The Unfairness Between Mental Health Services & Insurance Companies

Working at a psychiatric hospital during the 2010’s was a wake up call for me. I remember wanting to set up service for an individual but was unable to do so because of their insurance. You would think as long as someone has insurance they’re covered right…but I was sadly mistaken. This insurance challenge is no stranger to people in the mental health field. Which leads to more frustration and confusing when a clinical teams discuss next steps for ongoing care.

This helps with the stigma of mental health. When it becomes a circle to receive services, individuals walk away, leaving a lot of unanswered questions and treatment on the table. The lack of insurance coverage is also the reason many clinicians move to private pay. When you have private pay participants you no longer have to deal with the burden of insurance carriers, denied claims, or the delay of receiving payment for your services.

For services like Psychiatric Rehabilitation Programs (PRP), commercial insurance do not consider these programs as a medical necessity. They do not believe these kinds of programs are beneficial and believes there are less expensive programs for their insurers. How can they determine what is best for someone’s care, especially if they are only reading their case from a piece of paper? Due to this, families are pushed to switch to Medicaid which allows individuals to receive services that commercial insurance would not think twice about paying.

Many family members prefer for their children to be on their plan because overall it makes sense. When you are already paying for a family plan, why complicate things and file paperwork to receive state insurance? This puts families in a bind especially when they know their loved one will not get the same care because oftentimes it’s rare a practice will see people who have medicaid and commercial insurance within the same practice. It’s either you see individuals with state insurance or those with commercial coverage. A change in services can hinder the individuals treatment causing more disruptions in their care.

Insurance companies collectively is projected to make over 450 billion dollars this year, 2025 alone, and the fact that people are struggling to receive mental health care is absorb. There is a lack in this system when it comes to mental health and wellness. People are living in times where their emotional wellbeing is on thin ice. The uncertainty of this country can lead anyone’s mind in shambles, the cost of groceries is rising and certain political parties continue to turn a blind eye. We are in dire need in this country and mental health challenges will be on the rise, if they are not already.

It’s disheartening to know the billion dollar insurance companies gladly take payments from working families, leaving them with little or not support when it comes to their mental health and wellbeing. There needs to be a stand in this and we have to find away to close that gap on care.

SNAP Doesn't ONLY Apply To Single Mothers: Let's Stop This Narrative

One thing I know for sure is the dire need of support we need in this country. I worked in the mental health industry since 2008, I know for a fact individuals living with mental health diagnosis, disabilities, and other challenges are feeling the disconnect pertaining to politics and where we stand today. The federal shutdown has impacted so many people it’s unread. And for this to be the longest in history with no end in sight is alarming.

One of the things I am seeing on social media is black single women with children are affected most by the SNAP benefits. This thought process annoys me so much and the stigma that people on SNAP benefits are lazy is down right gut wrenching!

Let’s educate ourselves for a moment, there are veterans, individuals who are homeless and those with disabilities that benefit from programs like SNAP. There are people who fought for this country, or worked their entire life that rely on assistance that can get them through the month.

Breakdown of Who Receives SNAP Benefits

White: about 37 percent; African American: 26 percent; Hispanic: 16 percent; Asian: 3 percent; and Native American: about 2 percent. (source is USDA)

Among those participating in the program, most are children, elderly persons, or individuals with a disability. In fact, 86 percent of all SNAP benefits go to households that include a child, elderly person, or person with disabilities. In addition, about 92 percent of all SNAP benefits go to households with income at or below the federal poverty line. (source is USDA)

What I don’t understand is why do we tear each other down when things like this happen? There are so many things I see on social media stating, “people are lazy and need to get a job,” or “stop having children and stop using the government,”. This is such an ignorant statement and it does a disservice to those who are on these benefits that deserves to be.

Hard times are on the rise and government assistance like SNAP helps those who are in need, whether its temporary or permanently. There have been plenty of people who benefit from SNAP in the past and just to think everyone is “using the system” is not a fact. Now do people use the system, I am not going to argue and say they do not, but there are so many other things that are being used and played with in front of our face and its time we stop tearing each other down and look at what is in front of us.

How did we get here? Is one question we all should be asking, it’s time to get involve, understand what is going on and be a help in our communities instead of a hinderance. I encourage you today to support your local grocery stores, organizations and resources because right now is the time where we all need each other.

If you know of a resource that can help someone in need, a food bank, or national support hotline be sure to list those resources below. It can help someone.

Having Trouble Speaking Up...Read This!

During my adolescent and young adult years, I found myself not being as vocal as I am now. This had a lot to do with my upbringing. Anytime someone in my community was not satisfied, it mostly ended in an argument or worse, a fight. I felt like if stating my issue or presenting my feelings to someone resulting in a scuffle, it wasn’t worth mentioning. I wasn’t a fighter but I have seen many fights in my day that escalated because of lack of communication.

Fast forward to adulthood I’ve learned that you can bring your concerns to individuals, but it all depends on how you present it. Most importantly you don’t want to be so high off emotions that the issues doesn’t get resolved. I also know I am not the only person who had challenges in this area, and so I thought it would make sense to brush up on my blogging experience and write about it.

I must say it took me some time to learn how to present my issues, and not because I was afraid or anything, but because I wanted them to get resolved and not linger. Now do I always get it right…no. But I do at least try. A lot of relationships end because of miscommunication, a lot of information is misinformed because of miscommunication. And this goes for EVERYONE, no matter your economic, race, or ethnicity. All in all, we have to learn how to communicate and speak up effectively.

4 ways to speak up effectively

1. Practice Assertiveness: listen, everything comes with practice. Even speaking up! One way I started being assertive is when I receive customer service. If there was something that I didn’t like, for instance if my food order was wrong, or they forgot to provide my beverage, I would let them know. I also provide compliments for anyone I see who is wearing something nice. Just speaking up in general gives you the motivation to want to speak up consistently.

2. Be Direct: how often are we not direct. We can fumble with our words a lot and beat around the bush. Making the person on the receiving end more confused or annoyed that you brought the conversation to their attention. That’s why it is important to practice. Write down what you want to say, and practice how you want to say it. There’s nothing wrong in doing that, if anything it can boost how you present yourself to others.

3. Seek Support: I am all about providing support. Talk to your friends and ask them how you can be more assertive. They know your personality best. They more than likely can provide you with feedback and let you know a thing or two about yourself.

4. Listen: this is a part of resolving conflict. It’s imperative to listen to the other person. They have a voice and it’s critical that it’s heard. And most importantly do not listen to respond, but listen to understand. This goes a long way!

These four tips helps me even today. I have more tips you can listen to on my podcast Going Thru W/Jamie. Speaking up is not something we are born with, it’s an action we all learned. As a child there were times when I wanted to speak up, or have spoken up and was shut down. I believe this is what inhibit me from speaking up for myself during my adolescent and early adult years. So if you have little ones, there’s a way you can teach them to be heard and vocalize how they feel. We don’t want to do a disservice to ourselves and our children. So check out the podcast and be sure to check out our magazine for more tips on better ourselves!

Let me know how you speak up when some things are not going your way. I look forward to reading them in the comments!