Written by FundaMental Health,
August 27, 2024
In this blog post, a FundaMental Health board member, Erin Randoll, writes about her journey as both a patient and mental health provider. Dive in to hear her unique perspective on the challenges facing those who seek and provide mental health services in America:
Mental health does not discriminate based on your age, gender, or socioeconomic status—and it certainly doesn’t care if you’re a therapist yourself. I’ve been a practicing therapist for over 10 years and hold a master’s degree in marriage and family therapy, but even as someone who is part of the system, I struggled to find the help and resources when I needed them most..
I think many will find my story relatable. Some time ago, I started to experience physical health issues– a process that caused my existing anxiety and depression to increase while leading to panic attacks. Although I had always contended with some form of anxiety and depression, they hadn’t yet impacted my daily functioning. However, these new issues were different. They affected my work, my ability to socialize, and even my capacity to leave my home. When I asked for help, I was handed a 72-page document with referrals to possible mental health providers. I couldn’t believe it. After all, where does one even start, particularly when you are already struggling in your daily life with a mental health condition? My worries and fears around my physical health were directly related to my panic attacks, and yet these were being treated like two separate issues. No one was there to help me navigate these challenges– or even provide advice.
My story is not unique. When new patients start seeking mental health help, it is typically much harder than getting an appointment to see a traditional medical physician. As an example, a recent study by NORC at the University of Chicago found that 40% of insured patients using in-network mental health providers had to contact four or more providers to obtain an appointment– versus only 14% for physical health providers. The study also found that patients were 2.5 times more likely to use out-of-network services for mental health than physical health. In my case, I had to become a great advocate for myself to receive treatment, and I still paid out of pocket while remaining on insurance waitlists. The frustration from these experiences led me to a clear conclusion– mental health care has a serious access problem in how patients seek and receive treatment.
As a mental health professional, I have the unique perspective of seeing these problems play out on both sides. Providers face major issues too– including low reimbursement rates from insurance, a rising demand for services, and poor work/life balance leading to burnout. The issue of low reimbursement rates is particularly complex. A recent article by Mental Health America ‘Fix the Foundation’ showed that insurance companies often reimburse procedural work—such as surgeries and diagnostic tests—at higher rates compared to cognitive work, which includes mental health services like therapy and counseling. Consequently, this affects the availability and quality of mental health care. Because of these challenges, providers are given the option of seeing more patients in a day or opting for higher pay through flat-rate cash payments. With reimbursement rates at approximately $60 per session, therapists might see up to 8 or 9 clients in a single day simply to break even. Additionally, clinicians often run their own businesses– managing marketing, billing, waitlists, and other administrative tasks. This situation has contributed to intense burnout in the field and an increasing shortage of providers. I’m incredibly passionate about helping people, as are my colleagues, but the ability to provide high-quality care and attract high-quality providers is truly put in jeopardy by current insurance practices.
I strongly believe we must do better for patients and mental health providers. It is important for me to share my own struggles to help normalize mental health issues, just as I find myself called to advocate for providers working under a severely limited system. However, awareness alone isn’t enough. Fundamentally, we need to make it easier for patients to access mental health treatments and for providers to have the funding and capacity to provide high-quality care.
At FundaMental Health, we are challenging the system and making up for its shortcomings with three key components: funding, care coordination, and support. As a non-profit, FundaMental Health provides fair compensation directly to mental health providers for the care of patients in our grantee program. We also support applicants in finding quality care through care coordination, ensuring accurate diagnosis, appropriate placement, logistics, follow-ups, and more. This is the critical and humanized missing piece that new mental health patients need– actual assistance versus a 72 page document of providers with long wait lists. For those potentially interested in the services of FundaMental Health, you can learn more here as an applicant, mental healthcare provider, or donor. We’d love it if you joined us on this vital journey.
