kugelmass, 2016). Finally, stigma in our society can also stop people from seeking out treatment that they need (Bathje & Pryor, 2011). The mental health system in the United States is not capable of caring for the mentally ill, as insurance, socioeconomic status, and perceived stigma all act as barriers that prevent people from receiving the treatment they need.

Problem Statement: The World Health Association defines ‘good’ health as: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” However, in the United States, access to care and funding for mental health care are grossly neglected and underfunded in comparison to other aspects of health care.

In the United States the Mental Health Care field is one of the most underserved areas of healthcare. The mental healthcare field faces many challenges to the proper treatment of patients from both a societal and professional standpoint. From a societal perspective a negative stereotype is associated with patients seeking psychiatric care. Patients seeking care are often labeled as defective or damaged. Add in the complication that most patients with mental illness appear to be normal, accepting that someone is ill without outward symptoms can also be difficult for a society to understand. From a professional perspective the challenges within the mental health care industry include personal prejudice, staffing issues, and problems with coordinating care. The combination of these factors has a direct negative impact on the willingness of individuals suffering from mental illness in seeking the care needed to treat the symptoms of mental illness.

What is left is that we have many citizens who are mentally ill and are not receiving treatment. However the patients who are able to receive treatment are only able to have some treatment covered. Health insurers are responsible for covering the immensely large cost of substantial treatment, a mixture of medication and therapy; since therapy is highly priced, less reliable, and time consuming; patients typically do not receive treatment for therapy. Health insurers would much rather cover medication because it is cheaper, it heals patients faster, and it is more reliable than therapy. However, medication is not made to heal, but to only coax symptoms of a mental illness (Sandberg).

Lack of access to mental health care and treatment is one of the top ten reasons that many mental health conditions go untreated. Many private and group health insurance plans only include minimal mental health care coverage or do not incorporate mental health care coverage at all. Over half of adult citizens of the United States of America, who possess a mental illness, do not obtain mental health care treatment. According to the U.S. Department of Health and Human Services, one out of every five adults in America have endured their own mental health difficulty, and one out of every twenty-five American adults suffer from a severe mental illness, such as major depression, schizophrenia, or bipolar disorder. (Top 5 Barriers to Mental Healthcare Access, Social Solutions.com, 2017)

Access to mental health care is not as good as than other forms of medical services. Some Americans have reduced access to mental health care amenities because they are living in a countryside setting. Others cannot get to treatment for the reason of shortage of transportation or vast work and household tasks. In some areas, when a

It is estimated that 43.5 million Americans, adults 18 or older, live with mental illness. This number represents 18.1% of all U.S. adults (National Institute of Mental Health, 2014). Stigma toward those who are seen as different have existed for as long as civilization itself, with the stigma for mental illness being one of the most prominent and long lasting that society has had to face throughout its ages (Arboleda-Florez & Stuart, 2012). Increased understanding and awareness for those individuals suffering from mental illness is necessary for us to overcome the impacts stigma has on our society.

Mental health—and the stigma that comes along with it—is a very important issue, one of global importance. Shah and Beinecke explain that 450 to 500 million people suffer from mental illnesses (15). Just considering the amount of people who suffer from mental illness is enough to prove that this is a global issue. Despite the large amounts of people who are affected by mental illness, only one third of countries have some sort of program to help (15). This shows the lack of concern for those who suffer from mental illness. Stereotypes affect many people, and those with mental illness are no exception. Everyone has their own preconceived perspectives and notions of mental health, and many of them are uninformed and unjustified. It is up to us to start changing our viewpoints on mental health.

While untreated mental illness sufferers pay the ultimate price, stigma not letting sufferers get treatment also pays a toll on society. The first item that proves this is the money spent on large amount of medical costs from attempted suicides. In another finding from the Oklahoma Department of Mental Health and Substance Abuse Services, among suicide attempts the medical costs such as ER visits and hospital stays

“I want to be able to talk to someone in a pub and say ‘I have been mentally ill’ and for them to say ‘That’s interesting, what did you experience?’”, said a survivor from the UK in 1997 (Sayce 18). Almost twenty years later and this man 's wish still has not come true. People may ask why, and the answer is because of the stigma that comes along with having a mental illness. Mental illness is something not often talked about because of the fear of being judged. According to the National Alliance on Mental Illness, one in every four Americans has a mental illness, and only about 40% of them seek professional help (Hamid). People are being put into mental institutions instead of getting the help that they need to get better, because even people in the medical field are not understanding about this situation because they do not understand how it feels. The stigma and stereotypes towards mental illnesses are overwhelming, therefore people should be made aware of their impact and take steps to reduce stigma and stereotypes.