Still need to edit, and redo the opening and such.
Center for American Awesomeness
United States Mental Health Care Needs a Trip to the Doctors
Jacqueline Proszynski March 26, 2013
On December 14, 2012, disaster struck the peaceful Newtown, Connecticut area. Adam Lanza committed suicide after he shot and killed his mother as well as twenty innocent children and six adults at Sandy Hook Elementary School. This made it the second deadliest school shooting in American history (1). This tragedy revamped the continuous debate concerning gun control in the United States, as numerous legislation proposals banning the production and sale of particular semi-automatic weapons flooded the government. (2). A number of people, including politicians, shifted their attention to zone in on controlling unsafe weapon usage, thus sometimes neglecting to realized the significance of another factor: mental health. Swift action must be taken to reform the current Mental Health Care policies of the United States to make treatments more accessible, improving America’s quality of life and benefitting society as a whole.
Shockingly enough, in some cases guns and weapons are more available to citizens than mental health services (3). Adam Lanza, the unstable perpetrator, had access to over twelve firearms owned by his mother, Nancy (4). Over the past four years, gun ownership has actually risen and a similar pattern is seen in the relationship between violent crimes and gun usage. On the other hand, this positive trend does not lend itself to mental health services, as many have no choice but to forgo receiving care for many reasons. Insurance coverage is often skimpy, people are unsure of what insurance does cover, and many fear the condescending labels associated with seeking cognitive therapy (5).
According to the investigation records, Lanza was diagnosed with Asperger syndrome, Sensory Integration Disorder, or SID, and showed signs of other personality disorders (6). Characteristics of personality disorders include, “difficulties in cognition, emotiveness, interpersonal functioning or control of impulses,” with the possibility of extreme anxiety, distress, and depression. These mental impairments contribute an astonishing 40-60 percent of psychiatric diagnoses, making them the most common among patients today (7). However, the Newtown shootings not only took twenty-eight faultless lives, but it further damaged public perceptions of mental disorders and illnesses.
Setting Things Straight
Throughout history, those with mental troubles have been viewed as dangerous, weak-minded and beyond repair. Generally speaking, people with mental illnesses are not dangerous. A relatively small number of mentally ill people, who suffer from symptoms such as paranoia and hallucinations, are violent. Ninety percent of the 38,000 suicides each year involved mentally ill people, showing that self-inflicted harm is far more common than any outward aggression towards others. It has also been determined that the risk of violence and suicide among those who develop mental illness is 15 times higher without treatment (8). In situations where violence does occur, the incident is usually the result of outside stimuli, such as feeling threatened or terrified. Moreover, pointing the finger at the mentally ill for causing crime is not the answer, and it is important to be cautions of this. Instead, our society must become aware of that fact that we can prevent situations like the Newtown shootings by doing a better job of caring for those people in the first place. After all, the United States earned the number 1 global ranking for the level of mental illness, making this issue rather pertinent (9).
Our nation leads the way in the amount of mental disorders and disabilities, but little to no improvement has been seen over the past quarter century in the way our government handles them. Approximately 26.4 percent of American citizens match the archetype of having problems of the mind. In 2009, barely half of these people receive the assistance necessary for them to live a functional, happy life due to negative stigmas and cost (10). A later survey conducted by the Substance Abuse and Mental Health Services Administration discovered that the rate decreased to 38 percent just two years later in 2011 (11). Perhaps the languorous economy is partially to blame for this situation as states all over the country reduce their budgets. Mental health services are among the first up on the chopping block when spending needs a little trimming partially because there is little attention drawn to it (12). As stated by Jeanne Kirkton, Missouri lawmaker, “people with mental illness are by and large invisible to many state legislators, so they’re the easier cuts to make without having a big backlash.” (13). These methodologies wreak havoc on Americans.
