Professionals weigh in on the need to improve mental health

By: Grace Cope

In our society, mental health often is viewed as a taboo subject.

With the history of an uneducated public and reluctant diagnoses, people with mental illnesses face a variety of challenges even today. Not only do they struggle with the difficulties that arise from having the disorder, but they also face battles with insurance companies to get coverage, unsuccessful parity laws and an arduous petitioning process.

Most, if not all, of these difficulties stem from one central issue: stigma.

The stereotypes and prejudices surrounding mental illness and the conversation of mental health makes all of these challenges infinitely harder.

Veronica Smith, director of professional outreach and communications at Rose Hill Center, a long-term mental health facility in Michigan, understands this dilemma.

“Despite the fact that so many people experience some level of mental health concerns, there still remains a great deal of stigma,” says Smith.

“And that influences people’s ability to seek treatment and the ability of insurance companies to pay for treatment. It really does affect people’s ability to receive care.”

Considering our society has dealt with stigma for so many years, most mental health advocates are hopeful for a future where these stereotypes don’t exist.

“I think it is possible with more awareness and discussion, normalizing the fact that nobody has total mental health. I think we are all on a spectrum somewhere. And just taking the mindset of people is what it will take to really reduce that stigma,” says Smith.

This stigma is perpetuated by the difficulty to access education about mental health.

Although many schools’ curriculum includes mental health education, it often is not near as in depth or detailed as it needs to be. This makes it even tougher for people with mental illness to understand that they need treatment.

“We struggle with our residents that have thought disorders. People, through no fault of their own, are not aware that they’re ill. So that makes coming up with a treatment plan and moving forward with your life that much harder, because the illness itself is telling you you’re not ill,” says Smith.

“You don’t experience that with anything else–– your heart is not telling you it doesn’t have clogged arteries. So self-awareness really makes it difficult for folks who are experiencing that symptom.”

Joelin Hahn, director of integrated care at Bay-Arenac Behavioral Health, is adamant about mental health being represented the same as any other illness.

“Unfortunately, throughout history, mental illness and substance abuse has not really been recognized as a physical health illness, and they are. They’re brain diseases, and the brain is a part of our body. It’s a part of our physical health,” says Hahn.

She described how this is starting to become recognized by primary care, which often includes a social worker on its staff to screen patients for mental illness.

“And it’s just… it’s awesome. We’re behind, but we’re getting there,” says Hahn.

However, this representation, though still having a long way to go in our society, is much more progressive than how mental illnesses have been represented in the past.

“In the 70s is when Michigan institutionalized their state facilities,” says Hahn. “I know of someone who used to be a therapist, and in talking with her about her life experience, she had actually lived in a state facility for the first 5 years of her life because she had a cleft palate. And that would never happen nowadays, thank goodness.”

With the lack of education and endless stereotypes that people with mental illness face, it’s no wonder that many patients have unrealistic expectations when actually going into treatment.

Mental health care providers, including Hahn, have experienced patients who become frustrated when results are not immediate. It extends past simply the age of instant gratification and more into education and representation issues.

“It’s not a quick fix, it’s not a simple process, but it is so worth it. Because once you get the right treatment for you, in the end, the payoff is that better life without that burden sitting on your shoulders,” says Hahn.

Rachel Keyes, an outpatient therapist at List Psychological Services, has witnessed this situation firsthand.

Many patients believe therapy is the finish line, says Keyes. The realization that there is actually more to do can be difficult for the patient, especially when getting through the front doors was hard enough.

“Sometimes people come in and they're like, ‘Alright, I'm here. Where’s that magic wand? Fix me, I need to be better, like, next week,’” says Keyes. “It's a little more than people bargain for.”

But as hard as entering therapy and pursuing treatment is for patients, the reality of living with mental illness often makes this essential. Even daily actions like holding a job or getting out of bed in the morning can be difficult.

“Because we work with folks that are very seriously ill, the majority of residents have had one or more hospitalizations before they come to us. Quite often they have lost jobs, been unable to live their daily lives in a way that they would like to, so it really does impact their ability to live the life that they would want,” says Smith.

This only further requires patients’ need for treatment. But sometimes, getting insurance to pay for their treatment and therapy can be tough.

“The most frustrating aspect of insurance coverage is the level of complexity that policies have. Many individuals feel from reading about their coverage that insurance should pay for residential mental health treatment,” says Smith.

“However, the phrasing is so confusing and the responses from phone calls so frustrating that it is difficult for people to understand.”

But fortunately, insurance has come a long way in including coverage for mental health.

“Anyone with Medicaid truly does have a great benefit now. They have 20 to 30 outpatient visits a year, they can see a psychiatrist. For substance abuse they have medications such as treatment, therapy for prevention, all kinds of programs,” says Hahn.

“Where we have a gap in the state of Michigan is individuals who don’t have insurance and don’t meet criteria for Medicaid or Healthy Michigan insurance. Those people unfortunately have to reach a certain level of treatment needs before they get the services paid for.”

Another issue people with mental illness face is laws that sometimes make getting insurance harder than it already is.

Kevin’s Law, assisted outpatient treatment, was created in order to help get patients treatment without having to put them directly into a mental health hospital, according to Hahn.

With this said, assisted outpatient treatment has a gap that excludes people with substance abuse. Although people with substance abuse hurt themselves by using drugs and alcohol, she has no way to help these people out, says Hahn.

“An [assisted outpatient treatment] will work with someone who has a substance abuse disorder, but the mental health has to be primary.”

It’s situations like these that further increase the challenges that people with mental illness or substance abuse face. Although advocates are tirelessly fighting for change and for representation in society, there is still a while to go before these challenges are eradicated.

“I wish stigma would go away so people would get mental health and substance abuse treatment no different than if you had high blood pressure,” says Hahn.

“I hope the day comes that that’s how things will be, that we’ll treat it like every other illness out there.”