The Absence of Help

The Absence of Help

By:Emily Ryherd

Beginning

My red watery eyes stare at the small flatscreen TV that’s secured onto the white wall, as a random episode of I-Carly begins playing. My body shivers slightly as goosebumps begin to form on my arms, and I find myself annoyed at how cold hospitals always seem to be. Out of the corner of my eye, I can vaguely make out the woman who's been assigned to watch me, who is sitting in an uncomfortable plastic chair and staring silently at the TV but every now and then I can see her take a brief look at me. The sudden eruption of a greatly distressed baby crying makes its way into my room, and I’ve been hearing this kind of thing off and on ever since I got here so at this point, I’m able to easily ignore it. My eyes blankly watch the show on the TV as the episode gets closer to its end, but on the inside, everything seems to be like it is falling apart. Hours ago, a social worker explained to me that there are no beds available in any of the surrounding psychiatric hospitals, so I find myself waiting in hopes that a bed becomes available soon. This is not the kind of thing I would have expected to hear, because you would think after trying to kill yourself, you would be able to get the help and treatment you need immediately. Instead, I find myself trapped in this depressing reality where I sit stuck with a stranger in a small ER room for hours on end, watching countless episodes of I-Carly while rounds of tears roll down my face, and feeling more alone than I have ever felt in a long time.

Introduction

Mental health is something that has always existed but looking at the past it can be seen how misunderstood the topic of mental health has been perceived and there have been times when it has been completely left in the dark. In today’s world mental health is discussed much more frequently than it was decades ago, as more and more people have started to speak up about the issues that are arising within their mental health. Even as more people express their mental health struggles the number of services offered to treat these symptoms has either remained the same or decreased. Funding for mental health has become less and less in the past years, leaving people with nowhere to turn for the help they seek and need. The currently offered mental health services are constantly filled up and other services that are needed still do not exist, so we find many people in our world left to deteriorate from the untreated symptoms they experience. The lack of accessible and affordable mental health services is a pressing issue that is not just affecting a specific group of individuals but is affecting a wide range of people. Changes need to be made immediately because this is not an issue that is going to disappear, but with time, will only add to the neglect individuals in our society are already facing. The current state of mental health services offered to the public is inadequate because of the following reasons: parents are unable to find help for their children, working adults cannot get the treatment they need, and there is a lack of understanding of mental illnesses.

Overview of the current State of Mental Health Services

It seems very hard to believe that a good number of people in the public are aware of the current state of our mental health services, because of how absent those services have become. There is a wide variety of mental health services that can be very beneficial for people experiencing mental health symptoms which include but are not limited to: therapy, psychiatry, intensive outpatient, inpatient, support groups, etc. These services are needed because mental health symptoms affect way more people than we can understand. A study from the Centers for Disease Control and Prevention 2020 states, “It has been estimated that between 13% and 20% of children in the United States experience a mental health problem every year and the costs to individuals, families, and the society have been estimated to be approximately $247 billion.” Even with this statistic opening our eyes to the fairly large number of children in the United States experiencing mental health struggles, there are still so many others who remain silent. There are so many people, more than we realize, who are living with untreated mental health symptoms, and they stay untreated because services remain unavailable. This issue is not going to go away over time, and it has done the exact opposite because, between 2020 and 2022, there was a rise in the prevalence of poor mental health in adults 31.5% vs. 36.3%, p = 0.0005. Adults in the United States were 1.28 times more likely to be mentally ill in 2022 than they were in the early stages of the pandemic (Jiyeong, et al.). As saddening as this reality is, there still has not been a response near good enough to help provide this increase in adults suffering from mental health complications with the services they need. There are many people I have encountered throughout my own mental health journey who have desperately needed professional help but with the current services overfilled, they are put onto the bottom of months-long wait lists, expected to handle their symptoms until a spot hopefully opens for them. A close family member of mine told me at one point that when they were a child in need of a residential placement, they were placed on a wait list for mental health services. It took them an additional one to two weeks to be admitted to a residential facility from a psychiatric ward. They felt like they would never find somewhere to go after being away from home for so long, so it was very difficult for them to wait for residential(Ryherd, Katelyn). As someone who has also experienced something like this, I can say that this is an incredibly difficult situation to be put into when your mind is relentlessly fighting against you. It should be no surprise to us that in the upcoming future, based on estimates, by 2025, there is projected to be a need for an extra 15,400 psychiatrists and 57,490 psychologists to fulfill the US population's need for mental health services (Purtle, et al.). Looking at these staggering numbers, the severity of this crisis that we have allowed ourselves to get stuck into only becomes clearer. In the upcoming years, there is a harsh reality waiting for us all, one where the shortage of mental health services is going to be much worse. Right now, it is already a tremendous struggle to get into seeing a psychiatrist, psychologist, or therapist, and I cannot imagine what it is going to look like if we allow those predictions to become our reality.

