June 12, 2022

Rachel Strella

No One Cause Nor Simple Solution Exists for the Mental Health Crisis

Mental Health

I’ve been fighting a battle to overcome a mental health crisis. This is my fourth — and hopefully my final post — on this topic. If you’re new to my situation, you can catch up by reading my earlier posts:

In my most recent post, I shared that Mark Schaefer is spot on in his post. He calls our current climate a “mental health crisis.” The recent headlines I’ve seen online confirm this dilemma. 

Why Does This Problem Exist?

When I updated my Vistage group on my Mom’s status, my fellow members were shocked that the earliest we could initially schedule an appointment with a neurologist was March of next year. For my mom to obtain a mental health case worker and proper treatment, seeing a neurologist first is required.

The group asked, “Why? What’s the reason for the backlog? Has everyone gone crazy?”

I couldn’t fully answer that question. I could only speculate on the causes based on what I have witnessed personally. 

So, I decided to do some digging. My research revealed a perfect storm of factors — including financial and racial barriers to mental healthcare access and a lack of mental health professionals. Also, we have an aging population. While severe mental health issues like dementia aren’t caused by age alone, aging is the greatest risk factor. Additionally, the pandemic has wreaked havoc on our mental health, increasing the demand for psychological treatment.

For people who need advanced care, there’s a shortage of neurologists. A recent report published in the Journal of Neurology states, “In nearly every US state, a large mismatch exists between the need for neurologists and neurologic services and the availability of neurologists to provide these services. Patients with neurologic disorders are rising in prevalence and require access to high-level care to reduce disability. The current neurology mismatch reduces access to care, worsens patient outcomes, and erodes career satisfaction and quality of life for neurologists as they face increasingly insurmountable demand.”

This explains why March of next year is the earliest we could secure an evaluation for Mom. 

I spoke with a social worker in my community — Kimberly Preske MSW, LSW — for more insight into the mental health crisis. She confirmed a lot of the information I found in my research and explained some differences in how insurance pays for mental health vs. physical health issues.

She shared, “The reimbursement rates for being a therapist are low and the liability of working in mental health is high.”

“Mental health is not a money maker; sometimes people are uninsured or insured on a public plan with low reimbursement rates. Fields like cardiology and neurology are reimbursed at higher rates and sometimes these professionals are also given more respect for working in those fields, compared to mental health.”

This past week, my own doctor told me he has to be careful how he identifies mental vs. physical alignments for insurance to cover care. For example, I have ADHD and anxiety. He said he tries to find something physical attached to conditions like that; otherwise, insurance won’t pay for the associated costs. 

It’s a flawed system, to say the least. 

I spoke with someone else in my community who works in the foster care system. She explained that people in the social services field work with human beings on a very personal level. However, they aren’t the ones who can “fix” the problem. They often must rely on others for information, support, and cooperation to assist clients and their families.

“I don't like the word ‘fix’ as it pertains to people,” she explained. “People are not mechanical things that can be ‘fixed’ and neither is this system. The system can be improved, just as humans can, but as always, bureaucratic red tape gets in the way, and improving the system is not a one-person job. Quotas seem to be more important than human beings that need help. One of the many reasons people probably can't obtain medical or mental health appointments they need. If quotas have been met, then it might be hard to get an appointment.”

She confirmed the pandemic has taken its toll on people working in the mental health field. Employee turnover is rampant. Many professionals now face their own mental health issues and are expected to work long hours helping others.

“Sometimes, it gets to be too much,” she said.

Embracing the Silver Lining 

Those of you who have been following my journey might be wondering about the outcome of the guardianship hearing. It finally took place last week, and Dad and I were named co-guardians over my mother. This is positive news only because we can decide what’s next for Mom’s care. It creates a lot of unknowns as well. Fortunately, Dad and I make a great team, and we’ll figure it out together. 

If you recall, March was the earliest appointment we could get for Mom to be formally diagnosed with a mental health disorder from the DSM (Diagnostic and Statistical Manual of Mental Disorders). A diagnosis is required to request a mental health case worker to work as an advocate for Mom. Fortunately, my Vistage membership gives me access to healthnetwork, which acts as a concierge to securing appointments at top hospitals in the nation. It took a few weeks, but I was able to secure an appointment for Mom with a neurologist at Penn Medicine in August.

Moving Forward 

We have a very long road ahead of us, but I feel better knowing we have secured resources and have a starting point. I appreciate all the support I’ve received from my social media community. I hope everyone with a family member suffering from mental health issues can soon access the help they need.

Has the mental health crisis impacted you? What hurdles have you faced, and what resources have helped the most?

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