Why Accessing Mental Health Treatment is Harder than Ever (And How Mental Illness Has Become a Pandemic)

Why Accessing Mental Health Treatment is Harder than Ever

With an opioid epidemic brewing and a sharp spike in suicide rates across the US, equitable access to mental healthcare is more important than ever. The Mental Health Parity and Addiction Equity Act, signed in 2008, intended to make mental health treatment as accessible as surgical/medical treatment.  But what happened after it was passed?

Behavioral healthcare visits were still 6 times more likely to be out-of-network than medical/surgery visits in 2015.  Out-of-network means that the health care provider does not have a contract with your health insurance company. This is more expensive than recieving in-network care. In New Jersey, 45% of behavioral health visits were out-of-network in 2017.  In DC, that number is at 63%.  The disproportionate percentage of out-of-network visits is troubling, as none of those visits are covered by insurance.  Instead, the patient or their family must pay the whole bill.  

Here is Just How Costly Psychiatric Treatment Can Be.

An initial consultation with a psychiatrist costs $500 on average, and each subsequent appointment costs at least $100 per hour, according to Angie’s List. Assuming that each appointment is an hour long and is attended once weekly, that’s at least $5700 per year.  In three years, the total cost adds up to $16,300. Imagine having to pay $16,300 just to seek psychiatric treatment. Having to pay $16,000 for basic treatment ranges from burdensome yo impossible for many people.

The reality of the costly nature of psychiatric treatment

Because many people simply cannot afford that treatment, some people don’t seek out the help they need.  Skipping treatment has real consequences for the human body. From a rapid decline in mental health to unexplained chronic pain, untreated mental illness becomes a slippery slope towards serious consequences.

The message is clear:  High treatment costs come with an even heftier toll:  a worldwide pandemic of mental illness. 

Why is this the case?

Because of low reimbursement rates, mental health care professionals are often unwilling to contract with insurers. Hence, there are drastically fewer in-network therapists to satisfy the needs of the patient population. What is left is a vast network of expensive, out-of-pocket mental health professionals, discouraging some from seeking treatment simply because some simply cannot afford it.  

Rising costs, however, are only a fraction of the barrier patients face when seeking mental health treatment.

Cultural Perspectives of Mental Illness

According to one review done by the University of California San Francisco and Kaiser Permanente, mental illness is accompanied by “enormous personal suffering and socioeconomic costs.”  Because many people still do not believe that mental illness exists, those who actually need treatment are denied by non-psychiatric physicians who do not believe their patients’ concerns and symptoms. In many cases, brain autopsies reveal nothing about certain mental diseases, so mental illness remains largely invisible.

The invisible nature of Mental Illness, and how this impacts cultural perspectives

Hence, mental illness continues to be a far-off, abstract concept to many, even when the symptoms are very much real. The refusal to acknowledge mental health concerns reflects a cultural lack of empathy around mental illness, as we continue to only be concerned with tangible as a whole–not the intangible. We need to move beyond that and consider that though mental illness is invisible to the eye, it being invisible does not make it any less real.

I find this denial towards the mentally ill disappointing.  Some perceive themselves as being “compassionate enough” for saying a few comforting words. That, however, is not enough.  We focus too much on what can be seen, whilst ignoring the unseen. It was common for Neurologists to do this towards the end of the 19th century, and we still do that today.

The Impact of this Widespread Denial

Experiencing a lack of sympathy often discourages people from seeking treatment.  In fact, the disdain for mental illness implies that hiding our illness is actually better–when that is clearly not the case.  The sad reality is that this delayed treatment worsens mental illness outcomes, as suggested by one study done by the University of British Columbia and the University of Calgary. Hence, those who are suffering are often left in the dark and without treatment.  Life for those who suffer from untreated mental illnesses becomes a perplexing whirlpool of denial and hopelessness.

