Monthly Archives: October 2019

Mental Health Coverage and Health Insurance

There are millions of people that require the services of mental health professionals but are unable to access these resources because of the lack of funds. The cost of services can be very costly particularly if one has to pay for this type of helping service without the aid of insurance. For those individuals that are in the market for health insurance it is recommended that a policy that includes the coverage is selected. Having the ability to seek the counsel of a mental health professional and receive assistance paying for these services is very beneficial as one can never know when this type of service will be needed.
One of the main ways that people pay for mental health coverage is through a health insurance plan. There are many plans that include coverage for mental health services. However, whether this coverage is commonplace or an optional benefit varies. Most of the more comprehensive plans do allow an insured individual to seek mental health services, but in many cases the coverage for these services varies based on the number of visits that the individual accumulates. The coverage is usually a percentage of the cost of the mental health service per number of visits. For example, the individual will have to pay 20% coinsurance for the first five sessions after meeting a deductible. As the number of visits to a mental health professional increases the coinsurance amount that the individual is responsible for will steadily increase. Eventually an individual with health insurance will at least pay for half of the services that are received while the company pays for the remaining half. Under some plans there are lifetime limits on the amount of coverage that the health insurance will provide for psychiatric services. Anyone considering the use of these services should speak to their health insurance provider to receive detailed coverage information.

An additional coverage option for mental health services is a medical savings account also known as a MSA. A medical savings account is a savings account where individuals can place funds to pay for medical expenses. This type of account is usually used in conjunction with high deductible insurance plans. An individual can place funds into this account for medical expenses and will not incur any taxes. This money can be used for any health related expense except for the payment of premiums so it is an option for those looking for a way to pay for services.

Even if you’re self-employed, many states are now requiring that the coverage provided by health insurance companies be just as comprehensive as physical health coverage. This will help to alleviate the financial stress that can be caused when trying to pay for these services. It is always best to inquire about the mental health coverage options attached to a health insurance policy. Having this type of coverage is necessary as one never knows when it will be needed.

An Approach to Overcome the Challenges Faced by Modern Mental Health Services

Like all areas of modern healthcare, particularly in industrialized nations such as the UK and USA mental health services are in crisis. The problem is twofold, state run services are oversubscribed and underfunded; while private services are for many patients simply unaffordable.

Developing countries also have problems with access to psychological care, though for somewhat different reasons. Cost and lack of state funded health systems is part of the problem, but the bigger issue is that there is still a big stigma attached to admitting that you need help to cope with the problems of life, this is particularly prevalent in Asian cultures where any form of mental illness is viewed as a form of weakness.

Modern life itself is the main causative factor in mental health today. The way that we live can be held directly responsible for the near epidemic level of anxiety and depression that we are now seeing in some places. This high incidence of ordinary people with issues puts a huge burden on mental health services. No longer is psychological intervention merely for so called ”lunatics”, slowly but surely individuals are seeing the importance of having a sound mind and at the same time are more aware of the impact that emotional disorders can have on overall health.

All of the aforementioned problems faced by modern mental health care can be solved in whole or in part by utilizing the correct therapeutic approach. Individual therapy is effective for many, but at the same time is very expensive; whether paid for by the state or the client themselves. One to one approaches also limit the amount of people that can be helped at any one time, by an individual practitioner.

By utilizing a group approach we can both lower costs to the state system and allow more patients to be treated at any one time. This is because client to therapist ratios are much higher in group therapy. Twelve patients to one therapist are not uncommon, nor so high as to prevent effective outcomes from being achieved.

Most people would view traditional group therapy as consisting of multiple individuals verbally expressing the nature of their problems or feelings in turn, with the occasional interjection by the hosting psychotherapist in order to guide the session. This is indeed the general way of things, such groups tend to meet on a regular basis for a set number of weeks and often to have a psychoanalytic slant to their therapeutic model.

In contrast to the typical group scenario, what I propose is more of a corporate approach to therapy. Instead of working in an overly clinical way, therapy can be conducted like an academic seminar or workshop. By taking this approach clients do not feel that they are being treated for an illness, instead they are able to look on the therapy as if it were simply any other type of business meeting that they are required to attend. This can be very advantageous, as one of the obstacles to overcome in order to make any type of group work effective is the participants own perception that they are being ”singled out” from ”normal” people because they are attending group therapy sessions. Another advantage of such workshops is that the whole process does not need to be a lengthy one, typical group therapy consists of a set number of sessions for a set number of weeks; some groups may in fact meet on an ongoing basis. At this point we must draw a clear distinction between proper group therapy and self-help support groups. Group therapy is always guided by a professionally qualified therapist, and has specific goals in mind and the aim is usually to achieve these goals within a specific timescale. Support groups on the other hand aim to provide a forum where one can talk with other who have experienced, or are experiencing a similar situation; often they are led by volunteers who have experienced similar things to the group members. They usually receive training in group methodology but are not qualified therapists.

