The Struggle For Mental Health

health insurance roadblocksIt’s a heartbreaking scenario that is far too common: someone makes the difficult decision to seek out professional help for a mental health or substance abuse problem for themselves or their loved one and is faced with a myriad of roadblocks. They start calling providers on their insurance plan and find that they are not taking new patients, or they no longer accept insurance and only want cash. And the cost of paying out of pocket is too much for many to afford.

Here is the reality: Health insurers are required by law to offer an adequate network of providers for their beneficiaries to choose from, and not just for physical illnesses. This requirement is known in the health insurance industry as network adequacy.

Along with the difficulty of finding a provider who will accept your insurance, the problem is often complicated by a family’s reluctance to seek help for a mental health or drug problem, as opposed to physical illnesses like cancer or diabetes. Despite progress in public education, stigma still looms large.

Once someone takes the leap of faith to ask for help, he or she is too often told, “I’m sorry, I don’t accept your insurance any longer.” When this happens there is a chance they will give up.

It is this reality that spurred North Shore Child & Family Guidance Center to launch a research initiative called Project Access. This entailed creating a survey that was completed by almost 650 people across Long Island. Here is some of what we found:

• Almost 50 percent of the participants said that it was more difficult finding help for mental health or drug problems than finding help for physical illnesses, especially when they were in crisis.

• Nearly 40 percent said that their insurance company did not have an adequate number of providers.

• 66 percent reported that their insurance company was not helpful in finding a suitable provider for themselves or a loved one.

One survey respondent wrote: “A family member within my household required therapy and we had difficulty finding a provider; when we did, scheduling was a nightmare because so many patients were trying to see him. I believe it was because he was one of the few willing to accept multiple insurance policies.” This was a familiar refrain.

Health insurers reimburse mental health and addictions care providers at such low rates that they flee health insurers in droves. This is a civil rights issue and a situation that puts lives at risk.

The NY State agency that Governor Cuomo has charged with monitoring and enforcing network adequacy is the Department of Financial Services. We are using the Project Access data to demand that Governor Cuomo and the Department of Financial Services launch a full scale investigation of access to care in New York State and to hold commercial health insurers’ feet to the fire.

If you agree, print this column, add a note saying “I agree” and include your name and address. You can write to the governor at: The Honorable Andrew M. Cuomo, Governor of New York State, NYS State Capitol Building, Albany, NY 12224; email him at Press.Office@exec.ny.gov; or call him at 518-474-8418.

To read the full Project Access report go to: www.northshorechildguidance.org and click on the Project Access tab.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

Want It In Print?

We now offer matted and framed copies of articles upon request.

Andrew Malekoff
Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. Visit www.northshorechildguidance.org for more information.

1 COMMENT

Leave a Reply

Discover

Sponsor

Latest

Philanthropic Response Fund Launched To Support Long Island Nonprofits

The Community Foundation will work closely with sector leaders to understand evolving needs and gaps in funding.

Spring Gardening Tips From Old Westbury Gardens 

If there is a silver lining to the ongoing pandemic, it is that many of us in self-isolation have much more opportunity to discover...

FCA Pays Virtual Visits To Isolated Long Island Seniors

Article By: Lisa Stern, AVP Senior and Adults Services, FCA The stress and anxiety caused by COVID-19 has increased the vulnerability of Long Island seniors....

A Lost But Not Forgotten Season For St. Mary’s

First it was postponed, then St. Mary’s Athletic Director Patrick Welsh got the call from the league—their girls basketball state semifinal game was canceled....

New York Blood Center Urgently Calls For Blood Donors

The New York Blood Center (NYBC) is in urgent need of blood donations after New York State Governor Andrew Cuomo announced the closure of...

Get Updates Via Email

Enter your email to be updated with all the latest news and special announcements.

x