Time to improve mental health care

Angelo McClain

Angelo McClain, Ph.D., LICSW

According to the Centers for Disease Control and Prevention, about 50 percent of Americans will experience some mental health issues over their lifetimes.

The most common mental illnesses in the United States are anxiety and mood disorders. In any given year, about 25 percent of adults experience a mental health issue. The estimated impact in terms of loss of productivity in the workplace is approximately $63 billion.

Among the estimated 44 million adults and 13.7 million children affected by mental illness, the Substance Abuse and Mental Health Services Administration estimates that less than half get help, even though 80 to 90 percent of mental disorders are treatable.

We know that mental illness can be more effectively managed when addressed early. According to a 2011 study from the Kaiser Commission on Medicaid and the Uninsured, 60 percent of Americans and 70 percent of U.S. children suffering from mental illness aren’t getting treatment due to various social, financial and systemic barriers.

One reason Americans aren’t getting treatment is because of the stigma associated with mental illness. Stigma and misunderstanding of mental illness are so pervasive that many consider mental health problems to be the result of personal shortcomings. Reducing stigma calls for public awareness that mental disorders have a biological and neurological basis, are not character flaws or personal weakness, and are not only common but also treatable. If we are to create a societal culture that encourages people to seek treatment, perceptions of mental illness and the stigma that surrounds seeking help must change.

Another barrier to Americans getting help is the costs of care and insurance limits on coverage. Prior to 2014, many individual or small group health plans had no coverage for behavioral health services. Treatment of mental health and substance use disorders is now a required benefit within the Affordable Care Act’s essential health benefits package. As a result, roughly 5 million people who had individual or small-group health plans at the end of 2013 gained either mental health or substance use disorder coverage, or both.

In addition, the ACA requires health plans to comply with the Health Parity and Addiction Equity Act of 2008, which requires group health plans and insurers that offer mental health and substance use disorder benefits to provide coverage that is comparable to coverage for general medical care.

Recently, the Centers for Medicare and Medicaid Services proposed a rule that applies certain provisions of the Mental Health Parity and Addiction Equity Act of 2008 to Medicaid and Children’s Health Insurance Program, which ensures mental health and substance use disorder benefits are as comprehensive as medical services. The rule supports federal and state efforts to promote access to behavioral health services as part of health care through the ACA.

A systemic barrier to Americans seeking mental health care is the frequent failure to detect mental illness. A recent study found that primary care providers fail to recognize almost two-thirds of their patients who have a mental disorder.

The study also found that less than half of those who meet diagnostic criteria for mental disorders were identified by their physicians. By detecting mental illness early there’s the potential to dramatically change patient outcomes.

On June 3, 2013, President Obama convened the White House Conference on Mental Health. NASW was proud to join President Obama, Health and Human Services Secretary Kathleen Sebelius, Education Secretary Arne Duncan, stakeholders from across the nation, and celebrities like Glenn Close and Bradley Cooper in this important discussion to advance our nation’s response to mental health.

During the conference, President Obama launched the historic Now is the Time plan. The plan kick-started a nationwide effort to hold conversations across America where communities could discuss mental health openly, build partnerships and plan for change. SAMHSA reports that we are progressing with making behavioral health resources and assistance more accessible to all Americans.

As we commemorate the 63rd anniversary of Mental Health Month, now is the time for social work to reaffirm our support for a national response to mental health that addresses stigma, reduces minority health disparities, and narrows the gap between those needing and those receiving services.

This means advocating for policies that continue the trend of integrating behavioral health with physical health, ensuring that mental health prevention and intervention programs are in all schools and colleges, and partnering with primary care providers to support, and better educate, them in the early detection of mental illness.

This also means continuing work to shorten the lag time between discovering comprehensive evidence-based practices and incorporating them into routine effective mental health care.

Now is the time for making landmark improvements in America’s mental health.

Contact Angelo McClain at