This is a bigger problem than just state budgets. Over the course of three years, an astonishing $4.35 billion in cuts has plagued mental assistance programs, diminishing funding for treatments of the entire country. In the private care sector, matters do not improve either and treatments are becoming increasingly hard to obtain. The remaining practices, however, fill-up quickly and often do not take insurance because they will not see an adequate return from insurance companies (14). That fact of the matter is that continuous proper psychotherapy is extremely expensive for insurance companies to cover, therefore making them limit what they can and cannot pay for. In the best-case scenarios, companies will only relieve clients of merely half the expense (15). If someone can afford the hefty price tag of mental health assistance, they are lucky. Unfortunately, that is not the case for that vast majority of those actually needing the help. Countless studies and research have suggested that “mental disorders are overrepresented in the lower social strata” concluding that people of lower socioeconomic are more likely to develop problems at some point in their lives (16). Those who need care the most cannot access it due to low income, so they will not see improvement thus perpetuating the vicious mental illness cycle.
The National Comorbidity Survey Replication, led by Harvard professor of Health Care Policy Ronald Kessler, finds that “Those who do seek treatment typically do so after a decade or more of delays, during which time they are likely to develop additional problems and the treatment they receive is usually inadequate.” (17). The amount of care provided is so insufficient that the health system of our strong and powerful nation earned a D rating from the National Alliance on Mental Illness (18). It is not a matter of the United States having bad therapist and psychiatrists; we actually have exceptionally well-trained professionals compared many countries with countless top-ranking Psychology undergraduate and graduate programs. It is a matter of availability.
……………………………………………………………………………………………………
Just What the Doctor Ordered
In light of all the negative aspects of the current United States Mental Health Care policies, extensive changes are underway. On January 1, 2014 President Barack Obama’s Affordable Care Act, ACA, will take full effect. The ACA is the biggest expansion and reconstruction of the American health care system following the introduction of Medicaid and Medicare in the mid-60s (19). As expected, this bill has caused quite the controversy during his time in office, since its lays the foundations for drastic reforms. The primary goals of President Obama’s Act are to lower the amount of uninsured citizens and to reduce the overall costs associated with health care. To accomplish this, mandates, subsidies, and tax credits are utilized to increase coverage rates of employers and individuals. The ACA obligates insurance companies to cover every single applicant and offer the same flat-rate price without discriminating against gender or those with pre-existing conditions (20).
Although this sounds ideal conceptually, some staunch opposition has resulted. Many question it’s Constitutionality, saying too much government control and regulation of health care will create a socialistic society. Some politicians and voters alike even wish to completely oust the bill from existence, but for what reason? It is nonsensical to do this. Of course the ACA incorporates a few, maybe many, flawed ideologies but after breaking it down into specific parts, one can see it’s potential. Yes, a few people disagree with aspects of the new general health care policy, but it will revitalize the brutally damaged Mental Health Care section:
- All qualified health plans under the ACA will be required to cover mental health services (21). Back in 2011 only a frugal 18 percent of small-group and individual plans cover mental health (22). Starting in January of 2014, under Title I, section 1302 of the Affordable Care Act all insurance companies must cover and accommodate, “mental health and substance use disorder services, including behavior treatment” because they will be seen as “essential health benefits”. Mental Health Care is number five of the ten essential health benefits listed in the law (23).
- It promotes new program, tools, and preventative measures. One of the major issues with the current state of mental services is the lack of resources, but the ACA will increase their quantity and quality. Health homes, interdisciplinary care teams, co-location of physical health and behavioral services, collaborative care, and the broadening of the Medicaid Home and Community-Based Services options are all on the horizon (24).
- Mental Health Care will be more accessible. President Obama’s reforms create the largest increase in mental health service access in decades. Coverage will be extended to almost 50 million Americans currently annexed from the $2.8 trillion United States healthcare system due to their lack of insurance (25).