Consequences of Inadequate Mental Health Services with Children and Their Families

We have allowed this crisis to worsen over the years is detrimental with a problematic widespread effect in many different areas in our society. With there being an inadequate availability of mental health services, the effects start with one person, but the consequences will eventually leak into the other areas of that person’s life. Ultimately a person who cannot receive the resources they need for their mental health will end up impacting their family, career, schooling, and financial stability. For children having nowhere to go for their mental health things like changing schools, and even moving completely have been tough decisions parents have had to make. With there being such a lack of available services, parents have been turning to schools in hopes of finding some support for their children’s mental health, but it’s been made clear that “Schools in most communities, and especially in high-poverty communities, have neither the capacity nor the expertise to deliver effective academic programming and mental health services concurrently.”(Atkins, et al.). It is becoming overwhelming for schools with the number of desperate parents searching for help for their children, but the harsh reality is that the schools cannot keep up with the increasing mental health needs of children. Even on the rare occasion when parents can get their child into a mental health service the amount of expenses are not exposed. Having a child with a mental health condition is already difficult emotionally but then you must remember to add the financial side to it. People don’t really think about how expensive it really can be when parents try to get their children the help they need, and it should be known that children with attention deficit disorder pay 58.4% more money than those without this condition. According to reports on this topic, the total annual care expenses of autism spectrum disorder (ASD) have been projected to be $1.4 million for those with ASD without an intellectual disability and $2.4 million for individuals with ASD with an intellectual disability (Brock-Baca, et al.). These costs are just the estimated costs for a child with ADHD or ASD, and in our world, there are so many more mental health conditions that children face. At one point I was one of those children dealing with mental health complications, and there were times when I was able to see just how difficult it was for my family. Parents of a child who suffers from a chronic mental health disorder already must deal with the stress of providing their child with the help they need, and then on top of all that they are confronted with the crushing financial stressors. Now let us not forget that these costs only occur if parents can even find available services for their child, and sadly in most cases, they are only able to find the bottom of months long waiting list to put their child’s name onto.

