Single Mom's Search for Therapist Foiled by Insurance Companies
How Therapy Became A Hobby of the Wealthy – Rather Than A Necessity for the Mentally Ill
Frustrated You Can't Find a Therapist? They're Frustrated, Too
A Decade Later, Obama Advances 'Mental Health Parity'
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Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. 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The other kids in the park aren’t interested in him. And he’s not interested in them.\u003c/p>\n\u003cp>“I just like to play by myself,” he says.\u003c/p>\n\u003cp>Strazh has autism. Today is a good day. But on most others, Strazh has meltdowns. Something frustrates him and he can’t control his emotions.\u003c/p>\n\u003cp>“I sometimes end up screaming,” he says. “And I end up yelling and screaming.”\u003c/p>\n\u003cp>And hitting and banging things, throwing things, adds Strazh’s mom, Natalie Dunnege. As a single parent, she says she bears the brunt of it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“He told me that I disgusted him,” she says softly. “He tells me he hates me.”\u003c/p>\n\u003cp>Dunnege puts all her spare money into therapy for Strazh. She says it helps a lot. But Dunnege herself is struggling, feeling depressed and overwhelmed. She decided to look for her own therapist.\u003c/p>\n\u003cp>“One of the things that I’ve really had to wrap my head around is that I can’t change him. I can only change how I handle the situation,” she explains. “And not that I would want to change who he is. He’s a really good kid, but it’s a lot to handle, especially as a single parent.”\u003c/p>\n\u003cp>But when she logged onto her insurance website to find a therapist, she realized her copay for a mental health visit was going to be upwards of $75 – more than double her copay for other doctors’ appointments. Under a 2008 federal mental health law, those copays are supposed to be the same.\u003c/p>\n\u003cp>“There’s no way,” Dunnege says. “It’s out of my budget right now.”\u003c/p>\n\u003cfigure id=\"attachment_186111\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-186111\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/1010622-e1463762466497.jpg\" alt=\"Natalie Dunnege and her son, Strazh.\" width=\"1920\" height=\"1280\">\u003cfigcaption class=\"wp-caption-text\">Natalie Dunnege and her son, Strazh. \u003ccite>(Sheraz Sadiq/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dunnege lives in a one-bedroom apartment with her son and her father in San Francisco's Haight district. Grandfather and grandson sleep in twin beds side by side. It’s an awkward walk past those beds to the only bathroom. Dunnege says $75 a week for therapy is impossible.\u003c/p>\n\u003cp>“My income, I just made lower middle income. Just by the skin of my teeth,” she says. “So I just have to hold off until I’m actually middle class.”\u003c/p>\n\u003cp>More than 43 million Americans suffer from depression, anxiety and other mental health conditions, according to the most recent \u003ca href=\"http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014.htm\" target=\"_blank\" rel=\"noopener noreferrer\">federal data\u003c/a>. But more than half the people who felt like they needed help last year, never got it. Even people who had insurance complained of barriers to care. Some said they still couldn't afford it; some were embarrassed to ask for help. Others just couldn't get through \u003ca href=\"http://www.nap.edu/catalog/23442/ending-discrimination-against-people-with-mental-and-substance-use-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">the red tape\u003c/a>.\u003c/p>\n\u003cp>Recent health laws, the 2008 Mental Health Parity Act and the Affordable Care Act, were supposed to fix this. They require health plans to provide benefits for mental health conditions on par with physical health conditions. Under the law, insurance companies can’t charge higher copays or set up separate deductibles for mental health care compared to other medical or surgical care. They can’t limit hospital stays or require preauthorization for mental health treatment if the same limits are not applied to treatment for physical health conditions.\u003c/p>\n\u003cp>But advocates say insurance companies are still finding ways to keep people who need care from getting it. Some are still not complying with the law. And some have found subtle, technically legally, ways to limit treatment.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/265497893\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\u003cstrong>Problems with Mental Health Provider Directories\u003c/strong>\u003c/p>\n\u003cp>Natalie Dunnege encountered some of these barriers when she tried again to find a therapist. In the last year, she got a promotion at work and moved into a larger apartment. Her employer switched to a better health plan, too. Now she has Blue Shield coverage, and her copay for mental health appointments is only $20.\u003c/p>\n\u003cp>\"Which I was really excited about,\" Dunnege says.\u003c/p>\n\u003cp>But when she looked for a therapist who took her insurance, she struck out.\u003c/p>\n\u003cp>“I contacted six or seven,” she says.\u003c/p>\n\u003cp>Only three called her back.\u003c/p>\n\u003cp>“One of them, they were completely booked,” she says. “And then the other two just didn’t accept the insurance anymore.”\u003c/p>\n\u003cp>Zero hits out of seven. Had to be a bad draw, right?\u003c/p>\n\u003cp>To find out, we decided to conduct our own survey and called all the psychologists -- 100 in total -- that were listed on the Blue Shield website for Natalie’s plan in San Francisco.\u003c/p>\n\u003cp>Here's what happened:\u003c/p>\n\u003cfigure id=\"attachment_186898\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg\">\u003cimg class=\"wp-image-186898 size-full\" title=\"Blue Shield In-Network Psychologists\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg\" alt=\"mentalHealthTreatmentPost\" width=\"1920\" height=\"2055\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-400x428.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-800x856.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-768x822.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-1440x1541.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-1180x1263.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-960x1028.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lisa Pickoff-White/KQED \u003ccite>(Lisa Pickoff-White/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The end result: 28 psychologists actually had appointments. And only eight of them had slots available outside regular work hours. Eight out of 100.