40% of Americans are Covered by Medicare or Medicaid and Struggle to Access Mental Healthcare

Thanks to NPR for this story about a study of how accessible mental healthcare is to those covered by Medicare and Medicaid. It’s not good news:

Medicaid serves people on low incomes, and Medicare is mainly for people 65 years or older and those who are younger with chronic disabilities.

The report found fewer than five active mental health care providers for every 1,000 enrollees. On average, Medicare Advantage has 4.7 providers per 1,000 enrollees, whereas traditional Medicare has 2.9 providers and Medicaid has 3.1 providers for the same number of enrollees. Some counties fare even worse, with not even a single provider for every 1,000 enrollees.

That’s a shockingly low number of providers available to the most vulnerable portion of the population.

It’s also somewhat shocking that those programs cover 40% of the US population, but that’s a post for another time and another venue about the US healthcare system.

The article identifies several issues: the lack of providers, the system’s complications that make it difficult to accept those patients, and the poor reimbursement rates, which seem designed to prevent providers from seeing these patients. These issues add up to a system that doesn’t meet the need—it doesn’t even come close.

Which brings us back to that other topic. The US healthcare system has a problem, and that extends to mental healthcare as well. It may be even worse when it comes to mental healthcare. The result is that some of the most at-risk people in the country, older, poorer, and those with chronic and disabling health conditions, can’t reasonably access mental health. We live in a country where a large portion of the population is told that it’s OK to reach out for help and that help isn’t there. It’s hours away, at best, and non-existent in other cases.

We talk a lot in the advocate community about not being alone with mental health issues. I try to encourage anyone to see others who are dealing with the same issues around mental health and childhood abuse and recognize that they are not in this alone. There are many of us out here dealing with the same thing.  Many in the US and other countries are alone in accessing care. That should shame us all.

Small changes at the edges will only go so far. This is a broken system. It needs to be replaced, not tweaked.