Effects on The Workforce

This issue is not just affecting our children and their parents, but like I explained previously the effects of this have become a widespread problem. Most of the adults in our society find themselves embedded in a career or working some type of job to maintain financial stability. As an adult bills and expenses needing to be paid seem endless, so working becomes a vital part of life to manage the day-to-day costs. This idea of working to stay in a stable financial place has turned into an increasing problem for many adults. With there being such a lack of services for adults dealing with mental health struggles, their symptoms are for the most part left untreated, and this ends up drastically affecting their ability to work. These untreated symptoms in working adults can affect productivity within the workplace which then creates the potential for a loss of human capital. Job responsibilities that could be accomplished without a problem in previous years are presently carried out less efficiently, which decreases productivity. Mental health struggles are more prevalent among individuals with demanding jobs with little social support along with jobs that involve direct human interaction, or "contact jobs” (Inger and Gunnarsson.). An adult who is suffering from untreated mental health-related symptoms can find it extremely hard to consistently go to work which is why mental health problems run the possibility of being temporarily excluded from the workforce and needing to take extended sick leave. Exclusion from the workforce could result in limited financial status, and personal distress is an element of mental health problems and can impact the family members of an individual and other relationships. The services that are available for adults with mental health concerns are not cheap, and not everyone has good insurance that will cover enough of the costs. People experiencing mental health complications are already struggling to stay working consistently so they can remain in good financial standing, but for them to keep up this balancing act they need professional help to alleviate their symptoms. In a perfect world for most adults caught in this type of situation, this could probably work out, but you need to remember that is not the reality we’re living in. A close friend of mine talked to me about how his ability to work has been impacted by his mental health in several ways. At work, it has been difficult for him to stay on top of everything because of the mental health symptoms he has experienced. Getting mental health services has been difficult for him at times and the longest he has had to wait was two months for a mental health service. He explained to me that scheduling his psychiatry appointments can take up to a month, and when he first tried to start that kind of service it took up to two months (Balducki, Daxton.). For these adults, like my close friend, who must work so they can make ends meet, there really isn’t any available relief for them, besides getting placed on a seemingly endless wait list for the services they need.

Factors Contributing to The Lack of Mental Health Services

A difficult factor about mental health is that in most cases it’s not easy to see it externally like you would with a physical illness. There have always been stigmas attached to the subject of mental health, and even as our society has tried to leave those stigmas in the past, they still show up today. More than a fifth of Americans, or 21%, have even lied to avoid telling people they needed mental health services. Approximately one-third of Americans, or 31%, were concerned about others judging them when they informed them, they were looking for mental health services. Younger Americans are more likely to have felt this stigma since they are more likely to feel concerned about others seeing them negatively if they share that they have sought mental health services. Stigmas surrounding mental health are typically formed from a lack of understanding of what it is like living with a mental health condition. With mental health presenting its symptoms more internally, it can make it much harder for someone with an outside perspective to fully grasp what a person with mental health complications may be going through. This dilemma can make it harder for others who do not personally experience mental health symptoms to realize the importance of having enough mental health services available. In comparison to cancer 68%, cardiovascular disease 41%, and dementia 28%, only three percent of funding came from charity fundraising, according to a 2019 British study conducted by the mental health research charity MQ. They found that, in comparison to $798.23 million spent on cancer research, an average of $162 million was spent on mental health research over four years 2014–17 (NHS Providers). All these physical health conditions received much more funding than mental health did, and they possess symptoms that can be seen externally in several different ways. It is extremely exhausting to deal with a chronic mental health condition, and when people refuse to understand what these individuals are going through, they start to feel so alone.

Counter Argument

Lately, our government has finally recognized that there is an issue with the lack of mental health services offered to the public. In recent years there have been some changes made to try and combat this issue, which has provided help in some of the areas of this overall issue. When the Affordable Care Act (ACA) was passed into law in 2013, it offered one of the greatest increases in the coverage of mental healthcare to that point. Most individual and small employer health insurance plans, as well as all plans available through the ACA exchanges, are required by law to provide coverage for a wide range of mental healthcare services (Cohen). Coverage for mental health services is very important so that people can get the help they need without having any financial limitations. Financial problems are one of the main reasons why people don’t even attempt to seek mental health services because they know that it will be too expensive. These changes that have been made in mental healthcare are helpful and do remove a lot of financial barriers that many people face. Some people would look at this information and think “this is enough”, but is it really? Even with these government changes, there are still things that fall in between the cracks, and that factor seems to be ignored. A significant amount of the commercial insurance market is excluded from legislative restrictions which ensure more equitable coverage of mental health services. Furthermore, it is frequently the case that legislative actions and regulations do not guarantee the coverage of psychotherapy, such as cognitive behavioral therapy (CBT). CBT and medication are frequently used in conjunction (Cohen). Changes have been made, which is a great start, but this is not a stopping point because in several different areas. there are many flaws. Let us remember that even with financial coverage there are still not enough services available, so what is the point of having coverage if you just end up at the bottom of a wait list anyways? These improvements made by our government show that they have acknowledged that this is an issue and are only willing to give us solutions that only hit the tip of the iceberg. We all deserve more than this because this issue is only going to get worse as time progresses. Cohen Veterans Network President and Chief Executive Officer Dr. expressed a very saddening statement which said, “There is a mental health crisis in America. My experience establishing mental health clinics across the country, coupled with this study, shows that more needs to be done to give Americans much-needed access to mental health services…”. The few things that have been done by our government are not enough and changes need to be made because this crisis is not going to resolve itself.