Cost and time required for effective therapy to take place then can be reduced, so much so in fact that for some conditions only one meeting may be required. This comment will surprise many readers, but by working with the correct therapeutic model we can in fact achieve results in just one session. Cognitive-behavioral therapy and psychoanalysis based treatments have both proved to be effective in general group settings. Another form of therapy though can give the same measurable results, is Gestalt. Gestalt has been utilized for years in group settings, some professionals are actually of the opinion that it is more effective as a group therapy than it is as a form of individual therapy. Experientially based, this therapeutic approach relies on practical experimentation or exercises. The founder of Gestalt therapy, Fritz Perls primarily utilized his method in groups.

Practical exercises help patients to help themselves. The idea is to give them strategies and skills that can be applied in their everyday lives, in order to alleviate or at least better cope with their condition. Talking alone may help to get feelings and emotions out in the open, but unless these feelings and emotions are addressed there can be no improvement in mental health. In order to address them patients must learn to deal with them as they arise in everyday situations. Furthermore, clients find it easier to internalize their feelings and reflect, rather than having to undertake the daunting and sometimes embarrassing task of letting their defenses down in a room full of people that they do not know.

To conclude the majority of the mental health burden in modern healthcare consists of conditions such as anxiety, depression and stress. All of these are inter-related, which means a similar methodology can be used to treat them. Therefore, it is possible for us to have set or scripted workshops, which can be hosted on a regular basis by a trained therapist. By taking this approach we can increase the number of clients which can be helped at any one time and decrease costs to the system. The only initial development required is of the workshops themselves, a task which can be undertaken by any therapist with training in Gestalt methodology. Conducting therapy in this way even opens up the possibility for individuals to self refer, thus saving the general medical services time.

A final note now, I have personally utilized the approach detailed here in order to treat feelings of anxiety. That is using one off experience based therapeutic workshops. Out of 10 people in attendance, only one required follow up individual therapy in order to fully manage their condition. Good feedback was received from all participants and most scheduled to return for seminars on managing other conditions.

The Catcher in the Rye: Mental Health Services and Social Connections for Children

The Catcher in the Rye, by J.D. Salinger, was required reading for my tenth grade English class. I remembered it as a story about the struggles of adolescence, the yearning for independence, and the reluctance to let go of youth. My son is now about the same age as I was when I read the book and we are living through his own nudge for independence, which sparked my interest to give the story another read. Before I began, I wondered what my take on the book would be at this point in life having survived adolescence and received training and experience in child development in addition to having a teen in the house. This reading accentuated the unresolved grief, family dysfunction, mental illness, and lack of social connectedness of the main character, Holden Caulfield, and how these difficulties exacerbate the issues experienced during the typical maturational process. As the country still debates gun control laws in the aftermath of Sandy Hook, and as we try to recover from the Boston Marathon bombing, The Catcher in the Rye reminds us about the importance of developing meaningful and genuine connections with our children and the need to address their mental health issues.

The Catcher in the Rye begins as a flashback story about Holden Caulfield’s experiences leading up to his nervous breakdown prior to Christmas. Holden narrates the story while receiving inpatient psychological treatment on the west coast. The events begin at Pencey Prep in Pennsylvania, where Holden has been expelled due to poor academic performance, and conclude in New York City as Holden attempts to return home. During the course of his journey, Holden attempts to make connections with a number of people however, he fails miserably due to his social ineptitude, lack of appropriate treatment for what may possibly be bipolar disorder, and inability to believe that other people are capable of being genuine. Holden eventually makes it home and connects with his younger sister. By that time he has decompensated to the point that, even though he is no longer experiencing suicidal ideations, he feels disconnected, misunderstood, and alone. Holden decides that he is going to go away, to escape from society and the rejection, the loneliness, and the pain that he feels. However, Holden makes one last trip to see his sister Phoebe before he disappears. Phoebe’s caring, anger, and innocence provide Holden with the connection he is looking for; she is both a peer and dependent to him. Through Phoebe, Holden is able to cling to his childhood and put off making the leap to young adulthood and independence.

One theme that I was more attuned to during this reading was the unspoken dysfunction of the Caulfield family. Holden frequently compares himself to his younger, deceased brother, whom he describes as brilliant and athletic, as well as his older brother, who has become a successful author. It is suggested that Holden is a challenging child, and somewhat of a disappointment to his parents as he has been unable to live up to their expectations. He has been expelled from at least four preparatory schools due to poor academic performance, he has difficulty socially connecting with others, and he has frequent mood swings. It is possible that Holden’s parents were drained from watching their youngest son battle with leukemia which left them with little strength to effectively deal with Holden’s grief and potential disability. In Holden’s eyes, they appear to have emotionally and physically divested themselves from him. He has little to no emotional family support and what appears to be very little communication with them. Holden is left adrift to navigate this tumultuous time in his life without support, understanding, and treatment. His efforts to reach out and communicate, including failing out of schools and getting into fights, are not understood as cries for help but are seen as personal shortcomings.