These benefits have already made their presence known. Just looking at the statistics presented by the U.S. Census Bureau demonstrates the effectiveness of Obama’s policy in regards to the Mental Healthcare world. In one year’s time the number of uninsured Americans deflated from 50 million to 48.6 million between 2010 and 2011. Because of the ACA provisions that took effect in September 2010, young adults are now covered on their parents’ insurance policies longer, which lead to this increase (26). Research funded by the National Institute of Mental Health (NIMH) have found that half of all lifetime cases of mental illness begin by age 14 (27). By allowing citizens to stay on their parents’ insurance until age 26, most psychiatric symptoms already developed, positively changing the course of illness via proper diagnosis and treatment (28). A similar pattern is expected for adults ages 26 to 64 years old once the major ACA coverage expansion begins in 2014. For the first time in four years the amount of uninsured Americans has dipped, instead of increase, thanks to the President’s reforms (29).
Surprising Benefits
The inclusion of Mental Healthcare coverage in the Affordable Care Act has a few bonus advantages as well that Americans will find quite attractive. National Institute of Mental Health conducted a study in 2008 finding that serious mental illness costs the U.S. economy $193.2 billion dollars per year in lost earnings. That nine-figure number doesn’t account for other miscellaneous costs, like the price of incarcerations and hospitalizations (30). The American Journal of Psychiatry published a study showing that people affected by a serious mental illness drastically handicapped their potential in the workplace, causing them to earn 40 percent less than their happy-go-lucky counterparts (31). Now that more citizens will have access to necessary mental services, productivity and revenue will actually increase.
On a grander scale, the United States as a whole will reap financial rewards from the ACA’s policy changes. The Congressional Budget Office, CBO, anticipates that future Medicare spending and deficits will decrease because of the reforms. From 2012 to 2021, they predict a $210 billion national debt reduction over that nine-year time frame. How is this possible? Well, the “law would result in net receipts of $813 billion, offset by $604 billion in outlays”, totaling to the $210 billion estimate (32). Providing adequate mental health insurance coverage equates to happier Americans and a happier national wallet.
……………………………………………………………………………………………………
Conclusion
Fifty percent of Americans desperate for mental services had to make do with out them, sometimes leading to drastic outcomes such as the Newtown, Connecticut shootings (33). Terrible stigmas have corrupted public perceptions of the mentally ill, leaving many to believe they are dangerous and threatening. This is obviously false, however it has also been determined that the risk of violence and suicide among those who develop mental illness is 15 times higher without treatment (34). Meanwhile, according to insurance providers, mental illness were not as serious as physical thus leading to a lack of coverage. The mental health world looked dull and dreary before President Obama’s Affordable Care Act provided a glimmer of hope for United States Mental Healthcare.
Under the Act, mental and behavior service coverage is mandated and became fifth on the list of the ten “essential health benefits” (35). This clarifies to the nation that the mentally ill need real help, and those afflicted with these problems are not just weak-minded. More programs and services will be made available to further benefit the population and promote wellness in the community. Most importantly, these programs and insurance coverage become more accessible because of the ACA. Furthermore, the president’s Affordable Care Act will not only save the mental healthcare system in this country, it is also predicted to provide positive economic patterns.
As stated by Dr. Dilip V. Jeste, president of the American Psychiatric Association, “This law has the potential to change the course of life for psychiatric patients for the better, and in that sense it is both humane and right.” (36). Americans, and people in general, deserve to live the most successful lives possible and thanks to the Affordable Care Act, that becomes all the more possible.
Buying local foods from a farmers market might be the better option, if available of course, because there is a much smaller carbon footprint and that produce will contain higher amounts of vitamins and minerals. Obviously the ideal situation would be locally grown organic food but we take what we can get. Also, buying organic is more critical for some produce over others. Delicate skinned produce has a greater pesticide absorption capacity compared to those with more rugged exteriors. A study conducted by the U.S. Department of Agriculture (USDA) found that “97.3 percent of nectarines sampled were found to contain pesticides,” which is an absolutely crazy amount… (Moore). This does not mean that if you eat a conventional nectarine you will develop some radioactive disease, but consuming high amounts of chemical pesticides can result in adverse health effects, especially for developing babies (DeCostole). Below is a simple guide for when to shop organically in order to reduce your produce’s carbon footprint and insure better health:
