Advocates have mixed feelings about national attention to mental health care
In the wake of the Newtown, Connecticut, shootings, President Barack Obama has said government should make "access to mental health care at least as easy as access to a gun."
So, how available is mental health care in America -- and what barriers block access?
Mental health advocates are weighing in on the conversation -- but not without reservations.
Mark Salzer of Temple University has devoted his career to improving the lives of people with severe mental illnesses. Having a national platform for the issue of access to mental health care would usually be a dream come true -- but not right now. "I think it's coming from the wrong place," said Salzer. "Linking mental health issues and access to care to mass killings is flawed thinking."
Salzer, who chairs Temple's Department of Rehabilitation Sciences, says that untreated mental illness typically results in quiet suffering, despair and isolation, not violence. "Linking it to the Newtown, Connecticut, shootings actually increases prejudice and discrimination," he said. "And in the end that will keep people from seeking services that they need."
Salzer argues that prejudice and stigma remain the biggest barriers to care; people are afraid to seek treatment because they don't want others to know they are struggling with mental illness.
But stigma is just one problem on a long list of barriers.
Insurance coverage for mental health treatments often lags behind coverage for physical illnesses, despite parity laws in some states.
Doris Fuller, who directs the Treatment Advocacy Center in Arlington, Virginia, experienced this firsthand when her daughter was hospitalized during a mental breakdown. Her daughter was in college, and Fuller said her policy had generally solid coverage.
"It turned out that there was a cap on in-patient psychiatric care of $10,000," recalled Fuller. "So she had a million dollars in coverage, of which $10,000 was available for mental health care. it's a big problem!"
Fuller says a worsening shortage of psychiatrists threatens access to treatment, as well as a lack of research funding dedicated to treating mental illness effectively. For example. Fuller says, there's not enough money dedicated to developing medications for patients with the most severe mental illness.
"Those kinds of problems affect everybody," said Fuller. "If you can't find a psychiatrist, even if you have the best kind of insurance in the world, you may not get the treatment, you may not get the care that you need."
Fuller's organization is also working on changing in-and out-patient commitment laws that would ease legal barriers on getting people into treatment against their will. The Treatment Advocacy Center recently published a study pointing to a severe lack of in-patient psychiatric beds across the country.
Both Salzer and Fuller agree that recent state and federal budget cuts to mental health service have been devastating.
Salzer says a national conversation on these issues is much needed, but it has to be framed in a way that does not increase stigma.