With the passing of Medicaid, deinstitutionalization began in the late 1960’s. That began the snowball effect that created today’s American mental health care system. Though deinstitutionalization ideally would have improved care, this set a precedent for later policy makers to greater decrease government involvement in mental health care. During his administration, Ronald Regan established block grants for states thus ending federal government involvement in the system. Recently, after the Great Recession, states had to cut public mental health spending by $4.35 billion.
But, the real issue here is not why it happened but why it matters. People living in poverty are statistically more likely to suffer from mental illness. A study conducted by researchers at Washington University School of Medicine found that “children raised in poverty were more likely to be at risk for clinical depression.” NPR reported a correlation between poverty and mental illness. It stated, “cases of mental illness last longer, are more severe and had worse outcomes,” when seen in people also suffering from poverty. But, even though the poor are more likely to need psychiatric help, the mental health system does not cater to them. Instead, the system better serves the interests of those who have money.
Since significant budget cuts have been made from state mental health spending, people who fall below the poverty line have a difficult time finding a doctor who will see them. The system has become a cash market. This means there has been high demand for psychiatrists so they can charge higher rates, thus making a profit. By opening private practices, especially in affluent areas, mental health providers are able to charge exorbitant prices. A podcast produced by NPR states that “therapy has become a hobby for the wealthy.” It is a new fad for the well off to seek psychiatric help that disadvantages those who actually need it. The podcast states, “There can be plenty of mental health professionals in the area but still a shortage to care for those in need; they can’t find someone to take their insurance.” Already disadvantaged, this cash market has made it even more difficult for poor patients to find care.
Pharmaceutical companies have also benefited greatly from the current mental health “market.” It has become common for doctors to just write a prescription rather than take the time to better an individual. Pharmaceutical companies, like Pfizer, make a great deal of money by using the mental health “market” to their advantage. They fund research for their drugs and send representatives to hospitals to give doctors free samples. Also, ads for new medications are everywhere. But, poor patients are disadvantaged again because these medications are expensive. Some are lucky enough to have insurance to help with the payments but the copays add up. A book written about the mental health care system describes “they can get the meds and then have to stop taking them from either side effects or cost.” This is just another way the system disadvantages them.
America’s current mental health care system disadvantages poverty-stricken citizens. The system has turned into a cash market causing a shortage of doctors to be available to the poor. Expensive medications are used as a form of treatment instead of thoroughly understanding the cause of patient’s symptoms. Often times poor patients are not able to afford these medications and are left without help. But, what can be done to better the system in the future? If states were to allocate more funds for mental health care, the cash market would decrease. Also, if more primary care providers are able to screen for basic mental illness symptoms, the need to seek specialists would be eliminated. Raising awareness through programs like “Time to Change” create a bigger movement for change. By implementing changes in the American mental health system, those who would benefit greatest are those who need care the most.