\u003c/p>\n\u003cp>“Sorry, I wish you the best of luck,” was a common refrain in therapists’ voicemail messages.\u003c/p>\n\u003cp>For Natalie Dunnege, after seven rejections, she gave up looking.\u003c/p>\n\u003cp>\"It's hard when you're feeling sad and you feel like you can barely keep things together,” she says. “It just seemed like way too much at the time.”\u003c/p>\n\u003cp>Mental health advocates say this is exactly what insurance companies are hoping.\u003c/p>\n\u003cp>“It’s a way to control cost,” says Keith Humphreys, a Stanford psychiatry professor who served as an advisor to Congress when it was developing the 2008 Mental Health Parity Act. He says while insurers are now required to keep an adequate number of clinicians listed in their directories, they still find ways to sidestep the rules.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KbISjuBjk7yP8P3jc2UosQlAqr1b85dD\"]“You know the law doesn't say you can't put people on there who are dead, or you can't put people on there who are not taking new patients,” he says. “What that translates into, then, is people have to wait longer for care, which then cuts expenditures for the insurer and reduces access.”\u003c/p>\n\u003cp>California passed a law last year, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB137\" target=\"_blank\" rel=\"noopener noreferrer\">SB 137\u003c/a>, raising the standards for physician directories. Insurers will have to police their lists for providers who are booked or retired. But a lot of questions remain about how the law will be enforced, especially when it comes to mental health providers, who are largely self-employed, solo practitioners.\u003c/p>\n\u003cp>The insurance industry says it will be a challenge.\u003c/p>\n\u003cp>“When you have networks as large as ours and you have as many enrollees as we have here in California, you're not going to be able to just have everything accurate every single second of every single day,” says Charles Bacchi, CEO of the California Association of Health Plans.\u003c/p>\n\u003cp>He said the industry is working to make it better.\u003c/p>\n\u003cp>“But we also need to be realistic,” he says. “We don't run a mental health provider's office. They do. And how they handle people calling their offices is their job.”\u003c/p>\n\u003cp>In a statement, Blue Shield said it tries to make it easy for providers to update changes in their contact information and schedule.\u003c/p>\n\u003cp>“We understand that there are a number of issues that impact a provider's availability to take new patients, such as administrative limitations and fluctuating numbers of patients based on their individual needs. When those instances arise, the provider is required to notify us so that patients have access to the most up-to-date information about who is available in their area.\"\u003c/p>\n\u003cp>The industry also says it’s facing another challenge: a nationwide shortage of mental health providers, further exacerbated by the millions of people who signed up for insurance under the Affordable Care Act.\u003c/p>\n\u003cp>In California, there are \"around 4 to 5 million more people with coverage, just in the last two years,” Bacchi says. “And that’s creating a strain for everybody, plans and mental health providers.”\u003c/p>\n\u003cp>But is it really just a supply and demand problem? Is it that there aren’t enough therapists, or is it that there aren’t enough therapists who are willing to work under the terms and rates set by the insurance companies?\u003c/p>\n\u003cp>\u003cem>This story was originally published on May 23, 2016. The video will be broadcast on KQED Newsroom July 15, 2016. \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"A single mom, a son with autism and a maddening search for the help she badly needed. ","status":"publish","parent":0,"modified":1633454531,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":46,"wordCount":1440},"headData":{"title":"Single Mom’s Search for Therapist Foiled by Insurance Companies - State of Health","description":"A single mom, a son with autism and a maddening search for the help she badly needed. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"185796 http://ww2.kqed.org/stateofhealth/?p=185796","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/07/15/single-moms-search-for-therapist-foiled-by-insurance-companies/","disqusTitle":"Single Mom's Search for Therapist Foiled by Insurance Companies","videoEmbed":"https://youtu.be/yFsEBqebRGc","customPermalink":"2016/05/23/single-moms-search-for-therapist-foiled-by-insurance-companies/","path":"/stateofhealth/185796/single-moms-search-for-therapist-foiled-by-insurance-companies","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">A\u003c/span> 12-year-old boy named Strazh hangs from the monkey bars, staring at the ground. The other kids in the park aren’t interested in him. And he’s not interested in them.\u003c/p>\n\u003cp>“I just like to play by myself,” he says.\u003c/p>\n\u003cp>Strazh has autism. Today is a good day. But on most others, Strazh has meltdowns. Something frustrates him and he can’t control his emotions.\u003c/p>\n\u003cp>“I sometimes end up screaming,” he says. “And I end up yelling and screaming.”\u003c/p>\n\u003cp>And hitting and banging things, throwing things, adds Strazh’s mom, Natalie Dunnege. As a single parent, she says she bears the brunt of it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“He told me that I disgusted him,” she says softly. “He tells me he hates me.”\u003c/p>\n\u003cp>Dunnege puts all her spare money into therapy for Strazh. She says it helps a lot. But Dunnege herself is struggling, feeling depressed and overwhelmed. She decided to look for her own therapist.\u003c/p>\n\u003cp>“One of the things that I’ve really had to wrap my head around is that I can’t change him. I can only change how I handle the situation,” she explains. “And not that I would want to change who he is. He’s a really good kid, but it’s a lot to handle, especially as a single parent.”\u003c/p>\n\u003cp>But when she logged onto her insurance website to find a therapist, she realized her copay for a mental health visit was going to be upwards of $75 – more than double her copay for other doctors’ appointments. Under a 2008 federal mental health law, those copays are supposed to be the same.\u003c/p>\n\u003cp>“There’s no way,” Dunnege says. “It’s out of my budget right now.”