There has always been a great deal of political debate over the health care system in United States. This created a big divide in the views society held on the way policy, funding, and insurance should be governed. Yet another type of health care that is equally as important but usually overlooked is mental health care. While mental health always seems to be pushed aside for issues seen as more important, it is a big topic of debate for most people. Not everyone has personal experience dealing with mental disorders or illnesses, yet most people want to have a say in how the government regulates these types of programs. Currently, the health care system is not providing people with all of the proper benefits they need and could improve with some changes and reforms. By personalizing care and making it more accessible for the general public, the United States will be able to fix its failing mental health care system.

The way the health care system is currently governed does not ensure that its patients are cared for properly or that they are even able to get the appropriate treatment. While mental health care has improved immensely over the past one hundred years, the way patients are treated is not conducive to help them learn how to cope with their illness in the real world. Institutions often mistreated patients and forced them to live in almost unbearable conditions. Since institutionalization was so dangerous and expensive, the government decided it would be better to move more toward community centered care. Many professionals believe that if patients are treated “in the least-restrictive settings possible” then that would “protect the civil liberties of the mentally ill and hasten their recoveries” (Kliff) If a person is locked up in a hospital and not allowed to leave or even make the most basic life decisions for themselves, they will never be able to recover and assimilate back into regular society. While improper institutional care does more harm than good, institutions that are regulated can be a positive place for people that are extremely mentally ill. Some more severe patients, like Samantha Bernstein’s son Max who suffers from pediatric bipolar disorder, need to be carefully monitored to make sure that they are not be a threat to themselves or others (Satlin). After trying countless times to care for her son herself, “Bernstein enrolled her son in Hampshire Country School, a therapeutic boarding school for boys in Rindge, N.H. She said that Max, now 10, no longer has violent outbursts and is off medication” (Satlin). More severe patients that are unable to cognitively function on their own require the constant attention that an institution offers; not everyone requires such intense observation which is when out-patient treatment is the best care plan. A survey done in 2014 took a sample of about 36,000 adults mental health records, out of 36,467 adults 9,723 received treatment for any mental illness and 2,608 were treated for severe mental illness (Walker). Even though outpatient treatment is generally better, most of the time patients are prescribed medications that aid in covering symptoms instead of actually treating the illness or disorder. Whether it be medication or counseling, in the year 2012 about 15.7 millions of people received some type of mental health care that year and most will continue to receive the same care years later (Kliff). The cost of treatment is more expensive than most middle and low class families are generally able to afford. Mental health care is offered minimally by government run organizations so people must seek out private practices in order to receive the proper treatment. Even when families are able to find adequate public mental health care, their insurance often will not cover it leaving them to pay the expenses out of pocket. Since mental health care is so expensive most people see it as a luxury when in reality it is crucial for well-being since the brain controls all bodily functions. Mental health care usually seems to be the first program to face budget cuts even though it is equally as important as other types of health care. One reason for mental health care providers becoming scarce it that “while states are slashing funding for treatment, private care is getting harder to obtain” (Satlin). Not only is treatment financially out of reach, but there are so few providers that when people are able to find places where care is available it is difficult to get an appointment. If they are able to find an appointment available for consultation the private practice may be very far away and inconvenient for transportation. The lack of available mental health care causes the cost of treatment to rise since it is in high demand but there are few practices able to provide the proper services needed. Leaving people with serious mental disorders to care for themselves is going to be more dangerous and costly for the general public in the long run than just giving them proper medical attention in the first place. The current system that is set in place is able to delay those that are suffering from having a psychotic break or becoming dangerous but should be able to do so much more for patients instead of using medications to hide symptoms. 