Actions That Need to be Taken

Many different steps could be taken when trying to solve this issue which is big and complex. The current funding for mental health services is not even close to where it should be for people in need of these services. Increasing the amount of funding would be very impactful in terms of allowing these services to expand and grow. In actuality, the nation would save billions of dollars if mental health care spending were increased rather than decreased. Budget increases would allow more people to receive care and decrease the likelihood of ending up in emergency rooms, jails, prisons, homeless shelters, the streets, or worse (GoodTheraphy.org Staff.). People with mental health conditions tend to end up in places like the emergency room, homeless shelters, and prison which causes the public a ton of expenses. Increasing funding is a step that we need to take to prevent people with mental health conditions from ending up in those kinds of places. A portion of the costs of treating mental health disorders are paid for by the federal government. A quarter of the $280 billion spent on mental health services in 2020 came from the Medicaid program in the United States. However, more could be done. A growing body of research indicates that having health insurance coverage directly increases the use of effective mental health services and lowers stressors that may hurt mental health. Increasing health insurance coverage is a crucial part of addressing cost-based barriers to receiving adequate treatment (WH.GOV). In addition to an increase in funding the coverage for mental health services needs to be improved, which goes back to the need for more funding. Most people who are trying to seek help through the currently offered mental health services run into financial troubles because insurance is not covering enough of the costs. Providing more coverage for these services will allow people to not feel hesitant when wanting to get the help they need. This is an important step we need to take because if people cannot afford these types of services, then there wouldn’t be much of a point in increasing the number of services offered. These are not optional changes that we can just think briefly about and then choose to ignore. We need to make these changes, all of us together as a society because this is what is going to take to start resolving this issue.

Conclusion

The current state of mental health services offered to the public is inadequate because of the following reasons: parents are unable to find help for their children, working adults cannot get the treatment they need, and there is a lack of understanding of mental illnesses. This is not an issue that is just affecting a small group of people but really affects a vast number of people, and anyone can become affected. To fix this mental health crisis we have found ourselves in changes that need to be made because this is not an issue that is going to be resolved itself. An increase in funding and more insurance coverage are steps that need to be taken to start the process of eliminating this overall issue. We need to eliminate this absence of help that has remained the same for so long because we are all worthy of the adequate mental healthcare that we deserve.

Works Cited

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“Study Reveals Lack of Access as Root Cause for Mental Health Crisis in America.” National Council for Mental Wellbeing, www.thenationalcouncil.org/news/lack-of-access-root-cause-mental-health-crisis-in-america/#:~:text=Several%20individuals%20blamed%20the%20U.S.%20government%20and%20insurers.

Cohen, Joshua. “Mental Health Awareness Isn’t Enough: More Funding Is Needed.” Forbes, www.forbes.com/sites/joshuacohen/2022/10/15/mental-health-awareness-isnt-enough-more-funding-is-needed/amp/.

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The White House. “Reducing the Economic Burden of Unmet Mental Health Needs.” The White House, 31 May 2022, www.whitehouse.gov/cea/written-materials/2022/05/31/reducing-the-economic-burden-of-unmet-mental-health-needs/.