(Apr. 9, 2015) More than half of people with serious mental illness who sought help in the last year were unable to get it because they lacked Medicaid coverage, according to a new study released this week by the American Mental Health Counselors Association (“Wanting mental health treatment and not getting it,” the Pew Charitable Trusts, April 8).
The study of more than 700,000 people diagnosed with severe mental illness, serious psychological stress or substance use disorder found that 570,000 people were denied access to treatment because their states refused to participate in the Medicaid expansion program.
“The health of hundreds of thousands of people would be improved if all states provided Medicaid coverage . . . under the Affordable Care Act,” said Joel Miller, executive director of the AMHCA.
But for some people with severe mental illness, the issue is not just a lack of insurance or Medicaid coverage.
It is important to note that this study was based on people with SMI who recognized their illness, desired treatment and had sought help. But the population of people with serious psychiatric illness who aren’t getting help is actually much larger than that.
For people with anosognosia, who are too sick to recognize their own illness, self-directed treatment is often not an option. For this group of seriously ill people the consequences of nontreatment are particularly devastating – jail, homelessness, victimization or worse, just to name a few.
For the most seriously ill, states must do more than expand Medicaid. They must restore psychiatric beds to meet the needs of their severely ill population and have effective laws and policies in place that facilitate much-needed medical care. They must demand training for police officers on how to respond to people in a psychiatric crisis and finally, states must stop ignoring those who are the hardest to treat.
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