Holden perceives most people as being phony, superficial, and hypercritical. This may in part be due to his social awkwardness, lack of maturity, and feeling of being abandoned by his parents. He is continuously let down by everyone that he reaches out to for help as they either don’t live up to what Holden has built up in his mind, or they try to take advantage of him. Therefore, Holden comes to believe that everyone is phony who doesn’t or is incapable of meeting his preconceived expectations. In addition, Holden clearly experiences moments of mania during the story, which are often followed by feelings of sadness to the point where he does express some suicidal thoughts. It seems that the lack of communication with his parents, the unresolved grief and guilt over the death of his brother, and the inability to effectively and appropriately connect with others result in Holden being unable to interact with others on anything but a superficial level. The exception to this is Phoebe. Her reluctance to let her brother leave provides Holden with the strength to go home and ask for help. However, in the end, Holden continues to suffer from a lack of love and feelings of loneliness. He states, “Don’t ever tell anybody anything. If you do, you start missing everybody.” At this point, Holden continues to find it difficult to have genuine, meaningful relationships believing that when you open up to people that they will turn away from you in order to keep the relationship on a superficial level. Holden continues to be plagued by this emotional void and, while there is a hunger for social connectedness, he will continue to experience emptiness and rejection due to his quirkiness.

For me, reading The Catcher in the Rye in high school highlighted the struggle for independence and Holden’s war on hypocrisy. On this reading, I was able to obtain a better understanding of the tragedy that occurs as a result of Holden’s parents being unable to provide him the emotional support that he needs to overcome his brother’s death and deal with his mental health needs. Holden’s repeated failure to socially connect and develop a meaningful relationship with anyone other than his sister and the lack of treatment for his mental health issues made me think of the recent tragedies in Colorado, Sandy Hook, and Boston. It reinforced the need to take mental health needs and services seriously; just because these conditions are unseen doesn’t mean that they aren’t debilitating. Feeling cared for and connected to others reduces the stress, stigma, and isolation that are associated with these conditions. It made me wonder whether these tragedies could have been avoided if the people involved had received appropriate therapy and treatment. They may have felt connected and accepted, and these tragedies may have been avoided. The message of being accepted and cared for from The Catcher in the Rye continues to be relevant to young people today as we all strive for acceptance.

School-Based Mental Health

School-based mental health services are sorely needed to deal with mental health issues that are often barriers to learning. Such services need to be a critical component in schools to combat barriers to academic success. Unfortunately, schools are often poorly equipped to deal with such problems. Because states tend to bundle educational and mental health services, funds are directed primarily toward education and not treatment. In many school districts communities are also lacking in emotional support services and families do not have the means to purchase needed medical insurance to support outside treatment. Transportation to mental health clinics may not be available. Parents are often reluctant to send their children out of district to such centers. School psychologists are overloaded with assessment responsibilities while school counselors deal mostly with classroom problems, college applications, and day-to-day crises. Additional services from trained psychologists, social workers, and psychiatrists are badly needed to treat emotional problems and for prevention of future problems.

A number of studies report on the prevalence of mental health problems in children. A report of the Surgeon General (1999) indicates that 20.9 percent of children and adolescents, aged 9-17, have mental or addictive disorders. Other studies support the statement that one in five students in school may have mental health concerns. At least two to three students in every classroom may have emotional problems of varying degrees of severity. One estimate is that 4.3 million students nationally suffer from mental illness that impairs their functioning at home, in school, and with peers. A report by Katoka, Zhang & Wells (2002) indicates that 78 percent of children aged 6 to 17 with mental disorders and 88 percent of Latino children do not receive needed mental health care. Mental health concerns are likely to increase in response to the recent economic downturn.

Mental health is not only the absence of mental illness but also includes the skills needed to deal with life’s challenges. Emotional and behavioral health problems represent serious barriers to academic success and behavioral adjustment in school. Children and adolescents with emotional problems have the highest failure rates; fifty percent of such children drop out of high school. Emotional disability is the fastest growing special education in schools. In Ohio, one in five high school students reported seriously considering a suicide in the previous twelve months. Suicide is the third leading cause of death among young people and is considered a public health crisis by both the Centers for Disease Control and Prevention and the World Health Organization.

Federal and state requirements mandate that schools attend to mental health issues since behavioral problems are treatable. Students who receive social and emotional support and decision-making skills have better overall grades and higher standardized test scores. Youth who received mental health services in schools showed significant reductions in psychiatric symptoms as measured by both parent and teacher ratings., Trained therapists serving on a consultant basis coordinate their efforts with school counselors and social workers. The cost of their services is often offset by savings from maintaining students in public schools who might otherwise need to attend more expensive specialized private facilities at the expense of the school district.