Why Cost is a Systemic Barrier to Accessing Mental Healthcare
Systemic barriers are embedded in social and/or organizational structures. They stand in the way of positive outcomes, particularly when disadvantaged people try to access services meant to support them.
A number of these barriers exist in mental healthcare and access to treatment, with cost being one of the most substantial. Reducing the economic burden of therapy and other support measures is critical to improving mental health outcomes in Maryland and across the country, especially among underserved populations like Black men.
Mental health organizations can and should do their part to make quality care more affordable and accessible. But cost of care conversations are incomplete without considering the wider context.
Americans, and Marylanders, are feeling the pinch…
People are financially stressed to start with. This can both coincide with or cause the psychological pressures they feel.
For example, personal finance expert Suze Orman estimated earlier this year that only a third of Americans could afford a $400 emergency expense if they had to pay it. It’s easy to understand why. After all, financial magazine Barrons reports that 65% of Americans live paycheck to paycheck.
In Maryland this year, the average individual paid $344 a month in grocery costs, $128 a month in utility bills, and carried an average balance of nearly $7,000 in credit card debt that usually costs a few hundred dollars a month to service.
Housing, childcare costs, school supplies, out of pocket medical and dental expenses, and transportation also mean that our state’s relatively high median household income doesn’t go that far when all is said and done.
…and that’s before they think about therapy
Simply put, therapy feels like an inaccessible luxury to most people. Consider that about a third of therapists in the U.S. do not accept insurance at all, and the sticker price of sessions can be $200 or more per hour. Someone who needs intensive support and sees a counselor once a week can easily run up bills of $800 a month or higher. Hardly surprising, then, that 25% of Americans regularly choose between meeting their other critical expenses and seeking mental health support.
Even only 55% of psychiatrists, who prescribe medicine but often don’t give therapy, accept insurance. And when people can find an affordable therapist, either one who charges comparatively low rates or accepts their insurance, there’s no guarantee that therapist will be a match to the person or their needs.
Working to dismantle the cost barrier
Organizations like The Mental Health Emergency Fund, Inc. are doing our part. For many people who live check to check and have minimal savings to fall back on, our stipend program has made therapy possible. It’s powered in large part by the generosity of Baltimoreans and other donors committed to our vision.
Right now, we’re continuing to build out our network of therapists participating in the stipend program, making it that much easier to find help by giving people vetted resources to turn to.
The bottom line: Realistically, it will take time and effort to break the link between quality mental healthcare and cost. Along with expanding conversation and tackling stigma, future advocacy will need to include more intensive efforts to relieve the material pressures that keep people from getting support.
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Written by James Benjamin, Communications and Social Media Associate at The Mental Health Emergency Fund, Inc.
Check out his work at www.james-benjamin.com
