What Good Is Awareness if Mental Health Care Is Still Out of Reach?

Every May, insurance companies roll out the marketing: mental health matters. But behind the awareness campaigns and event sponsorships for Mental Health Awareness Month is a harder truth — the same companies promoting access are often the ones making it harder to get care.

Insurance companies seem to have the answer. They have whole ad campaigns designed around it. North Carolina needs more trained therapists and psychiatrists – only then will mental health care be accessible to patients. It’s certainly part of the issue – there is no doubt we need more trained mental health professionals, especially for children. But that’s not the whole story and in fact, takes the focus off what the health plans are not doing. The best part – health plans don’t need any special funding or laws to make mental health care more affordable. It’s already law.  

Health plans have several legal obligations to provide mental health care coverage to patients. It was not until fairly recently that most health insurance plans were required to cover mental health benefits and treat mental health benefits the same as other covered health services including how provider reimbursement rates are determined, prior authorization practices, network design, and utilization management practices to determine if a service is approved.

Despite these legal requirements, state enforcement is lax, and insurers continue to sidestep the law – especially in North Carolina, where there are significant discrepancies for in-network coverage and provider reimbursement rates compared to other medical professionals. Health plans have fought hard against recent federal rules that provide greater enforcement of these standards, likely because it will result in higher rates for clinicians, more care authorized, and greater transparency on how our dollars are being used on our own healthcare.

But let’s take the bait laid out by health plans: don’t we need more mental health providers?

What health plans are not telling patients is that high rates of mental health professionals do not take any insurance. In fact, a recent national survey shows a third of psychologists don’t accept insurance despite many of them previously doing so. The reasons mental health professionals choose not to take insurance are straightforward and well documented: reimbursement rates are low, administrative burdens high, and too many times the insurer puts barriers between a highly trained professional and their patient.  The insurance company may question the treatment plan – often decided upon between the clinician and the patient – deny claims, or delay payments to providers.

So while insurance companies are spending your money on fancy sponsorships for events that focus on how to fix the mental health system, they are diverting the focus away from their culpability that forces North Carolinians to pick up the tab, literally. There are countless stories of hardworking North Carolinians with “good” insurance budgeting for their child to see a therapist or psychiatrist who is self-pay. If health plans really cared about mental health access, wouldn’t they put their effort into addressing the reasons so many mental health providers say “thanks, but no thanks” to being in-network? And wouldn’t it be great if our policymakers demanded insurance companies work for us – the people paying for a service – rather than its shareholders? Other states like Illinois and New Mexico have passed laws to make sure health plans are playing by the rules. North Carolina hasn’t.

If we’re serious about honoring Mental Health Awareness Month, it’s time to stop the marketing campaigns and start making the law mean something.