\u003c/p>\n\u003cfigure id=\"attachment_186111\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-186111\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/1010622-e1463762466497.jpg\" alt=\"Natalie Dunnege and her son, Strazh.\" width=\"1920\" height=\"1280\">\u003cfigcaption class=\"wp-caption-text\">Natalie Dunnege and her son, Strazh. \u003ccite>(Sheraz Sadiq/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dunnege lives in a one-bedroom apartment with her son and her father in San Francisco's Haight district. Grandfather and grandson sleep in twin beds side by side. It’s an awkward walk past those beds to the only bathroom. Dunnege says $75 a week for therapy is impossible.\u003c/p>\n\u003cp>“My income, I just made lower middle income. Just by the skin of my teeth,” she says. “So I just have to hold off until I’m actually middle class.”\u003c/p>\n\u003cp>More than 43 million Americans suffer from depression, anxiety and other mental health conditions, according to the most recent \u003ca href=\"http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014.htm\" target=\"_blank\" rel=\"noopener noreferrer\">federal data\u003c/a>. But more than half the people who felt like they needed help last year, never got it. Even people who had insurance complained of barriers to care. Some said they still couldn't afford it; some were embarrassed to ask for help. Others just couldn't get through \u003ca href=\"http://www.nap.edu/catalog/23442/ending-discrimination-against-people-with-mental-and-substance-use-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">the red tape\u003c/a>.\u003c/p>\n\u003cp>Recent health laws, the 2008 Mental Health Parity Act and the Affordable Care Act, were supposed to fix this. They require health plans to provide benefits for mental health conditions on par with physical health conditions. Under the law, insurance companies can’t charge higher copays or set up separate deductibles for mental health care compared to other medical or surgical care. They can’t limit hospital stays or require preauthorization for mental health treatment if the same limits are not applied to treatment for physical health conditions.\u003c/p>\n\u003cp>But advocates say insurance companies are still finding ways to keep people who need care from getting it. Some are still not complying with the law. And some have found subtle, technically legally, ways to limit treatment.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/265497893&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/265497893'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Problems with Mental Health Provider Directories\u003c/strong>\u003c/p>\n\u003cp>Natalie Dunnege encountered some of these barriers when she tried again to find a therapist. In the last year, she got a promotion at work and moved into a larger apartment. Her employer switched to a better health plan, too. Now she has Blue Shield coverage, and her copay for mental health appointments is only $20.\u003c/p>\n\u003cp>\"Which I was really excited about,\" Dunnege says.\u003c/p>\n\u003cp>But when she looked for a therapist who took her insurance, she struck out.\u003c/p>\n\u003cp>“I contacted six or seven,” she says.\u003c/p>\n\u003cp>Only three called her back.\u003c/p>\n\u003cp>“One of them, they were completely booked,” she says. “And then the other two just didn’t accept the insurance anymore.”\u003c/p>\n\u003cp>Zero hits out of seven. Had to be a bad draw, right?\u003c/p>\n\u003cp>To find out, we decided to conduct our own survey and called all the psychologists -- 100 in total -- that were listed on the Blue Shield website for Natalie’s plan in San Francisco.\u003c/p>\n\u003cp>Here's what happened:\u003c/p>\n\u003cfigure id=\"attachment_186898\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg\">\u003cimg class=\"wp-image-186898 size-full\" title=\"Blue Shield In-Network Psychologists\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg\" alt=\"mentalHealthTreatmentPost\" width=\"1920\" height=\"2055\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-400x428.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-800x856.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-768x822.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-1440x1541.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-1180x1263.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/mentalHealthTreatmentPost-960x1028.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lisa Pickoff-White/KQED \u003ccite>(Lisa Pickoff-White/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The end result: 28 psychologists actually had appointments. And only eight of them had slots available outside regular work hours. Eight out of 100.\u003c/p>\n\u003cp>“Sorry, I wish you the best of luck,” was a common refrain in therapists’ voicemail messages.\u003c/p>\n\u003cp>For Natalie Dunnege, after seven rejections, she gave up looking.\u003c/p>\n\u003cp>\"It's hard when you're feeling sad and you feel like you can barely keep things together,” she says. “It just seemed like way too much at the time.”\u003c/p>\n\u003cp>Mental health advocates say this is exactly what insurance companies are hoping.\u003c/p>\n\u003cp>“It’s a way to control cost,” says Keith Humphreys, a Stanford psychiatry professor who served as an advisor to Congress when it was developing the 2008 Mental Health Parity Act. He says while insurers are now required to keep an adequate number of clinicians listed in their directories, they still find ways to sidestep the rules.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“You know the law doesn't say you can't put people on there who are dead, or you can't put people on there who are not taking new patients,” he says. “What that translates into, then, is people have to wait longer for care, which then cuts expenditures for the insurer and reduces access.”\u003c/p>\n\u003cp>California passed a law last year, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB137\" target=\"_blank\" rel=\"noopener noreferrer\">SB 137\u003c/a>, raising the standards for physician directories. Insurers will have to police their lists for providers who are booked or retired. But a lot of questions remain about how the law will be enforced, especially when it comes to mental health providers, who are largely self-employed, solo practitioners.\u003c/p>\n\u003cp>The insurance industry says it will be a challenge.