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Mental health care a high priority

A depressed man alone at sunset, saddened by life. (Photo: songpholt, via Shutterstock)

Behavioral health is a touchy subject for many.

For some, there is a stigma attached to receiving mental health care. Sometimes, help is hard to find.  Understanding the roots of a behavioral problem can be difficult, and there are additional barriers of cost, insurance coverage and the amount of time that must be invested to visit a mental health specialist.

With the Affordable Care Act, behavioral health coverage has been expanded to lower income people on Medi-Cal who otherwise could not afford therapy.

Politically, the issue crosses partisan, ethnic and racial lines — a rarity in an increasingly hyperpartisan political environment.

That expansion generally is in line with the results of a recent statewide survey.

According to a poll by the Institute for Governmental Studies at UC Berkeley, Californians are strongly supportive of insurance plans that cover mental health care.  The survey, commissioned by the California Healthcare Foundation, reported that three in four Californians (74 percent) feel it’s very important for insurance plans to cover treatment for mental health conditions.

“We have come to a place at which people now understand behavioral health is not just a nice add on that some larger group plans,” said Catherine Teare, an Associate Director at the California Healthcare Foundation.  “Increasingly the culture is changing so people do understand mental health and substance abuse services are an essential part of overall health care coverage.”

Politically, the issue crosses partisan, ethnic and racial lines — a rarity in an increasingly hyperpartisan political environment.

Support is consistent across all political parties, though strongest among Democrats (86 percent), followed by independents (67 percent), and Republicans (59 percent).

Women (83 percent) are more supportive than men (65 percent) by a nearly 20-point margin, and more than eight in 10 Latinos and African Americans support behavioral health coverage. It drops to 70 percent among whites and drops even further to 60 percent among Asians.

When asked if they or a family member received mental health treatment for a condition like depression or anxiety in the last year, 22 percent said they had.

“Typically we see something of a differential because women tend to manage health care and health insurance for their families,” said Teare.  “There may be some difference about stigma between men and women on mental health needs.”

When asked if they would seek treatment for mental health issues, such as depression or anxiety, if it was covered by insurance and created no financial burden, two-thirds of respondents said they would very likely seek treatment, with Democrats (75 percent) in the lead, followed by independents (59 percent), and Republicans (54 percent).

When asked if they or a family member received mental health treatment for a condition like depression or anxiety in the last year, 22 percent said they had.  This drops to just 4 percent when asked if they or a family member received treatment for an alcohol or drug use problem.

For respondents or family members that sought treatment for depression and anxiety it’s highest among whites (30 percent), followed by African-Americans (19 percent), Latinos (16 percent) and Asians (11 percent).  Among Latinos there was a significant difference between those that that took the poll in English (26 percent) and those that took the poll in Spanish (7 percent).

The disparity of Spanish- and English-speaking Latinos in the poll was highlighted again when respondents were asked whether treatment can help people with mental illness lead healthy and productive lives.

Just half of Spanish-speaking Latinos (50 percent) said this was true, while 47 percent don’t know.  This is in comparison with about 8 out of 10 whites, Asians, and English speaking Latinos and nearly 9 out of 10 African-Americans who said this is true.

About 9 out of 10 respondents with annual incomes over $40,000 believe treatment can help people with mental illness lead healthy and productive lives.

“I think its shows how pervasive our language access problem continues to be,” said Kiran Savage-Sangwan, Policy Director at the California Pan-Ethnic Health Network.

“Different populations have had very different experiences with our mental health care system.  It’s a perception borne out by outcomes by our health care system.  We have a mental health care system that is not culturally and linguistically competent.  We know most mental health care providers are not bilingual.”

These numbers correlate with income and type of health insurance.

About 9 out of 10 respondents with annual incomes over $40,000 believe treatment can help people with mental illness lead healthy and productive lives, while it’s just 73 percent of respondents with income between $20,000-to-$40,000 and 63 percent of respondents with incomes less than $20,000.

For those respondents with insurance through their employer or independently purchased insurance, 83 percent find the statement true, while for those who are insured by Medicare it’s 67 percent and those insured through Medi-Cal it’s 65 percent.

“California provides medical beneficiaries a spectrum of services and it changed a lot with implementation of the Affordable Care Act.  We have expanded a lot of benefits and services through the ACA.  I think that it’s not something that people necessarily know about,” said Savage-Sangwan.

“We went from a system that provided people limited access to mental health and people who have had difficulty getting mental health who don’t know about their benefit, and it’s something that the state should address,” she said.

 


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