Mental health care has steadily gained recognition as a critical issue in healthcare debates, especially during elections. Yet, significant barriers still hinder progress, highlighting the need for greater advocacy. While society has come a long way in terms of understanding and treating mental health concerns, there are still a variety of sticky issues that prevent mental healthcare in American from being everything it could and should be. In today’s blog, we will investigate the barriers to effective mental healthcare in America and the steps you, individually, can take to make a difference in our system.
The Progress
I’m going to take a page from positive psychology and start off with the good news. The fact that I am writing this article and that you are reading it is already a great sign. Over the past few decades, mental health has become more integrated into the overall understanding of health and well-being. According to NBC News, stigma toward mental health has decreased; technology such as telehealth and mental health apps have made help more accessible; and federal regulations have worked to put mental health care on par with other medical healthcare, both conceptually and financially. Now, we see that newer generations are embracing trying to understand their mental health and being open about seeking treatment. Primary care physicians now routinely screen for mental health concerns in their visits. There is much to be thankful for, and we need to acknowledge past progress to see the pathways to change that have worked, and to use that momentum to keep moving forward.
The Issues
Despite these gains and efforts to advance care, there is still much room for improvement in the American mental health system. Several important barriers are in need of addressing:
Lingering Stigma: Has acceptance and openness about mental health improved? Yes. Does talking about mental health still sometimes elicit discomfort or judgement from others? Unfortunately, also yes. A staggering 47% of Americans believe that seeking mental health treatment signals “weakness,” and thus likely would not seek care themselves. According to Kryss Shane, social worker and educator, “We continue to see mental healthcare as a response to problems, rather than something recommended for everyone as a way to improve life in general.” Long story, short: stigma is still a problem.
Access: Yes, access has gotten better, but we’re nowhere near meeting demand. First, there is a basic shortage of providers and specialists in America. A 2022 survey found that approximately 25% of those with mental health concerns had needs unmet by the system. Studies indicate that individuals seeking behavioral health services face an average wait of 48 days, with some experiencing delays of three months or more to access a psychologist, underscoring critical gaps in timely care. Over half of Americans live in Mental Health Professional Shortage Areas (Mental Health HPSAs), and rural communities are often significantly more underserved than urban. On the consumer side, these challenges make navigating the system complex, frustrating, and time consuming. On the provider side, these shortages can lead to overwork and burnout.
Cost: Let’s get into the numbers. The average price tag for therapy is $100-200 per session; a comprehensive psychological evaluation costs approximately several thousands on average; and inpatient hospitalization for acute mental health episodes for youth costs about $600 a day. Insurance is complicated and can sadly deter people from seeking treatment if enough roadblocks get in the way, and many mental health providers are unable to accept insurance due to the inability to get paneled or difficulties consistently being reimbursed at fair rates.
Finding the right fit: So, you’ve gotten a provider to call you back, sorted through your insurance and payment options, gotten on the schedule, and waited the two months for your first appointment. But after the first few visits, something isn’t clicking. It is important that client and provider feel like they are a good fit for each other. Mutual understanding and the relationship are key ingredients for progress in quality therapy. Thus, among the other challenges mentioned above, searching for this fit can be an added challenge, especially among minoritized communities attempting to connect with a largely homogenous mental health workforce.
How You Can Make an Impact as a Consumer
Anyone can be an advocate. If the mental health of a child, a loved one, or society at large is important to you, here is how you can help:
- Educate Yourself – Every article about mental health advocacy starts in the same place – know your stuff. Whether you are a parent, teacher, or patient, you can learn the facts and myths about mental health disorders, treatments, and healthcare systems and be able to spread accurate information in everyday conversations. I’d like to put extra emphasis on the accuracy Given the prevalence of misinformation, it’s crucial to rely on reputable sources like the CDC, the NIMH, SAMHSA, or the Mayo Clinic to build a solid foundation of knowledge about mental health.
- Voting Matters – Pay attention to what issues your elected representatives support and how they vote. Look up candidate websites, or use Ballotpedia to learn what they care about. Then, when it’s your turn to vote, choose those who support the mental health issues that matter to you to represent you.
- Money Talks – This is the “voting with your wallet” approach. If you have the means, donating to fund mental health research, programs, organizations, and supportive public servants who champion the causes and policies most important to you. Here is a list of mental health groups you may consider researching and supporting.
- Get Involved – Don’t feel like you have to start from scratch or reinvent the wheel if you want to get involved. There are already organizations out there who do excellent work advocating for better mental health awareness and treatment options. Consider volunteering with your local chapter of the National Alliance on Mental Illness or Mental Health America. You could even become a trained volunteer for the 988 Lifeline or Crisis Text Line to provide support directly to those in need.
How You Can Make an Impact as a Provider
Providers are generally citizens and consumers, themselves, but there are some special steps you can take if you are a part of the mental health field:
- Join Professional Organizations – There is power in numbers. There are national, state, and even local professional organizations who are well-aware of the issues discussed in this article and who have organized plans to address them. For instance, in my state, the Florida Psychological Association hosts a “lobby day” every year, wherein they train key psychologists on how to communicate most effectively with politicians, and we set up meetings with our representatives to communicate about the most pressing policy issues for mental health in Florida.
- Volunteer Your Expertise – Consider tackling accessibility concerns head on by volunteering your time and knowledge. You could try providing pro bono services for under-served communities or volunteering with the American Red Cross for disaster mental health team. Also, as stated above, a foundational step to garnering public support for mental health is to disseminate accurate information about it. As a provider, you already have that good info. Consider hosting an in-service for a local school or writing educational materials for a community group to share what you know.
- Mentor Others – Another way you may think about volunteering your time is by mentoring future colleagues. With the mental health workforce shortages mentioned— especially for practitioners from diverse backgrounds or who specialize in helping specific populations—think about those newer in the field you may be able to connect with to help fill those gaps. Could you speak to student groups consider a mental health career? Could you train a practicum student in your practice? Could you meet one-on-one with a junior colleague to provide guidance and support?
- Take Breaks – Advocacy work is notoriously challenging and somehow never quite finished. As such, any sustainable advocacy plan will involve rest. A long-term advocate is one who takes the time to replenish energy, reconnect with their purpose, and generate new ideas. (See our previous post on provider self-care.)
Further Resources
AARP: Volunteer to Help Improve Mental Health: 5 Ways to Provide Support and Raise Awareness
Mental Health America: 10 Ways to Volunteer Your Time for Mental Health
Butler Hospital: 19 Policy Changes That Can Improve Behavioral Health Treatment
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About the Author
Taylor Thompson, Ph.D., serves as a distance learning developer and literature coder on the Services and Products Development team at PracticeWise. Learn more about Dr. Thompson on the PracticeWise team page.
