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For mental health care, look to community

By Debbie F. Plotnick | 11/25/2013, 10:01 a.m.
The mental health system in the United States is fragmented, and reductions in public mental spending have resulted in severe ...
The mental health system in the United States is fragmented, and reductions in public mental spending have resulted in severe shortages of services, including housing and community-based services.

Editor's note: Debbie F. Plotnick is the Senior Director of State Policy for Mental Health America, , a community-based network that advocates for changes in mental health and wellness policy, and delivers mental health and wellness programs and services.

(CNN) -- In the days and weeks ahead, we hope to learn more that will help us understand the tragedy that befell Virginia State Sen. R. Creigh Deeds and his family last week. On Friday, Deeds was released from the hospital four days after his son Austin "Gus" Deeds stabbed him repeatedly before shooting himself to death.

Mental health officials initially said that after a psychological evaluation for the younger Deeds, they had been unsuccessful in finding a bed at a psychiatric hospital for him. But nearby hospitals later said that they had available space but were never contacted. The state of Virginia is investigating the matter and also conducting a review of state and local mental health services to determine if changes are needed.

Much is still not known about that sad incident. But what we do know is that mental health care is an area that remains underserved; many who need care do not get it. For years, the mental health system has suffered from shortages of funding and political attention. Of the estimated one in five people who experience a mental health challenge each year, about 60% receive treatment.

While the one-in-five number includes depression, anxiety, insomnia, eating disorders and substance use, it is important to note that those are the issues that people report to their doctors when they do seek help. Sometimes these symptoms indicate that there is a more serious problem that, if treated early, it can be key to preventing a disorder from reaching a crisis or leading to disability.

The mental health system in the United States is fragmented, and reductions in public mental spending have resulted in severe shortages of services, including housing and community-based services. Since 2008, more than $4.5 billion has been cut from state budgets nationwide, and there are unmeasured challenges brought about by sequestration. These include reductions in block grants to the states for mental health and justice initiatives and cuts to Indian Health Services, which have resulted in fewer mental health counselors being hired.

These cuts have placed even greater demands on programs that provide community treatment and crisis services. And while we don't know whether these difficulties played any role in the Deeds incident, we do know that years of discrimination toward people with mental health conditions has contributed to confusion about how to access care and often resulted in denied care.

Fortunately, there has been significant progress in removing barriers and expanding and equalizing insurance coverage. The Affordable Care Act includes mental health care and substance use treatment as one of its 10 essential health benefits. That sends a strong message about the importance of mental health to overall health and wellness. Coupled with the just-released final regulations for the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, these changes will greatly improve access to care.