National Consumers League

Consumers and mental health services: barriers and access issues

headshot of NCL Executive Assistant Adrienne Archer

By NCExecutive Assistant Adrienne Archer

For many consumers, securing access to reliable and affordable mental health care can prove to be a difficult feat. The Mental Health Parity and Addiction Equity Act (MPHAEA) of 2018 require health plans to provide the same level of benefits for mental and substance use treatment and services as for medical and surgical care, otherwise known as “mental health parity”. Provisions were expanded so that the health plans could also cover behavioral treatments and services. Yet despite the passage of the MHPAEA, significant barriers and disparities persist in the mental health care space.

The National Alliance on Mental Illness (NAMI) has reviewed state health plans and finds that mental health coverage is often limited even if the state health board mandates full parity. Consumers face barriers to mental health care access in the form of high deductibles, which can prompt patients to forgo care. Additionally, mental health providers often charge high rates per session, which can drastically impact the frequency of a patient’s care. Health plans sometimes limit access to in-network mental health providers and those providers can limit new patients, forcing patients to seek out-of-network providers for care.  Patients that have either Medicaid (fee for service plans) or Medicare are encouraged to use in-network providers for care, with costs being covered by their plan.

There is also a shortage of available therapists skilled in cultural competency that can treat minority populations. A 2016 American Psychological Association (APA) Report has noted that 85 percent of therapists were Caucasian, 4 percent were Hispanic, and 4 percent were African American. APA also noted that for every active male psychologist, there are 2.1 female psychologists.

The National Consumers League suggests that states do the following to counteract the above-mentioned barriers:

  • adopt policies to ensure that health insurers/providers of health plans provide the same level of benefits for mental & substance use treatment and services;
  • work with insurance companies to adequately cover the cost of mental health treatment and expand access to mental health services; and
  • increase training and certification of diverse mental health care providers.