\u003c/p>\n\u003cp>“When you have networks as large as ours and you have as many enrollees as we have here in California, you're not going to be able to just have everything accurate every single second of every single day,” says Charles Bacchi, CEO of the California Association of Health Plans.\u003c/p>\n\u003cp>He said the industry is working to make it better.\u003c/p>\n\u003cp>“But we also need to be realistic,” he says. “We don't run a mental health provider's office. They do. And how they handle people calling their offices is their job.”\u003c/p>\n\u003cp>In a statement, Blue Shield said it tries to make it easy for providers to update changes in their contact information and schedule.\u003c/p>\n\u003cp>“We understand that there are a number of issues that impact a provider's availability to take new patients, such as administrative limitations and fluctuating numbers of patients based on their individual needs. When those instances arise, the provider is required to notify us so that patients have access to the most up-to-date information about who is available in their area.\"\u003c/p>\n\u003cp>The industry also says it’s facing another challenge: a nationwide shortage of mental health providers, further exacerbated by the millions of people who signed up for insurance under the Affordable Care Act.\u003c/p>\n\u003cp>In California, there are \"around 4 to 5 million more people with coverage, just in the last two years,” Bacchi says. “And that’s creating a strain for everybody, plans and mental health providers.”\u003c/p>\n\u003cp>But is it really just a supply and demand problem? Is it that there aren’t enough therapists, or is it that there aren’t enough therapists who are willing to work under the terms and rates set by the insurance companies?\u003c/p>\n\u003cp>\u003cem>This story was originally published on May 23, 2016. The video will be broadcast on KQED Newsroom July 15, 2016. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/185796/single-moms-search-for-therapist-foiled-by-insurance-companies","authors":["3205"],"series":["stateofhealth_2768"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_68","stateofhealth_2713","stateofhealth_2519"],"featImg":"stateofhealth_186111","label":"stateofhealth_2768"},"stateofhealth_186794":{"type":"posts","id":"stateofhealth_186794","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"186794","score":null,"sort":[1464093025000]},"guestAuthors":[],"slug":"how-therapy-became-a-hobby-of-the-wealthy-rather-than-a-necessity-for-the-mentally-ill","title":"How Therapy Became A Hobby of the Wealthy – Rather Than A Necessity for the Mentally Ill","publishDate":1464093025,"format":"image","headTitle":"State of Mind | State of Health | KQED News","labelTerm":{"term":2768,"site":"stateofhealth"},"content":"\u003cp>There’s something that really bothers Stanford psychiatry professor Keith Humphreys. When he thinks of all the years he spends training the next generation of psychiatrists, the enormous investment in medical school and residency, he wants them to devote that education to taking care of people with serious mental illness.\u003c/p>\n\u003cp>But many of them instead set up a private practice, where they can charge $400 an hour in cash to help people who Humphreys calls “the worried well” –- people who enjoy the self-exploration of therapy but do not necessarily have a mental health problem.\u003c/p>\n\u003cp>\"A minute I spend training that person is a minute of my life wasted,” Humphreys says. “That very well-trained person should be taking care of very, very troubled people. When they don’t, everyone who needs that care loses out.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'They’re horribly addicted to OxyContin or their child is showing signs of bipolar disorder, and they can’t find somebody to take their insurance. It’s unjust.'\u003ccite>Keith Humphreys, Stanford Psychiatry Professor \u003c/cite>\u003c/aside>\n\u003cp>Humphreys says this trend of mental health clinicians shunning the health insurance industry and decamping to the cash market dates back 70 years, to the end of World War II.\u003c/p>\n\u003cp>In 1946, the majority of veterans cared for by what was then called the Veterans Administration were mental health patients, Humphreys says. But there weren’t enough mental health providers to take care of them. So the VA partnered with several medical schools, including Stanford where Humphreys teaches, to train mental health professionals.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Those schools started turning out hundreds and hundreds of psychologists a year. The expansion dovetailed with soaring American affluence -- and soaring American interest in self-exploration.\u003c/p>\n\u003cp>Having a psychoanalyst became \"a sort of status symbol,\" Humphreys says.\u003c/p>\n\u003cp>A lot of psychologists who were trained to work in the public sector saw a better financial opportunity and jumped ship. They hung shingles and started their own private practices where they could charge wealthy people much higher rates.\u003c/p>\n\u003cp>“When you put in a free market in a society where people were very interested in self-exploration, a lot of them went out and did their own thing,” Humphreys says.\u003c/p>\n\u003cfigure id=\"attachment_187932\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-187932\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/keithatDavos-400x225.jpg\" alt=\"Stanford psychiatry professor Keith Humphreys\" width=\"400\" height=\"225\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-1440x810.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-960x540.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">Stanford psychiatry professor Keith Humphreys \u003ccite>(Courtesy: Keith Humphreys)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The reason this was possible is because of how the overall U.S. health care system was established, Humphreys says. Most people got their health insurance through work. Employers competed with each other for the best employees by offering better benefits.\u003c/p>\n\u003cp>So the standards for coverage developed over time in a piecemeal, haphazard way.\u003c/p>\n\u003cp>As health policy evolved, mental health benefits continuously lagged, Humphreys says. Coverage for mental health treatments or hospitalizations was meager or nonexistent.\u003c/p>\n\u003cp>“We don’t seem to have this problem with cardiology or oncology,” Humphreys says. “You don’t see people lining up to pay cash for those services because the benefits are so low.