While the mental health care system is definitely flawed and has room for improvement, that does not mean that the whole system needs to be abandoned. Many think that the mental health care system was fixed when it stopped institutionalizing in the 1960s (Potts). Since most institutions were unfit for taking care of people, having them closed down was a major improvement. While mental institutions held a good majority of the mentally ill population, eventually “these were a depository for groups marginalized by society” (Potts). Outpatient and community care seemed to be beneficial when they were first developed by allowing patients with mental disorders to live somewhat normal lives with the rest of society. After abolishing institutional care, it seemed that “surely community life was better for mental health than a cold, unfeeling institution” (Kliff). A most notable change was that people got the right to choice when they were treated in the community instead of being trapped in an institution. Patients seem to respond better to outpatient programs of treatment than to impatient programs of treatment. Community centered care cuts back costs of having to pay for full time housing and caregivers which makes treatment available to all people instead of just those that suffer from severe illness. Not all people that need mental health treatment have a serious mental illness or disorder, most of the time patients are get treated for things as small as depression or ADD. For disorders that are not as debilitating, outpatient treatment is the most effective way to help the patients cope with their illness by giving them medications that can repress symptoms. While these medications can be expensive, there are laws in place that require insurance companies to have some varying degree of coverage for mental health treatments. It is required by law that “all states have some type of enacted law but these vary considerably and can be divided roughly into three categories” (Cauchi). Requiring states to have laws that protect a persons’ right to mental health care was a major improvement from the old mental health care system to the new one. These laws must fall under the category of either “Mental Health ‘Parity’ or Equal Coverage Laws”, “Minimum Mandated Mental Health Benefit Laws”, or “Mental Health ‘Mandated Offering Laws’” (Cauchi). Choosing what specifically gets covered is up to the states individually, but nationally it is required that insurance must cover some sort of mental health care. While it is important that there is some sort of coverage for mental health care, “there is not a uniform consensus about the extent to which state government should require coverage for mental health” (Cauchi). The type of care that is currently practiced is patient centered care which tries to tailor treatments in a way that will cohesively fit into the patients’ everyday life. Patient centered care is classified as a process where “patient and clinician should each be prepared to engage in deliberation and shared responsibility regarding the final decision, which they mutually agree to implement” (Angell). This system helps to ensure that the patient has full consent and is voluntarily committing to the treatments they are receiving which balances out the power the doctor possesses in the relationship between doctor and patient. Not everyone responds to the same treatments positively, something that can improve symptoms for one patient may not subside the symptoms of another. It is important to focus on the needs of each patient individually so they get the proper medication and therapy that is necessary for them to better their condition. While the current mental health care system is moving in the right direction, there is more to having a functioning mental health care system then just making regulations. 

Laws and regulations are essential to an efficient mental health care system, but it is also important to have some sort of accountability system in place that will ensure these rules are being enforced. While community and outpatient care are an effective way to treat patients most of the time, it is only useful for those that do not suffer from a severely debilitating mental illness. Having people with serious mental illness left to care for themselves makes it seem like “we’re protecting civil liberties at the expense of health and safety” (Kliff). When people are unable to support themselves in order to survive due to a mental disorder then they are left for their families to care for. If a patient’s family is unable to financially support them or does not want to care for them, then it is more than likely that they will end up incarcerated or homeless. It seems as though prisons have become the mental institution considering that “56 percent of state prisoners and 45 percent of federal prisoners have symptoms or a recent history of mental health issues” (Satlin). Instead of being in a safe environment dedicated to helping patients to cope with their disorder, “they wind up on the streets or in jail, environments that will exacerbate their problems” (Potts) The demographic of people with history of serious mental illness or not the only one that require mental health care, anyone is susceptible to have a psychotic break. There could be certain events that lead a person’s stress to a point where they will act out in a way that could be harmful to themselves or others. These people will end up incarcerated for crime instead of receiving the proper care that they needed to prevent them from reaching an extreme state of mental crisis. Many professionals believe that “rather than solely crisis intervention, we should pursue intervention” (Utley) Most of the time mental health care intervention is only offered after something terrible has already happened to or been done by the individual that experienced the psychotic break. “75% of uninsured adults with any mental illness and 56% of uninsured adults with serious mental illness” do not seek the proper health care that they need due to a few different barriers (Walker). “A 2007 study in the journal Psychiatric Services looked at 303 mental health patients who had, in the past year, thought about going to the doctor but decided against it” because of either cost or social stigma (Kliff). Most adults believe that receiving mental health treatment comes with a social stigma which creates a barrier to treatment. In a study, it was discovered that most people avoid seeking out mental health treatment since they believe there is “stigma about mental disorders and their treatment and misconceptions about the effectiveness of treatments” (Walker). Most people avoid getting treatment, even if they would benefit from it, because they either do not want to be labeled as unstable or they believe they problem will go away on its own. Another barrier for treatment is the cost and insurance coverage. Only people that are wealthy enough to pay for mental health care themselves are able to be treated for mental illnesses and disorders due to lack of insurance coverage. Since the prices for mental health care have risen so drastically, about “ 40 percent of adults with serious mental illnesses reported not getting treatment at all in 2009” (Satlin). Most patients and their families end up having to pay for their care in full since “around 20% of people with mental disorders are uninsured” (Walker). People that use public mental health insurance get worse care then those who have private insurance. There are few mental health care providers, “only 40 percent of mental health care providers accept Medicaid, so even in states with the Medicaid expansion, recipients are squeezing in too few appointments with the too few providers who will see them” (Potts). Insurance gives such poor coverage that people will sometimes just forego it all together by paying out of pocket or by not getting treated. Sometimes private practices will not accept insurance coverage due to the fact that “reimbursement rates [from insurance companies] to mental health providers are not on par with making a living” (Satlin) There are common instances where insurance will not cover certain treatments so the only choice for the patients and their family is to pay for the care all without help from insurance. Doctors overprescribing medications is a common occurrence in the new mental health care system considering that “it is much cheaper for insurance companies to pay for medication than ongoing psychotherapy” (Satlin). Insurance coverage is not great seeing that government funding for the mental health care system is way worse than funding for many other health care programs. “The United States spends $113 billion on mental health treatment” which works out to be about 5.6 percent of the health care budget (Kliff). If the money that is currently funding mental health care was put to use effectively, then is it conceivable that money could be saved in other areas like in prisons when people with mental health disorders are left there. Now that institutions have been abolished it seems that “the sickest patients have begun turning up in jails and homeless shelters with a frequency that mirrors that of the late 1800s” which costs the public more money in the long run (Kliff). These severe budget cuts limit the amount of care that can be offered through public health while the access to private care is also being greatly reduced. Proper mental health care is becoming harder to obtain due to the fact that “mental health advocates say that the number of providers nationwide has decreased in recent years” (Satlin). With limited access to mental health care, no way of paying for it, and care that is not proper for its patients, the mental health care system of the United States could use an entire reformation. While enforcing the current laws is an ideal first step that could be taken, there are a multitude of other practices that could be put in place to also aid in bettering the treatment of mental health disorders.

