We have all heard about the can of
worms. Fishermen love them and most people shrink from them. This article in WebMD is another can of worms. It is time that mental
health came back and became part of medicine. We even understand and
appreciate the coverage of pre-existing conditions as a benefit.
One of the factors is not mentioned and
this is the lack of trained doctors to treat people needing
treatment. This may the reason behind the new guideline manual the Diagnostic and Statistical Manual
(DSM5). In the manual they have a medication for every conceivable
mental health issue and almost say to forget counseling from a
positive perspective to enable their patients to take charge of a
mental health problem and overcome it. Medications are now the only
answer. This may have been anticipated that other doctors will need
to help fill the shortage in an as needed basis.
The psychiatrists and psychologists are
in short supply in most states and this is one reason many governors
discouraged mental health exams for gun owners and this confirms the
continuing shortage. See my blog here about the medications being
encouraged for most mental conditions.
According to the WebMD article, an
estimated 32 million people will gain mental health or substance use
disorder benefits, or both, as a result of the Affordable Care Act
(ACA). This results from the requirement that small group and
individual insurance plans offer coverage for mental health issues
and substance abuse services. The author claims most large insurance
plans already include such coverage; however, my blog here shows how
large insurance companies side step their obligations. Maybe under
ACA they will not do this as much.
The author quotes Susan Lindau, a
licensed clinical social worker and associate adjunct professor at
the University of Southern California School of Social Work in Los
Angeles, as saying, "parity has been written into the law so
mental health coverage ostensibly should be much easier to access."
Andrew Sperling, director of
legislative advocacy for the National Alliance on Mental Illness
(NAMI), is quoted as saying, "We're still waiting for the
final regulations. And, because of the Supreme Court decision, the
Medicaid expansion is optional, and a large number of states are
talking about not participating. There are a high percentage of
people that have a diagnosable mental illness living below the
poverty line."
There are two sides to this issue and
for the most part, more people will have more mental health care than
before, but a large number may still be unserved. This is a loophole
that needs to be eliminated, but with the current congressional
climate, may not be for several years.
With the current DSM5 guidelines, many
other doctors may see the shortage as a way of using prescription
medications recommended under DSM5 as a way to treat more patients.
Mental health care will fail under this treatment and more serious
mental health problems may become worse.
With the problems people with diabetes
have, this may not be good for people with diabetes needing treatment
for depression.
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