\"\u003c/p>\n\u003cp>This wouldn’t happen in places that have single-payer health systems, like Canada, Humphreys says, because all the health care payments are controlled by the government. Mental health care was baked into that system earlier on.\u003c/p>\n\u003cp>As a result, people in Canada with more severe mental illness are more likely to get services, according to \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJM199702203360806\" target=\"_blank\">a study\u003c/a> published in the New England Journal of Medicine.\u003c/p>\n\u003cp>That’s not the case in the U.S. People with less serious mental health conditions get more services here. Humphreys says it's mainly wealthy people who fall into the worried well category, who are consuming psychotherapy.\u003c/p>\n\u003cp>“If it’s a market where you pretty much have to pay for yourself, the rich are always going to win,” he says.\u003c/p>\n\u003cp>The growing workforce of psychiatrists, psychologists, marriage and family therapists, and licensed social workers has responded to that market demand.\u003c/p>\n\u003cp>And not just because it’s better money. Treating high-functioning professionals in a private office is a lot less stressful than doing rounds on a psychiatric ward of a public hospital.\u003c/p>\n\u003cp>“It’s understandable why someone would say this is really demanding,” Humphreys says. “For my own well-being or professional satisfaction, I’m going to stop doing this and move into doing outpatient psychotherapy with executives from Google who have angst. My salary goes up dramatically and my work is much, much easier.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"tU61AbaxNL1XAbjFbyvdGvgJyPnAKYCV\"]Especially in affluent places like the Bay Area, this creates a divide, a culture of mental health haves and have-nots. Mental health clinicians don’t need to participate in the health care system or take insurance to keep their schedules full -- making it harder and harder for people of lower income to find a therapist.\u003c/p>\n\u003cp>“That’s why you can have a lot of mental health professionals in an area, but still have a shortage of care for people in need,” Humphreys adds. “The person who’s hurt is the person who’s suicidal, maybe they’re horribly addicted to OxyContin or their child is showing signs of bipolar disorder, and they can’t find somebody to take their insurance. It’s unjust.”\u003c/p>\n\u003cp>Mental health advocates have worked to shift this balance, passing the Mental Health Parity and Addiction Equity Act of 2008 and the Affordable Care Act in 2010. Together, those laws require health plans to offer mental health coverage on par with other medical coverage.\u003c/p>\n\u003cp>But so far, it hasn’t put a dent in the cash market for mental health. Humphreys says given the nature of mental health care and the American obsession with self-improvement, the cash market will be here to stay.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Accessing mental health care is often pleasurable and enjoyable, and accessing a lot of other health care isn’t,” Humphreys says. “I mean, who goes to the dentist for fun?”\u003c/p>\n\n","blocks":[],"excerpt":"It goes back to the byzantine way health care -- and health insurance -- developed in the U.S. in the wake of World War II. ","status":"publish","parent":0,"modified":1464903392,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1006},"headData":{"title":"How Therapy Became A Hobby of the Wealthy – Rather Than A Necessity for the Mentally Ill | KQED","description":"It goes back to the byzantine way health care -- and health insurance -- developed in the U.S. in the wake of World War II. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"186794 http://ww2.kqed.org/stateofhealth/?p=186794","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/05/24/how-therapy-became-a-hobby-of-the-wealthy-rather-than-a-necessity-for-the-mentally-ill/","disqusTitle":"How Therapy Became A Hobby of the Wealthy – Rather Than A Necessity for the Mentally Ill","path":"/stateofhealth/186794/how-therapy-became-a-hobby-of-the-wealthy-rather-than-a-necessity-for-the-mentally-ill","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>There’s something that really bothers Stanford psychiatry professor Keith Humphreys. When he thinks of all the years he spends training the next generation of psychiatrists, the enormous investment in medical school and residency, he wants them to devote that education to taking care of people with serious mental illness.\u003c/p>\n\u003cp>But many of them instead set up a private practice, where they can charge $400 an hour in cash to help people who Humphreys calls “the worried well” –- people who enjoy the self-exploration of therapy but do not necessarily have a mental health problem.\u003c/p>\n\u003cp>\"A minute I spend training that person is a minute of my life wasted,” Humphreys says. “That very well-trained person should be taking care of very, very troubled people. When they don’t, everyone who needs that care loses out.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'They’re horribly addicted to OxyContin or their child is showing signs of bipolar disorder, and they can’t find somebody to take their insurance. It’s unjust.'\u003ccite>Keith Humphreys, Stanford Psychiatry Professor \u003c/cite>\u003c/aside>\n\u003cp>Humphreys says this trend of mental health clinicians shunning the health insurance industry and decamping to the cash market dates back 70 years, to the end of World War II.\u003c/p>\n\u003cp>In 1946, the majority of veterans cared for by what was then called the Veterans Administration were mental health patients, Humphreys says. But there weren’t enough mental health providers to take care of them. So the VA partnered with several medical schools, including Stanford where Humphreys teaches, to train mental health professionals.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Those schools started turning out hundreds and hundreds of psychologists a year. The expansion dovetailed with soaring American affluence -- and soaring American interest in self-exploration.\u003c/p>\n\u003cp>Having a psychoanalyst became \"a sort of status symbol,\" Humphreys says.\u003c/p>\n\u003cp>A lot of psychologists who were trained to work in the public sector saw a better financial opportunity and jumped ship. They hung shingles and started their own private practices where they could charge wealthy people much higher rates.\u003c/p>\n\u003cp>“When you put in a free market in a society where people were very interested in self-exploration, a lot of them went out and did their own thing,” Humphreys says.