Recent mass shootings — including the one in Georgia — paint a bleak picture of America’s mental health. The reasons for this are multifaceted and range from a breakdown in social cohesion and stable families to the degradation of human life and the spiking of mental and behavioral health problems as access to affordable care dwindles.
We face an unprecedented mental health crisis stoked by societal factors that seem out of control. One-fifth of the adults in the United States (57.8 million) struggle with a mental illness. Researchers think 50 percent of all Americans will experience a mental disorder sometime in their lifetime. The number of Americans seeking treatment has skyrocketed. Demand for therapy has risen 40 percent in the last five years.
These statistics represent real people experiencing suffering and who require comprehensive care to fully rehabilitate their lives. Unfortunately, our nation lacks the resources necessary to care for those affected by mental illnesses.
As demand for care surges, Americans face the reality of a mental healthcare landscape that cannot keep pace with an increasingly dire crisis. Nearly 60 percent of Americans struggling with a mental illness last year received no treatment for their illness. A quarter of sufferers sought treatment but were unable to find an available healthcare provider.
The problem is getting bigger and worse, as more than 150 million Americans live in a designated mental health professional shortage zone, where critical gaps exist between the mental health need and the care available.
While many issues are broader in societal cause and effect, we know more resources — doctors, therapists, psychiatric hospitals — will help reduce the gap between need and treatment. Public policies can improve the supply of professionals, and standards will help ensure quality care. Enforcement is also needed to weed out bad actors and to deliver justice when bad actors harm patients.
I am concerned that sensational reports paint one-sided stories that result in fewer resources for care. For example, a recent New York Times article implied inpatient psychiatric hospitals and mental healthcare providers broadly are at odds with patients. The report, predicated on extreme examples, pushes the debate in the direction of fewer resources and more stigma.
Articles that gloss over that behavioral healthcare facilities, as one would hope and expect, are highly regulated and are required to make decisions that are based on patients’ medical needs, not business desires. Here, state medical boards have a role to play to ensure care received is appropriate and providers are held to medical necessity standards for patient care. Medicare should ensure all hospitals meet standards of care in order to receive Medicare reimbursement. Criminal actions should be prosecuted.
Any poor patient experience that fails to meet standards of care or regulatory requirements should be addressed so that future instances can be prevented. Medicare already requires inpatient psychiatric hospitals to report quality measures, which are then used to leverage payment to good actors and to penalize underperforming facilities. These metrics could be tweaked further to reward good actors and discourage bad actors.
Mental healthcare is an inherently complex field, and the care provided is highly nuanced. Scrutiny should be focused on bad actors and producing a better system. This requires a complete picture lest we deter the next generation of providers from entering the field entirely, worsening the shortage of care.
America is experiencing a behavioral health crisis and, unfortunately, millions need treatment. When providing care to patients with opioid use disorder, psychiatric illnesses, or tendencies toward violence or self-harm, inevitably there will be some poor patient outcomes. Thankfully, poor outcomes from treatment are the exception as the vast majority of patients receive the treatment they deserve and require.
Inpatient psychiatric hospitals treat the most severe cases of mental health crises, including those at risk of committing mass shootings. There is no one standard procedure when it comes to mental healthcare, especially when it comes to inpatient care. Those with severe mental illness require intensive, highly individualized treatment plans to rehabilitate.
Every day, medical professionals at psychiatric facilities make decisions they believe are necessary to provide comprehensive care to their patients. One-sided critiques undermine support for effective treatment.
Behavioral healthcare providers are providing much-needed treatment. With patients’ health and well-being on the line, we must demand high-quality treatment. While they are imperfect and don’t always achieve desired outcomes, behavioral healthcare providers need more resources and our support to support the needs of patients in their recovery.