A wall of bricks with empty gaps between them

Sharing – Meet the people falling through the gaps of the mental health care system

This description of mental health care in Australia seems familiar to me as an American, too.

“The missing middle is where you’ve got at one end the severe and complex cases. They are people who will require hospitalisation for their mental health issues, and medication and often psychiatric intervention,” Dr Zena Burgess from the Australian Psychological Society told Hack.

“At the other end, you’ve got people who have transient short-term anxiety or depression, or social issues that need a bit of coaching and a bit of support to get through a particular circumstance,” she said.

Dr Burgess said our current system caters for both ends of the spectrum, but often lets people in the middle down.

They go on to describe someone with more complex issues being limited to ten therapy sessions a year. That’s less than once a month and wouldn’t be much help. In the US, it’s not uncommon to have insurance coverage for six or eight sessions in a year. That might be enough to help devise some strategies for dealing with stress and anxiety, which is a good thing, but for something like major depression, I don’t think a therapist visit every 6-8 weeks is going to help much.

I saw my therapist much more often than that. For two months, I saw her five days a week for neurofeedback sessions. My insurance didn’t cover much of it, so I paid out of pocket per session while living with family members for free. I was highly privileged in that regard. Not everyone would be. They can’t afford more than their insurance will cover, and it’s insufficient to help significantly.

And so, you wind up with many people just waiting to get worse before they can get any care. Even though we know early intervention is the key to treating mental health issues, there isn’t intervention until the person is “a danger to themselves or others.” Access to care may well come too late for many. They don’t make it that far.

We all deserve access to resources that would help us avoid becoming a danger to ourselves. These resources shouldn’t be limited to people like me, who are lucky enough to have family support to help cover the extra costs, and they shouldn’t require that we wait around for people to reach the point of needing to be hospitalized before we offer them any. That middle ground is full of people who deserve better.

https://www.abc.net.au/news/2024-05-30/the-missing-middle-in-mental-health-system/103912504

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