\u003c/p>\n\u003cfigure id=\"attachment_187932\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-187932\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/keithatDavos-400x225.jpg\" alt=\"Stanford psychiatry professor Keith Humphreys\" width=\"400\" height=\"225\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-1440x810.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/keithatDavos-960x540.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">Stanford psychiatry professor Keith Humphreys \u003ccite>(Courtesy: Keith Humphreys)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The reason this was possible is because of how the overall U.S. health care system was established, Humphreys says. Most people got their health insurance through work. Employers competed with each other for the best employees by offering better benefits.\u003c/p>\n\u003cp>So the standards for coverage developed over time in a piecemeal, haphazard way.\u003c/p>\n\u003cp>As health policy evolved, mental health benefits continuously lagged, Humphreys says. Coverage for mental health treatments or hospitalizations was meager or nonexistent.\u003c/p>\n\u003cp>“We don’t seem to have this problem with cardiology or oncology,” Humphreys says. “You don’t see people lining up to pay cash for those services because the benefits are so low.\"\u003c/p>\n\u003cp>This wouldn’t happen in places that have single-payer health systems, like Canada, Humphreys says, because all the health care payments are controlled by the government. Mental health care was baked into that system earlier on.\u003c/p>\n\u003cp>As a result, people in Canada with more severe mental illness are more likely to get services, according to \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJM199702203360806\" target=\"_blank\">a study\u003c/a> published in the New England Journal of Medicine.\u003c/p>\n\u003cp>That’s not the case in the U.S. People with less serious mental health conditions get more services here. Humphreys says it's mainly wealthy people who fall into the worried well category, who are consuming psychotherapy.\u003c/p>\n\u003cp>“If it’s a market where you pretty much have to pay for yourself, the rich are always going to win,” he says.\u003c/p>\n\u003cp>The growing workforce of psychiatrists, psychologists, marriage and family therapists, and licensed social workers has responded to that market demand.\u003c/p>\n\u003cp>And not just because it’s better money. Treating high-functioning professionals in a private office is a lot less stressful than doing rounds on a psychiatric ward of a public hospital.\u003c/p>\n\u003cp>“It’s understandable why someone would say this is really demanding,” Humphreys says. “For my own well-being or professional satisfaction, I’m going to stop doing this and move into doing outpatient psychotherapy with executives from Google who have angst. My salary goes up dramatically and my work is much, much easier.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Especially in affluent places like the Bay Area, this creates a divide, a culture of mental health haves and have-nots. Mental health clinicians don’t need to participate in the health care system or take insurance to keep their schedules full -- making it harder and harder for people of lower income to find a therapist.\u003c/p>\n\u003cp>“That’s why you can have a lot of mental health professionals in an area, but still have a shortage of care for people in need,” Humphreys adds. “The person who’s hurt is the person who’s suicidal, maybe they’re horribly addicted to OxyContin or their child is showing signs of bipolar disorder, and they can’t find somebody to take their insurance. It’s unjust.”\u003c/p>\n\u003cp>Mental health advocates have worked to shift this balance, passing the Mental Health Parity and Addiction Equity Act of 2008 and the Affordable Care Act in 2010. Together, those laws require health plans to offer mental health coverage on par with other medical coverage.\u003c/p>\n\u003cp>But so far, it hasn’t put a dent in the cash market for mental health. Humphreys says given the nature of mental health care and the American obsession with self-improvement, the cash market will be here to stay.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Accessing mental health care is often pleasurable and enjoyable, and accessing a lot of other health care isn’t,” Humphreys says. “I mean, who goes to the dentist for fun?”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/186794/how-therapy-became-a-hobby-of-the-wealthy-rather-than-a-necessity-for-the-mentally-ill","authors":["3205"],"series":["stateofhealth_2768"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_68","stateofhealth_2713","stateofhealth_2519"],"featImg":"stateofhealth_187929","label":"stateofhealth_2768"},"stateofhealth_185843":{"type":"posts","id":"stateofhealth_185843","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"185843","score":null,"sort":[1464073283000]},"guestAuthors":[],"slug":"just-like-patients-therapists-also-battle-insurance-red-tape","title":"Frustrated You Can't Find a Therapist? They're Frustrated, Too","publishDate":1464073283,"format":"image","headTitle":"State of Mind | State of Health | KQED News","labelTerm":{"term":2768,"site":"stateofhealth"},"content":"\u003cp>When San Francisco resident Natalie Dunnege needed a therapist, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/23/single-moms-search-for-therapist-foiled-by-insurance-companies/\" target=\"_blank\">she couldn’t find one\u003c/a> who took her insurance.\u003c/p>\n\u003cp>“When I would call them they wouldn’t return my phone calls or they wouldn’t be accepting patients,” she says.\u003c/p>\n\u003cp>Insurance companies say there’s a shortage of therapists.\u003c/p>\n\u003cp>But it’s not that simple. Especially in urban areas, there are lots of therapists. They just don’t want to work with the insurance companies.\u003c/p>\n\u003cp>Take Michael Klein, a psychologist practicing in San Francisco for more than 20 years. He considers it his spiritual calling to help people calm their social anxiety and to help couples stop fighting and build trust.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“With the right kind of support, they blossom,” he says.