As a child psychiatrist who has worked within the managed care system, I appreciate the article “Maryland mental health and addiction providers face financial and staffing pressures: ‘like a game of whack-a-mole,'” (April 14) highlighting the complete failure of our mental health system, especially for those with persistent illness and minimal social supports.
This is a national problem, and it would be interesting for your readers to understand more about these failures as they relate to the public mental health system being turned over to for-profit insurance companies that take dollars from patient care through refusal to authorize needed services and denials of care, and direct those dollars to their profits. These companies are well-organized profit machines intent on denying patients appropriate care or treatment and are structured to that end. Psychiatrists have become tools of decisions made by these companies as most hospitals refuse to stand up to these decisions for fear of losing money.
As for-profit managed care has assumed control of much of the country’s public mental health system, we have seen fewer dollars spent on mental health care in the past few decades, as suicides and drug overdoses escalate more rapidly than any time in history and access to treatment becomes more and more difficult. In psychiatry our patients and their critical treatment needs are undermined and ignored by the managed care industry and its decisions daily. In particular, the for-profit managed care industry has stabbed mental health providers and patients in the back under the guise of advocating for high-quality mental health and substance use treatment. Their motives are clear: billions of dollars in quarterly profit are funneled into insurance companies, and each of these dollars has been diverted from our patients and their treatment needs.
The data is clear, and the correlation between the onslaught of managed care denials reveals a path of destruction in escalating overdoses, increasing rates of suicide, especially among children and teens, and the continual shrinking of community-based mental health and substance use services. These actions are condoned by state and federal government legislative support, which results in a dictatorship of decisions whereby our patients have almost no chance of overturning a denial or obtaining needed services that are not authorized or not offered by their managed care organization. These “medical necessity” decisions will continue to harm our patients unless they are built upon scientific and clinical consensus and developed by independent experts. Until our state and federal legislators act to stop the destruction of our mental health system and work to create a system that benefits those in need, only the insurance company profiteers will benefit from the current system.
— Drew Pate, Baltimore
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