Posted on October 7, 2022.

September was Suicide Prevention Awareness Month. Some people—due to their race, ethnicity, gender, socioeconomic background, or location—are at higher risk of suicide and mental health issues.1 Our recent report—A human-centered vision for improving the mental health care ecosystem—examines inequities in mental healthcare and looks into ways barriers to access and care could be removed.

Consider this: The overall suicide rate among Black Americans is 60% higher than it is for white Americans.2 Black Americans are also 20% more likely to have serious psychological distress than white Americans, according to the National Institute on Minority Health and Health Disparities.3 Navigating the complexities of the mental health ecosystem can be particularly challenging for individuals who are also coping with issues such as housing insecurity or unemployment. In addition, people who regularly transition between group homes, psychiatric wards, emergency rooms, and the street can find it difficult to secure stable support for their mental health.

Inequities in mental health go beyond race, ethnicity, and socioeconomic class. People who live in rural areas tend to have less access to mental health services and are far more likely to die from suicide than are people who live in urban or suburban areas.4 More than 150 million people in the US—most from rural or partially rural communities—live in areas where there is a shortage of mental health professionals, according to the federal Health Resources and Services Administration.5

988, a national mental health crisis line that went into effect on July 16, could make mental health more accessible and equitable to people who live in rural areas or who have difficulty connecting to a mental health professional. More than $430 million in federal funding is being used to scale up existing state-run crisis centers to connect people in need to trained and empathetic healthcare professionals. The 988 code for the Suicide and Crisis Lifeline program is similar to the 911 nationwide emergency number.6 The program will allow people to connect to a healthcare professional via phone, text, or chat 24/7. Funding will also be used for special services, including a network of Spanish speakers. States are responsible for staffing and funding the call centers once federal funds are depleted, according to a press release from the Department of Health and Human Services.

COVID-19 exacerbated mental health challenges

Mental health inequities were exacerbated by the COVID-19 pandemic. In the nearly three years since the virus emerged, many Americans have found it increasingly difficult to access mental health services. Nearly 50 million adults experienced some form of mental illness in 2022, and more than half of them received no treatment for their conditions, according to our report. Moreover, the percentage of adults who reported symptoms of anxiety or depressive disorders nearly tripled from 11% before the start of the pandemic, to more than 30% by June 2022, according to the Kaiser Family Foundation. But mental health issues were already on the rise before the pandemic began. The worldwide incidence of mental illness and substance abuse disorders jumped 13% between 2007 and 2017, according to the World Health Organization (WHO).

Few therapists accept health insurance

The cost of mental health visits, combined with generally low reimbursement rates from payers, is one theme that emerged during our research. About one-third of therapists do not take health insurance due to low reimbursement rates, paperwork, and claim denials.7 The mental health professionals who do accept insurance are often in short supply.8 In addition, mental health issues can be more difficult to quantify than physical health conditions. For example, it is easy to measure a patient’s glucose levels or blood pressure and prescribe effective therapies. But assessing and treating mental health can be less straightforward.9 Nearly 20% of medical-necessity-claim denials were for behavioral health services among health plans sold through HealthCare.gov, the federally operated health insurance exchange.10

Conclusion

Untreated mental illness can lead to diminished productivity, higher unemployment, foregone tax revenue, more welfare expenditures, and an increase in physical ailments such as cardiovascular and metabolic disease, according to our research. For every $1 invested in scaled-up treatment for depression and anxiety, there is typically a $4 return in better health and productivity.11 Despite this return on investment and new models of care, people who need mental health care are often unable to access it. By understanding the challenges some people encounter when dealing with mental health issues, we are hopeful that policymakers at the federal, state, and local levels will push to create a more equitable mental health ecosystem that makes it easier for everyone to access the services they need.If you or someone you know is in crisis, you have options. Please call or text 988 for the National Suicide Prevention Lifeline; call 911; or visit your nearest emergency room.

Source: Deloitte.com