\u003c/p>\n\u003cp>Klein doesn’t accept insurance -- and he’s far from alone. Nearly half of therapists in California don’t take insurance, according to a \u003ca href=\"http://www.camft.org/ias/images/PDFs/articles/mariam/2015_demographic_survey.pdf\" target=\"_blank\">recent survey\u003c/a> from the California Association of Marriage and Family Therapists. The same is true of \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967759/\">psychiatrists\u003c/a>. There are two reasons why, Klein says.\u003c/p>\n\u003caside class=\"pullquote alignright\">Insurance companies say there's a shortage of therapists, but therapists struggle to be accepted into a network.\u003c/aside>\n\u003cp>“One, because the reimbursement rates don’t provide a living wage,” Klein says. “You can’t own a home and drive a car and survive on what in-network providers pay you.”\u003c/p>\n\u003cp>Most insurance companies pay therapists in their networks between $60 and $80 per session. In the Bay Area and Los Angeles, therapists say the market rate for therapy is more like $150 or $200 a session.\u003c/p>\n\u003cp>“The second thing is the paperwork. For an hour of psychotherapy you spend a half hour of paperwork. So, I got into this field because I don’t like paper work,” Klein says with a laugh.\u003c/p>\n\u003cp>On that first point -- money -- insurance companies acknowledge that they may have to raise their rates to attract more therapists, particularly in rural areas. But they also say it’s on therapists to compromise.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/265685067\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>“I think it’s unrealistic to expect either the state of California taxpayers or for health plans to just pay providers whatever they ask to be paid,” says Charles Bacchi, CEO of the California Association of Health Plans, a trade group for the insurance industry.\u003c/p>\n\u003cp>“That's not sustainable,” he continues. “So you're either in the system, and you want to be part of our health care system. Or you want to do concierge service outside of it and just pretend our health care system doesn't exist. That's your choice as a provider. Our job is to find providers that are willing to be part of the solution and willing to provide coverage to those of low and moderate income.\"\u003c/p>\n\u003cp>That’s exactly how San Francisco psychologist Jonathan Horowitz feels. He wants to take insurance. But he’s hit roadblock after roadblock. He sent out 10 applications to insurance companies and got nowhere.\u003c/p>\n\u003cp>“I might knock on Cigna’s door and say, 'Hey are you guys accepting any new therapists in 94105?'” he says. “And they might say, 'No we’re not doing that. We’re totally full.'”\u003c/p>\n\u003cp>[contextly_sidebar id=\"eS6QVmoo2kjciQQ0tu4JO43ybZNtSzAw\"]\u003c/p>\n\u003cp>Six different companies told Horowitz their networks were full.\u003c/p>\n\u003cp>So even though a patient like Natalie Dunnege might call seven therapists in her insurance network and not be able to get an appointment, insurance companies are telling new and willing therapists that there’s no demand for them.\u003c/p>\n\u003cp>“I definitely think it’s to control costs,” Horowitz says. “That’s very clear.”\u003c/p>\n\u003cp>He tried for a year, and one company finally said yes. Sort of. Horowitz never got a formal notice saying his clinic was admitted to the network.\u003c/p>\n\u003cp>“It was just like, 'Oh wait, it looks like we’re suddenly getting a couple referrals from them. I wonder if we’re in their directory,'” he explains.\u003c/p>\n\u003cp>They were. Sort of. The clinic was listed in the directory. But the therapists who work at the clinic weren’t approved yet, meaning there was no one who was allowed to see the clients calling the clinic.\u003c/p>\n\u003cp>So Horowitz tried to call the insurance company to clear things up. He tried many, many times. Here’s what happened during his latest attempt to navigate the automated phone system:\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company automated attendant:\u003c/strong> First I’ll need your provider identification number. If you need a moment, say, hold on.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> Hold on.\u003c/em>\u003c/p>\n\u003cp>Sound familiar? Turns out therapists get the automated run around as much as patients do. Horowitz persevered.\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> Okay, please say or enter your pin.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> My pin? Is this my pin? (He enters a few numbers).\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> I’m sorry I couldn’t find an account using the info you gave me. Do you already belong to the network?\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> I think so?\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> Sorry, yes or no.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> Um, I don’t know ... yes?\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> Alright. And have you already requested a credentialing application?\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> Yes.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> Sorry could you repeat that.\u003c/em>\u003c/p>\n\u003cp>These experiences did not bode well from Horowitz' perspective.\u003c/p>\n\u003cp>“Honestly, I got a really bad feeling about it,” he says.\u003c/p>\n\u003cp>He figured, if this is what it’s like just finding out if he’s in the network, how’s it going to be when he has a problem with a claim and can’t get paid?\u003c/p>\n\u003cp>“I could just see that getting out of hand really quickly,” he says. “So at that point we just said, do we really even want to do this?”\u003c/p>\n\u003cp>Not just that. The reimbursement rate was even lower than he expected, and the billing was so complicated that he was going to have to hire someone to do it. He says he couldn’t afford that.\u003c/p>\n\u003cp>“We made the decision that we’re just going to cancel the contract and continue to go with cash,” he says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Easier said than done. Horowitz hasn’t been able to get through to anyone on the phone to cancel the contract. In the meantime, prospective patients are finding his name on the directory and are calling for appointments. Horowitz says he just has to say no.\u003c/p>\n\n","blocks":[],"excerpt":"Insurance companies say there's a shortage of therapists, yet one San Francisco psychologist tried for a year to be added to a network.","status":"publish","parent":0,"modified":1464903461,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":45,"wordCount":1127},"headData":{"title":"Frustrated You Can't Find a Therapist? They're Frustrated, Too | KQED","description":"Insurance companies say there's a shortage of therapists, yet one San Francisco psychologist tried for a year to be added to a network.