In the past two years, there have been six mass killings in the United States with the most recent one in Las Vegas on October first being the deadliest in history, resulting in fifty deaths and five-hundred injuries. Due to these types of tragedies, there is a big divide in societal views on the way policy, funding, and insurance should be governed surrounding the mental health care system. The issue of mental illnesses and disorders seem to be a growing topic of debate as violent outbursts seem to occur more frequently now than in the past. Though not everyone has personal experience dealing with these types of concerns, majority of people want to have input on what happens regarding the mental health care controversy. The current system is not providing people with all of the proper benefits they need and could improve with changes and reforms. By personalizing treatment plans and making care 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 can do 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, New Hampshire. She said that Max, now 10, no longer has violent outbursts and is off medication” (Satlin). More severe patients, like Max, that are unable to cognitively function on their own require the constant attention from caregivers that an institution offers. This all depends on the type of illness that the patient suffers from, there are many patients that are fully capable of living normal lives with the appropriate medication.

Not everyone requires the intense observation provided by institutions, which is when out-patient treatment would be 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 considered better, most of the time patients are prescribed medications that aid in covering symptoms instead of actually treating the underlying 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). Out-patient care is proven to be more beneficial for people that suffer from less severe disorders, but the price of on-going treatments can get expensive if the patient and their family are left to cover the costs on their own. 

Mental health care is minimally offered 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. 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). 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. 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 available consultation appointment at a private practice, it may be located far away which is 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 that can provide proper services; this leaves people with serious mental disorders to care for themselves. In the long run, avoiding the fundamental issue will be more dangerous and costly for the general public than just giving the patient proper medical attention in the first place (Utley). The current system that is set in place is able to delay those that are suffering from having a psychotic break from becoming dangerous, but it 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 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 considerably normal lives comparable to 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). The people that were treated for mental disorders seemed to respond better to outpatient programs of treatment than to impatient programs of treatment. 

Community centered care is a type of outpatient program that focuses on providing the least restrictive form of treatment (Kliff). This type of care cuts back costs of having to pay for full time housing and caregivers which makes care 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, most of the time patients are 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 care. 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). This means that all people must be offered either some type of coverage, coverage of mental health that is equal to regular health coverage, or health coverage that is optional for the patient. Choosing what specifically gets covered is up to the states individually, but nationally it is required that insurance coverage must follow one of these three categories. 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 types of laws that are set into place are an exceptional start for reconstructing the mental health care system, but they should go more in depth to set guidelines for the way doctors treat patients to assure they provide comprehensive care.

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 recieve 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 “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, they are left for their families to care for them. If a patient’s family is unable to financially support them or does not want to take responsibility for them, then it is more than likely that they will end up incarcerated or homeless. It seems as though prisons have become the new 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). To prevent people from ending up incarcerated for crime due to lack of treatment, the government should be pursuing intervention.  

The demographic of people with history of serious mental illness are not the only ones 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. 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). 

Aside from cost, there are still barriers that prevent people from seeking out treatment to help their condition to improve. “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. Many 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). Keeping mentally ill patients on drugs so they are easier to deal with is not going to be beneficial to helping them recover and return back to their normal lives. They need to talk and find the root of their problems in order to work towards moving past it.  

Government funding for the mental health care system is way worse than funding for many other health care programs which is a major contributing factor to the elevated cost that patients must pay. “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). 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. There are few mental health care providers available with “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). Even if the patient is able to cover the cost without insurance, there is not guarantee that they will be able to make an appointment to see a professional. 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). Since there are many barriers that impede patients from acquiring care, about “ 40 percent of adults with serious mental illnesses reported not getting treatment at all in 2009” (Satlin). In a system that is meant to benefit the general population, it seems inefficient that people are not receiving mental health care due to the excessive amount of difficulty that they encounter. While enforcing the current laws is an ideal first step that could be taken, this alone would not be enough to fix a mental health care system is this condition.

It is important to have an effective mental health care system so everyone is able to receive the best, safest, and most effective care possible. An important part of treating mental health disorders is prevention by 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 will be easier as well as preventing the disorder from becoming debilitating. If a mental disorder gets diagnosed early enough “there is opportunity to begin treating mental health before an episode of psychosis occurs” (Utley). While it is important to treat people with a history of mental illness, they are not the only people susceptible to having a psychotic break. 

Anyone can suffer from psychosis, so it is important to treat a persons’ mental health before they reach 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). While there is no way to stop all tragedies from occurring, it would make it much harder for people to obtain harmful ammunition that would devastate the country once again.

In the cases where disaster is unpreventable, it would be beneficial 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 person. 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. There is a lack of professional care to help everyone that needs it, a suitable idea would be to “train members of communities to give mental health interventions, empowering ordinary people to care for others” (Patel). This would help to combat the rising problem of not having enough trained professionals to aid everyone that requires their services.

Allowing patients to have a say in the treatments they are given would guarantee that the plan would fit into their daily lives. An important technique that doctors utilize for this approach is “patient-centered care philosophy” since it “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 through with 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 to make a profit. If there was better coverage on mental health care for public insurance, more people would seek out treatment to improve their illness instead of letting it reach crisis level. Making insurance more widely available would also 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 treatment plans and making care more accessible for the general public, the United States will be able to fix its failing mental health care system. Throughout history, the United States has always been a country that prided itself on individualism. This makes it even more difficult for people that are struggling to seek out help perceiving that it portrays a sense of weakness and powerlessness. People that suffer from a mental disorder admit to this defeat every single day. As though experiencing this humiliation is not enough, now it is necessary for this person to go tell someone else that they are not able to control their life and care for them self alone. For the rest of their life, they go everyday believing that they are incapable; incapable of caring for themselves, controlling their thoughts and emotions, let alone care for a significant other or child. Battling a mental illness is never easy and there are a lot of times where people are unable to survive it. This is why it is important to help in any way possible. Economic barriers and social stigmas should not be preventing people from getting the help they need. The proper mental care to keep a person alive and happy should be attainable for all people not just those that can pay exorbitant amounts of money. It is important to vote for legislation that offers these benefits to all people, it could just save a life.
