Record numbers of Americans are seeking mental health care and struggling to get it. Here’s what it’s like.
By Katie Prout
I
was relieved that somebody had finally asked about my mental health.
All
spring and summer 2020, I kicked the ball of my fritzing brain down the field
to some imaginary goal of “things” getting better in the world, or at least
more stable. Plainly, that didn’t happen.
And
so, like many others, I went back to therapy. Or tried to.
I’m
on Medicaid, and while the insurance I receive through the program is accepted
by many dentists and primary care physicians, finding a therapist or a
psychiatrist who takes it has been, in my experience, impossible.
I
used Psychology Today’s search tool and found
just three therapists in my area who said they accepted Medicaid. Only one
returned my email, but after a detailed intake interview, I never heard from
her again.
Over
the next eight months, more fruitless attempts to find care for my mental
health took a real toll on my time, money, and well being.
I
asked for help finding a therapist and a psychiatrist from my in-network
primary care physician. A month later, she wrote to say that she knew no
psychiatrists who accepted Medicaid, ending the message with a well-intentioned
but unhelpful “;-(”.
After
combing the Internet, I found five other local psychiatrists who had “Medicaid”
listed on their profiles. They never returned my emails or my calls. I cried.
It
turns out I’m not alone. Americans are seeking mental health care in record numbers,
and many are struggling to find it. Even before the pandemic,
NPR reported that 77 percent of U.S. counties faced a severe
shortage of psychiatrists. Meanwhile the number of practices accepting Medicaid has declined.
For
people like me, our conditions can grow more disruptive and life-threatening
with every passing week without care. Studies show
that being poor is correlated to higher rates of mental illness. What is
perhaps less widely understood is that poverty causes mental illness, too.
Anyone
who has tried to get help knows that the process consigns whole days to the
dump.
During
my search, I was working as a freelance journalist. The time I spent chasing
down care was time I couldn’t spend filing stories and earning income to live.
For that matter, it was time I could’ve spent calling my mom, cleaning my
fridge, applying for a job, running around the block — anything.
Eventually,
I found a graduate student therapist for $25 a session. But a proper
psychiatric evaluation remains elusive. One place said I’d have to switch my
therapy over to them, but I wasn’t ready to do that. Another said I’d have to
leave my current primary care physician.
I
said no. I didn’t want to disrupt what stable care I had in exchange for the
uncertain promise of eventual help.
Medicaid
has been good to my body — I got a dermatologist, a primary care physician, a
gynecologist, and a gastroenterologist with relative ease — but it has
abandoned my brain. I need timely, accessible, affordable care — just like
millions of Americans. I want choice, not a fistful of deeply unhelpful options
wrestled from the cruel system we make poor people navigate to access health
care.
Some
days I still can’t believe that more than a year and a half into a pandemic —
with its massive layoffs, record unemployment, hundreds of thousands of deaths,
and increase in mental illness — this country still ties “good” insurance to
your employer.
We deserve so much more. For me, I want to be present in my existence, rather than getting lost in the endless twilight plains of my mind.
Katie Prout
is a staff writer at the Chicago Reader. This op-ed was developed by
the Economic Hardship
Reporting Project, adapted from a longer story
at the Chicago Reader, and distributed by OtherWords.org.