The Long Term  Impact of the Widespread Denial of Mental Illness

The Normalisation of Hurtful Language

It’s as if the balance of society’s focus towards the visible and invisible is skewed. It is common to replace medically accurate terms with offensive language.  Words like “psycho” and “lunatic” need to go.  These words only fill the gap between the unknown and satiate the unconscious bias. Using pejorative adjectives to describe one who is seemingly “scary” is unacceptable because these terms isolate and oversimplify.  These words seek to villainize, not humanize. Calling a mentally ill person a word such as “psycho” is never productive.

People with mental health issues experience genuine and complex struggles that should not be oversimplified.  These words are devoid of compassion and may discourage some from seeking treatment because these words focus not on the treatment, but the condition.

We need to start breaking the silence and denial around mental illness, the “pandemic of the 21st century.”

Collin Wong is an Inflammatory Bowel Disease blogger and advocate on Collin’s IBD Chronicles.  In the thick of the college application process, he decided to start a blog after realizing the lack of Asian Americans in disease blogging.  He was diagnosed with Crohn’s Disease in 2006, and he started this blog as a way to give an Asian American perspective on IBD.  Outside of blogging, he is a full time student who aspires to be a doctor one day.  

My Experiences with Anxiety and PTSD

My Experiences with Anxiety and PTSD

When I was first diagnosed with anxiety, PTSD, and OCD; I asked my counselor how I could have PTSD when I had never been in the military. There is so much misinformation and stigmas about anxiety and PTSD in our culture. If you have any mental illnesses, and if you have one that is normally tied to certain lifestyles/experiences, you aren’t supposed to talk about it. I have heard many times that it’s all in my head and to get over it; that if I just change the way I think, I will be fine. I developed my PTSD from a car accident I was in and some assaults that had happened while I was in college. Eventually, I had to admit to my “issues” and then talk about it with my counselor in order to try and find the best way to work through it or find coping skills/tools to be able to function in society.  I was working at the time and still am working, but I need to watch my surroundings for triggers.

There are days where I struggle with my body, both physically and mentally.  I feel like I should be helping more, but cannot due to my body that day. My anxiety makes me argue with myself and go rounds in my head, fighting the mental battle in what I should be trying to accomplish. On bad days, I second guess everything and am afraid of being judged. I give excuses for my choices and slip them into the conversations to defend my choices because I think they are judging me. No one told me that anxiety and PTSD would control every decision I make. I was never told how much it could impact my life and that I would have almost no friends because I was too anxious to go hang out.  

After having my daughters, I was diagnosed with PPD and PPA. Prior to this I had only heard about PPD because of the episode from Scrubs and never truly knew how often it was diagnosed. I just thought that it sometimes happens, I was never informed that if you already have anxiety or depression you are more prone to developing PPD or PPA or that it could develop any time up to two years postpartum. 

My Experiences of Parenting with Anxiety and PTSD

My anxiety symptoms

I had such high anxiety that I did not take my daughters anywhere and refuse to go out into public. I have fears that I am being judged as a “bad” parent, when in all honesty I am doing the best that I can physically and mentally do. I have that guilt as a parent that I am not doing enough and then I hear small comments that my daughters don’t get interactions with others their age. It then takes me a few weeks before I try to set up a playdate, and then cancel it again a couple days before to the day of.  Sometimes I have to cancel due to my body not functioning and other times I cancel because my anxiety gets in the way. It is a vicious cycle that won’t ever stop.

I had gotten a service dog to help mitigate my disabilities, mostly physical, but some mental. My service dog helps with alerting to anxiety/panic attacks and she helps lessen my triggers for my PTSD.  I have only recently become comfortable, to an extent, to talk about these things. I never wanted to admit to having PTSD or anxiety and struggled letting my husband know about them when we got engaged. I felt broken and damaged when I realized that they don’t go away, you can do counseling, therapy, etc and they will always be there.  

