Hey, Insurers and Employers: Put Up or Shut Up About Mental Health Support

It’s undeniably expensive to be sick in the United States. The U.S. population spends literal trillions on healthcare every year, paying into a system that hemorrhages money annually, and accruing a staggering, life-altering amount of medical debt in the process. Insurance (which, obviously, not everyone has) helps decrease the cost of being and staying alive, but often falls short, especially when it comes to out-of-network care. According to a new study, the Americans who are most often let down by insurance providers are those who seek out behavioral treatments for substance use disorders, despite a cultural push towards greater accessibility for mental health services.

Researchers at Ohio State University compared the healthcare spending of more than 3 million patients with either mental health issues (like depression and anxiety), drug use disorders, or alcohol use disorder to the spending of patients with either diabetes or congestive heart failure. The analysis found that mental health patients who sought behavioral treatments, particularly those with substance use disorders, spent more money out of pocket and received more out-of-network care than their counterparts with chronic physical ailments, even though the mental health patients spent less money on healthcare overall. Those with drug or alcohol use disorder ended up spending over $1,000 more than patients with diabetes, which is especially striking given the fact that diabetes patients are literally dying because they can’t afford insulin. Lead author Wendy Yi Xu attributed the pay disparity to insurance participation rates for mental health care providers. "Much of this disparity is likely due to the limited availability of behavioral health care providers in insurance plans—the participation rates by these providers are generally low, a problem that is fueled in large part by low reimbursement rates for clinicians, including psychiatrists," Xu said in a press release. It’s a blind spot that feels pretty related to reports predicting millennials will die from mental health issues at a rate that’s disproportionate from the rest of the American population.

The care deficiency when it comes to mental illness, particularly substance use disorders, makes a morbid amount of sense when you consider the way people with substance use issues are treated in every other realm of American life. One in every 16 Americans (around 20.3 million people) has a substance use disorder, and a little less than half of those people (around 9.2 million) have a co-occuring mental health disorder, according to the 2018 National Survey on Drug Use and Health. But the misconception that these patients are to blame for their addiction issues persists, as does the stigma surrounding substance use disorders. There’s no easy fix under our current, inept healthcare system, but in the meantime it’s worth considering and being compassionate how and why other people are suffering.

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