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The real reason for North Carolina’s mental health crisis

Across North Carolina, overburdened emergency rooms are taking care of psychiatric patients with nowhere to go.

When health insurers stand in the way of preventive mental healthcare, the results can be dire.

Though they are supposed to cover mental healthcare on par with physical healthcare services, the reality is insurance companies often don’t. Reimbursements are often well under what Medicare would pay, or the patient’s out-of-pocket costs are often so sky-high that getting help just isn’t feasible. If it costs a patient upwards of $200 for a clinically licensed therapist, per session, for most Americans, this prevents them from seeking treatment regularly, let alone once or twice a month. And if that patient has a more acute psychiatric condition, the odds are even more stacked against them.

And then, the buck seems to stop at hospitals.

The obvious outcome of an under-funded mental healthcare system is that patients in crisis wind up in emergency rooms with nowhere to go.

In fact, according to an August 22nd article from NC Health News, Atrium Health, located in Charlotte, says the demand for psychiatric care for children has tripled since the pandemic began.

The article explains that even prior to COVID-19, “North Carolina’s mental health system already relied heavily on emergency services. Now, hospital and state health officials say — and the data show — that the system is buckling under the influx of even more patients in crisis.”

But the system isn’t just “buckling” — it’s broken. And so is the way health insurers skirt their responsibilities to adequately cover preventive mental healthcare. The way our system is set up, preventative mental health care is practically a luxury good.

And whether it’s heart disease or mental health condition, the unfortunate end result is that people get sicker and sicker until they experience emergencies, and then the hospital has to be prepared to save their lives.

There will always be a role for hospitals to play in emergencies. But we can’t keep making them the last line of defense. Insurers have got to own up to their role in the situation, and actually help their members find quality, preventive mental healthcare – and then they’ve got to pay the providers for it. We’ve got to structure the system in a way that make sense, so patients can access care before the situation is dire.

Otherwise, states like North Carolina will continue to experience an increase in mental health crises, addictions, and suicide, until insurers decide to actually care about the patients they claim to serve.

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