Unfortunately, having my service dog with me can cause more anxiety in certain situations or when I’m having a bad day mentally. Some people can be outright rude when confronting me about my service dog because I don’t seem blind (I am not blind) or I don’t look like I have served in the military (I have not). These are the stigmas in society that can cause misinformation being spread and therefore making it harder for me to get out of the house.

My PTSD Symptoms

Some of the symptoms I have to deal with because of my PTSD are: nightmares (night-terrors), guilt, poor judgement (happens a lot to me, especially through social media), flashbacks, insomnia, anxiety (with having anxiety from separate issues this is a double whammy), avoidance (I do this a lot because I play “what if” scenarios in my head), startle response (my service dog is trained to help lessen these), negative self-image, stress, and isolation. These are some of the symptoms of PTSD, there are many more, but these are the ones that I experience almost daily.

My service dog is trained to help with my PTSD and anxiety by alerting or doing a few other coping mechanisms.  She will alert when she notices my heartrate rising before I notice it, which is an indicator that I am about to go into an anxiety/panic attack.  Typically, she will then guide me out to my car or to a quieter area where I can then sit on the ground with her. She will sometimes put herself between me and what is stressing me out (I struggle with crowds).  When I am putting myself in a situation that I know will cause me to panic or have a PTSD flashback, I will give her a command to guard/watch. This is where she will turn around facing behind me, which gives me a sense of security.  If my flashbacks, anxiety/panic attacks persist after she’s guided me to a quieter place, she will then do DPT, which is deep pressure therapy. She will also use DPT for another thing that she alerts to, but this is not associated with my mental illnesses.

I Am Thankful For The Support I Recieve

With my service dog, I am able to cope better with my symptoms and function out in society better. I did not initially get a service dog to help with these things, these tasks came about soon after I was diagnosed with PTSD, which was around 3 years after I had gotten my first service dog. There are other tasks that I have added slowly as my body physically gets worse over time and as I am learning that I need more help.

Having Support from my Family and Service Dog While Coping With Anxiety and PTSD

Along with my service dog that helps me cope and function on my own, I am grateful for a great support system.  My parents, parent-in-laws, husband, and a couple friends; help me be able to enjoy life and don’t guilt me (that often) when I bail out or am struggling mentally.  I truly believe that if I didn’t have the support system that I do have, I would not be able to function as well as I do. Sometimes all I need is a good listening partner so that I can process how I am feeling and why I don’t want to leave the house.

It also helps when I have someone be able to go out on errands with me so that I do not have to be alone. Other times, they gently push me to do things that I wouldn’t normally have the guts to do, like write this article. My anxiety got in the way and it took me three weeks to write this in fear of being judged.  Lots got deleted, put back in, deleted, and then put back in again. My support system helped me to feel comfortable to write this and have it published in this blog.

5 Ways To Reduce Stress When Dating With Mental Illness

5 Ways to Reduce Stress When Dating with Mental Illness

There are a lot of people in this world who find dating absolutely terrifying. Let’s face it: most of us have had the broccoli-in-the-teeth moment at a fancy restaurant.

Many who suffer with mental illness endure dating nerves over double the intensity of those without mental illness. The reality is, mental illness can impact human relationships in general, whether platonic or romantic.

It’s not always easy to navigate social settings. That being said, it doesn’t mean you shouldn’t try.

5 Ways to Reeuce Stress When Dating with Mental IllnessThis world can be a pretty lonely place. Having loved ones to share it with is definitely one of the perks of being human. Yet something a lot of us struggle with is expressing ourselves. Figuring out how to explain difficult, often sensitive, topics to others can be an overwhelming, daunting process.

I have compiled a list of why people with mental health issues may struggle with dating. Now whenever your Gran starts nagging you to find your future spouse, I’ve got your back! You can literally just thrust this article in her face then frogmarch out of there like a boss.

Sadly, I can’t promise it will stop the nagging, but it may at least make her think twice.

Why might people with mental health issues struggle with dating?

You don’t feel good enough.

