February 2022: Access To Mental Health Services

How's your mental health these days? It's a good time to check in with yourself to see where you fall on a scale of "totally fine" to "really not okay." If you're feeling like maybe you could benefit from some mental health treatment and support and you decide that you want to see a therapist, how would you go about finding one? It's a good question, right?

Access to mental health treatment varies widely depending on a number of factors. Insurance, geography, socioeconomic status, race, gender, sexual orientation... the list goes on and on. While this should not be the case, like so many things in our country, the more demographic boxes you check off, the less likely you are to be able to easily access treatment.

Massachusetts has a mental health parity law which essentially says insurers who provide mental health benefits for the diagnosis and treatment of certain mental disorders must do so to the same extent that they cover the diagnosis and treatment of physical disorders. However, there are many loopholes and hoops to jump through. You may have to prove that the treatment is "medically necessary", that your diagnosis is a covered condition, that you have proper authorization to see specific providers, that there is approval for each visit, and more. It's an exhausting list, but in theory if you have insurance, you have access to treatment. However, insurance is just the first step. You still have to find someone who is currently in practice, taking new patients, has appointments at a time that works for you, and has an office that is accessible.

If you identify as a BIPOC or other non-white person, there are additional barriers to treatment. In the U.S. roughly 80% of overall mental health providers are white. 68% of psychiatrists are white and 79% of psychologists are white. While classes in cultural sensitivity/awareness (in lieu of competency, which suggests that there is a point at which one achieves satisfactory completion of learning) are required in the schooling for these professions, representation still matters. In addition, most mental health treatment has been historically understood through a white, individual responsibility and accountability framework, not taking into consideration intergenerational trauma, historical events, and political, cultural, social and socioeconomic environments and realities.Many of those factors are social determinants to mental health (which is part of what Dr. Shawn Ginwright spoke to NPS about several years ago) which include (but are not limited to) racial discrimination, social exclusion, income inequality, poor access to quality food and housing, and adverse early life experiences.

All of this to say, while we can all agree that mental health treatment is necessary and should be accessible for everyone, our system is not set up to ensure equitable distribution of services. However, there are a number of providers, influencers and organizations working to create more awareness and access to mental health supports for underrepresented communities including Therapy For Black Girls, the Loveland Foundation, and Therapy For Black Men. Find more resources for the Hispanic/Latinx, Asian American, Native Hawaiian, and Pacific Islander, and Native and Indigenous People Communities here. There are also a number of resources available nationally for the LGBTQ+ Communities.

If you are looking for a therapist or other mental health support locally, start with your primary care physician- they can sometimes offer referrals and some practices are integrated with mental health providers. If you live in one of the participating communities, William James Interface can help connect you to a provider. Psychology Today has a solid directory with specific search functions that allow you to organize by insurance type, gender, main concern, location, etc.

Your mental health matters- and that's easy to forget when we are all overloaded and feeling the pressure to take care of everyone and everything around us. Remember, asking for and being open to help is one of the bravest, strongest things we can do for ourselves.

Be well,

Dr. J