Bottlenecks in mental health services – Part 4: Impact of state regulations

Mental health services have been an important component of medical care in the United States. The availability, costs and coverage of mental health services depend on various policy discussions and regulations. All the states across the U.S. have some type of law related to mental health services. The state laws can be divided into three categories:

Mental Health ‘Parity’ or Equal Coverage Laws:  These laws prohibit insurers or health care service plans from discriminating between coverages offered for mental health and substance abuse, and other physical disorders and diseases.

Minimum Mandated Mental Health Benefit Laws:  Many state laws need minimum coverage for mental illness, substance abuse or a combination of substance abuse and mental illness.

Mental Health ‘Mandated Offering Laws’: These laws differ from the other two laws in that they do not need benefits to be provided at all. These laws can do two things. First, they can provide an option for coverage to the insured for mental illness, substance abuse or a combination of both. This coverage can be accepted or rejected and, if accepted, would carry an additional premium. Secondly, these laws require that if benefits are being offered to individuals then they must be equal.

As part of the series, “Bottlenecks in mental health services,” we bring to you the fourth part that talks about state regulations and how they impact the mental health services.

Reasons for lack of access to mental health care facilities

The reasons for not receiving adequate mental health care treatment can be individual or generic. The most common reason behind lack of access or delayed access to mental health care can be attributed to the diagnosis of the illness which can further aggravate the symptoms and worsen the condition.

Even after diagnosis of a mental illness, finding access to the right kind of treatment is often difficult due to following barriers:

  • inadequate insurance
  • shortage of treatment providers
  • shortage of treatment services such as inpatient treatment and individual therapy
  • inadequate finances to cover treatment costs

Shortage in mental health providers also to blame

Lack of care for mental health patients could also be attributed to a shortage in mental health providers. Nationwide, for every 529 individuals, there is only one mental health care provider. The shortage of specialized mental health professionals, such as child psychiatrists, is even higher. States with the lowest workforce report only one mental health professional per 1,000 patients.

As per the American Academy of Child and Adolescent Psychiatry (AACAP), as compared to over 15 million youth with mental disorders, there are an estimated 8,300 child psychiatrists across the nation. As per the U.S. Health Resources and Services Administration (HRSA), there are over 4,000 areas across the nation that face shortage of mental health professionals.

Impact of state health care policies on access to mental health care services

Health care policies implemented at the state and local levels help provide mental health care to those needing the treatment. In the U.S., states that passed laws supporting the Affordable Care Act (ACA) and executed mental health parity laws showed improvements in access to insurance rates. The states that undertook aggressive policy changes, such as the execution of Mental Health Services Act in California, resulted in significant changes in access to mental health care. In July 2016, the U.S. House of Representatives passed H.R. 2646, the Helping Families in Mental Health Crisis Act to address critical flaws in the nation’s mental health system.

Expected changes in mental health sector

Fixing the nation’s health care system for millions of Americans suffering from substance abuse and mental illnesses seems to be the top priority of lawmakers. There is a growing concern among legislators regarding an increase in the number of mentally ill homeless people wandering on the streets, the cost of housing thousands of severely mentally ill patients in prisons and the increasing stress on emergency departments of hospitals holding such patients.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2012-2013, 57 percent adults with a mental illness received no treatment and 64 percent youth with major depressive disorders were left untreated.

Help at hand

Though more Americans have access to services such as insurance, most Americans still lack access to care. Improvement in the health of Americans and access to adequate treatment require a diligent effort on the part of the states to invest in mental health services.

If you or someone you know is suffering from some kind of mental disorder, it is time to seek professional support. We, at the California Mental Health Helpline, can help you find the best mental health facilities in California. Call us at our 24/7 helpline number 855-559-3923 or chat online with our experts to find the best mental health centers in California.

Read the other articles of the series, “Bottlenecks in mental health services”:

Part 1: California’s shortage of psychiatric bed impacts mental treatment

Part 2: Overcrowding ERs affecting psychiatric patients’ treatment

Part 3: Impact of state budget on treating mental illnesses

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