If you suffer with a mental illness, especially depression, you will know exactly what I’m referring to. The mind monsters come out to play, causing you to have negative thoughts and low opinions of yourself. It’s very easy to let your mental illness trick you into believing that you are unloveable.

A common worry for those dating with mental illness is that they have too much baggage. They begin to wonder whether anyone would ever want to take them on when they could find someone without mental health issues.

It feels like too much effort.

It doesn’t matter what mental illness(es) you suffer from: there is no “one size fits all.” You could find two people unusually identical in every way, suffering from the same illness. Even then, it’s still highly unlikely that the symptoms they experience will be the same.

However, it’s very common to feel fed up and worn out. The process of arranging and actually participating in dating is a lot of effort. Not to mention the prospect of feelings getting involved can be terrifying. The whole thing can seem like a mammoth task when suffering with mental illness.

You are scared of it impacting your mental illness and making it worse.

It’s a well known fact that our emotions in general can wreak havoc on our mental health issues. Inviting others into our lives and giving them the power to impact our thoughts and feelings can be panic-inducing. Why would you want to give someone the power and ability to hurt you?

You don’t know how to express yourself or explain your mental illness.

It can be difficult to express yourself when dating with mental illness.It can be difficult to express yourself. That’s a worry for a lot of people. When you have a mental illness that you have to try and explain? Well, it’s a whole new ballgame. How do you explain something you can’t fully understand yourself, am I right? Trying to figure out how to put into words something so complex seems impossible. It’s not as simple as asking a sketch artist to draw your description.

You panic yourself out of it.

I have lost count of the number of social situations I have talked myself out of over the years! It’s way too easy to think of justifiable reasons for why you shouldn’t do something. Even people without mental illness often let the fear of the unknown hold them back.

The real question is, what do you do? Well, I may be able to help you there.

5 Easy Ways To Reduce Stress When Dating

  • Choose a date idea that you are comfortable with. For example, if you are worried about eating in public, go bowling instead.
  • If you are concerned about your conversational skills, watch a movie; it gives you a topic to discuss.
  • Ask to be involved in the planning. Your input will be used when deciding the venue and the activity.
  • To ensure you will get along, arrange a video call before the date. It’s basically a face-to-face chat, but with the safety of the “end call” button.
  • Wear clothes you are comfortable in, especially shoes. It’s tempting to wear those killer heels, right? The trouble is, your feet hurting before you even reach the destination? Instant black cloud over your mood.

There are ways to overcome the challenges of dating with mental illness.At the end of the day, dating can be tough. Especially when you suffer with mental health issues.

The good news is when you meet someone who is perfect for you and your quirks, none of it will matter.

The truth is, as cliché as it sounds, it’s important to always follow your heart. If you are uncomfortable on a date then say so. If you are nervous, be honest about that.

It’s important that you never let anyone put you into a situation you are unhappy with. Anyone who is into you for the right reasons will be understanding and happy to follow your lead.

Just remember, life is way too short to let your mental illness take control of it.

Dating is not for everyone. There’s no question that dating while also trying to handle chronic illness can present some significant and unique challenges.

But what if you could get to know someone before you even meet in person? If you have a chronic illness and are looking to meet new people, check out this promising new dating app Lemonayde. Made for people with health challenges, it allows you to connect with others with chronic illnesses just like you from the comfort of home!

About the Author:

Sarah Jenna Jayne write about dating with mental illness at The Unchargeables.Sarah is a blogger who focuses primarily on chronic illness and mental health. Sarah also shares some of the embarrassing parts of her personal life when she’s feeling brave!

You Don’t Die by Suicide

Suicide prevention, awareness, and the continuing care of survivors is dear to my heart. I am a suicide survivor.

At a very low point in my marriage, while battling back from cancer surgery, I lost all my hope, all feeling of worthiness to breathe air, and believed I was a burden to society who had completely failed as a mother. Eventually it got to the point of lining up 15 or more prescription bottles and emptied them in to my stomach with a liter of Jack Daniels.