It is important to have an effective mental health care system so everyone is ensured the best care possible. An important part of treating mental health disorders is prevention and catching them early on to be treated. Professionals believe that “by conducting routine mental health screenings within primary care, patients will have the growing opportunity to reap the benefits of early detection” (Utley). If a mental disorder can be caught and treated early on then managing the symptoms is easier so the disorder does not become debilitating. If a mental disorder gets diagnosed early enough “there is opportunity to begin treating mental health before an episode of psychosis occurs” (Utley). Anyone can suffer from psychosis, it is important to treat a persons’ mental health before they get to a state of complete and total breakdown. While many mental disorders are genetic, there are occasions when “healthy people facing impossible circumstances can reach a point at which they need professional help” (Potts). When experiencing serious psychotic breaks people may become dangerous to themselves or others; in this case is it a good preventative measure to allow the government access to mental health records. A necessary preventative measure that should be taken is “a gun bill that would require therapists to report to the authorities any client thought to be ‘likely to engage in’ violent behavior; under the law, the police would confiscate any weapons the person had” (Carey). In some cases, disaster is unpreventable which makes it a good idea to have a comprehensive crisis intervention team that would be able to diffuse a dangerous situation. Law enforcement officers and people that are in a position of authority should be required to have “training to recognize signs of mental illness and training in nonlethal interventions can circumvent the use of physical force” (Miller, 261). In high threat situation it would be ideal for officers to have a background in ways to neutralize a dangerous threat. Crisis intervention training should also be basic knowledge for most people in a community to help with the fact that there is limited access to real professionals. Since there is a lack of professional care, “training members of communities to give mental health interventions, empowering ordinary people to care for others” (Patel). One last way that could help to ensure patients get proper care is to make sure that doctors allow patients to have a say in the treatment plans they are given. “patient-centered care philosophy encourages the practitioner to invite the patient to take an active role in making medical decisions through a collaborative partnership with the provider” (Angell). By giving patients a say in their treatments the have a full understanding of what they are agreeing too and then may be more inclined to follow their treatment plan. Some other small ways to improve the mental health care system would be to support better government funding. Since most other physical health care systems have a large amount of funding it should also be reciprocated in the mental health care system. The funding for this program should not always be what is cut first considering the fact that this form of health care is just as important as physical health. If government funding was better than the availability of mental health care would be better for all people and not just those with a greater socioeconomic status. There would be more public practices for people to seek out instead of just going to expensive private practices that charge more since they need to make a profit. Another way that mental health care can be available for more people would be if there was better coverage on mental health care for public insurance. Making insurance more widely available would help all of the people that have barriers to mental health treatment be able to afford at least some level of care. There are many ways to revolutionize the mental health care system that the United States currently has in place, these are just a few examples of ideas that would be effective in modern society.

By personalizing care and making it more accessible for the general public, the United States will be able to fix its failing mental health care system. Deinstitutionalization was a big move forward in terms of offering better care for people that suffer from mental disorders. While outpatient care is very effective for people that suffer from manageable disorders, those with debilitating disorders require more personal and constant care. The regulations currently in place are a good starting point for how the mental health care system should be run. The next step in making the mental health system more effective would be to make psychiatrists accountable for the way they treat patients so they are inclined to follow regulations and standards. Cost is a large barrier for most people to get access to the proper care and treatments they need. More funding and better insurance could make even the most basic mental health care available for those that need desperately need it. While mental health care has come a long way in the past one hundred years, it still has a long way to go. Leaving the mental health care system as it is now would allow the issues that are faced today to manifest until they are irreversible.