“I lost all my hope, all feeling of worthiness to breathe air, and believed I was a burden to society…”

I never lost consciousness, and didn’t even get sleepy. Nope, my OCD kicked in and I cleaned the house from top to bottom. My (now ex-) husband’s response was to demand what I was trying to do to him. The responses from my family and minister were no better. Filled with blame, shame, and accusations of lack of faith, I had nowhere to turn for help once I was released from the 24 hour hold. None of the health professions hooked me up with outside support. I was just put back into the same situation, the same nightmare of abuse and trying to be worthy of my children.

“Filled with blame, shame, and accusations of lack of faith, I had nowhere to turn for help.”

Looking back, there were so many warning signs. It’s amazing how well I avoided recognizing my spiral into hopelessness. The abuse I lived with daily throughout my marriage, including threats of not waking up in the morning, played a large part in my hopelessness. My background with depression started in middle school, as well as constant pain from undiagnosed diseases, and daily bullying both at home and at school added to my struggles.

Hopelessness is what a person who commits suicide dies from — the bone deep feeling of aloneness. The feeling your loved ones would be better off without you around is what drives most suicide attempts. Depression, self loathing, hateful inner dialogues, and abuse all contribute to hopelessness.

“Hopelessness is what a person who commits suicide dies from — the bone deep feeling of aloneness.”

Suicide isn’t attention seeking. Suicide isn’t a cry for help. Suicide is the result of hopelessness — of a soul dying.

In a study done by NIH covering the 2001-2015 period, rural counties consistently had higher suicide rates than metropolitan counties. The study also concluded suicide is the tenth leading cause of death in the United States. There were more than half a million suicides during the study period. 

“…suicide is the tenth leading cause of death in the United States.”

According to the Veterans’ Administration, recent statistical studies show that rates of veteran suicide are much higher than previously thought, as much as five to eight thousand a year or about 22 a day. PTSD, depression, and lack of mental care follow up after discharge all play a part in veteran suicide rates. Vets finally got some hope of the help they need when President Trump signed an executive order to provide more benefits to service members transitioning from the military to civilian life in an effort to decrease veteran suicides on January 9, 2018.  

Older veterans face a higher risk of suicide, the data showed. In 2014, about 65 percent of veterans who died from suicide were 50 years or older.

Warning signs for suicide, according to suicide.org include:

  • Appearing depressed or sad most of the time. (Untreated depression is the number one cause for suicide.)
  • Talking or writing about death or suicide.
  • Withdrawing from family and friends.
  • Feeling hopeless.
  • Feeling helpless.
  • Feeling strong anger or rage.
  • Feeling trapped — like there is no way out of a situation.
  • Experiencing dramatic mood changes.
  • Abusing drugs or alcohol.
  • Exhibiting a change in personality.
  • Acting impulsively.
  • Losing interest in most activities.
  • Experiencing a change in sleeping habits.
  • Experiencing a change in eating habits.
  • Losing interest in most activities.
  • Performing poorly at work or in school.
  • Giving away prized possessions.
  • Writing a will.
  • Feeling excessive guilt or shame.
  • Acting recklessly.

“You never know whose life you might save!”

PLEASE watch those around you. You never know whose life you might save! Tell the people you care about how you feel. Talk to your children and their friends openly and let them know you are someone safe to talk to about anything. If you see someone hurting, don’t ignore it — ask about how they are doing and show you really care. Watch people’s body language when they talk. Look for signs of discomfort like lowered eyes, crossed arms, or fidgeting when you are talking with someone.

Most of all, talk to listen and not to answer.

Hey y’all, I’m Wanda and I’m a Spoonie in my late 40s. I have several chronic illnesses I battle daily. I’ve raised two beautiful girls and have a wonderful service dog named Tucker. It is my hope to have shown and continue to show the world a face of chronic illness who chooses to become BETTER instead of BITTER.