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"185843 http://ww2.kqed.org/stateofhealth/?p=185843","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/05/24/just-like-patients-therapists-also-battle-insurance-red-tape/","disqusTitle":"Frustrated You Can't Find a Therapist? They're Frustrated, Too","path":"/stateofhealth/185843/just-like-patients-therapists-also-battle-insurance-red-tape","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When San Francisco resident Natalie Dunnege needed a therapist, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/23/single-moms-search-for-therapist-foiled-by-insurance-companies/\" target=\"_blank\">she couldn’t find one\u003c/a> who took her insurance.\u003c/p>\n\u003cp>“When I would call them they wouldn’t return my phone calls or they wouldn’t be accepting patients,” she says.\u003c/p>\n\u003cp>Insurance companies say there’s a shortage of therapists.\u003c/p>\n\u003cp>But it’s not that simple. Especially in urban areas, there are lots of therapists. They just don’t want to work with the insurance companies.\u003c/p>\n\u003cp>Take Michael Klein, a psychologist practicing in San Francisco for more than 20 years. He considers it his spiritual calling to help people calm their social anxiety and to help couples stop fighting and build trust.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“With the right kind of support, they blossom,” he says.\u003c/p>\n\u003cp>Klein doesn’t accept insurance -- and he’s far from alone. Nearly half of therapists in California don’t take insurance, according to a \u003ca href=\"http://www.camft.org/ias/images/PDFs/articles/mariam/2015_demographic_survey.pdf\" target=\"_blank\">recent survey\u003c/a> from the California Association of Marriage and Family Therapists. The same is true of \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967759/\">psychiatrists\u003c/a>. There are two reasons why, Klein says.\u003c/p>\n\u003caside class=\"pullquote alignright\">Insurance companies say there's a shortage of therapists, but therapists struggle to be accepted into a network.\u003c/aside>\n\u003cp>“One, because the reimbursement rates don’t provide a living wage,” Klein says. “You can’t own a home and drive a car and survive on what in-network providers pay you.”\u003c/p>\n\u003cp>Most insurance companies pay therapists in their networks between $60 and $80 per session. In the Bay Area and Los Angeles, therapists say the market rate for therapy is more like $150 or $200 a session.\u003c/p>\n\u003cp>“The second thing is the paperwork. For an hour of psychotherapy you spend a half hour of paperwork. So, I got into this field because I don’t like paper work,” Klein says with a laugh.\u003c/p>\n\u003cp>On that first point -- money -- insurance companies acknowledge that they may have to raise their rates to attract more therapists, particularly in rural areas. But they also say it’s on therapists to compromise.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/265685067&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/265685067'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“I think it’s unrealistic to expect either the state of California taxpayers or for health plans to just pay providers whatever they ask to be paid,” says Charles Bacchi, CEO of the California Association of Health Plans, a trade group for the insurance industry.\u003c/p>\n\u003cp>“That's not sustainable,” he continues. “So you're either in the system, and you want to be part of our health care system. Or you want to do concierge service outside of it and just pretend our health care system doesn't exist. That's your choice as a provider. Our job is to find providers that are willing to be part of the solution and willing to provide coverage to those of low and moderate income.\"\u003c/p>\n\u003cp>That’s exactly how San Francisco psychologist Jonathan Horowitz feels. He wants to take insurance. But he’s hit roadblock after roadblock. He sent out 10 applications to insurance companies and got nowhere.\u003c/p>\n\u003cp>“I might knock on Cigna’s door and say, 'Hey are you guys accepting any new therapists in 94105?'” he says. “And they might say, 'No we’re not doing that. We’re totally full.'”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Six different companies told Horowitz their networks were full.\u003c/p>\n\u003cp>So even though a patient like Natalie Dunnege might call seven therapists in her insurance network and not be able to get an appointment, insurance companies are telling new and willing therapists that there’s no demand for them.\u003c/p>\n\u003cp>“I definitely think it’s to control costs,” Horowitz says. “That’s very clear.”\u003c/p>\n\u003cp>He tried for a year, and one company finally said yes. Sort of. Horowitz never got a formal notice saying his clinic was admitted to the network.\u003c/p>\n\u003cp>“It was just like, 'Oh wait, it looks like we’re suddenly getting a couple referrals from them. I wonder if we’re in their directory,'” he explains.\u003c/p>\n\u003cp>They were. Sort of. The clinic was listed in the directory. But the therapists who work at the clinic weren’t approved yet, meaning there was no one who was allowed to see the clients calling the clinic.\u003c/p>\n\u003cp>So Horowitz tried to call the insurance company to clear things up. He tried many, many times. Here’s what happened during his latest attempt to navigate the automated phone system:\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company automated attendant:\u003c/strong> First I’ll need your provider identification number. If you need a moment, say, hold on.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> Hold on.\u003c/em>\u003c/p>\n\u003cp>Sound familiar? Turns out therapists get the automated run around as much as patients do. Horowitz persevered.\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> Okay, please say or enter your pin.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> My pin? Is this my pin? (He enters a few numbers).\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> I’m sorry I couldn’t find an account using the info you gave me. Do you already belong to the network?\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> I think so?\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> Sorry, yes or no.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> Um, I don’t know ... yes?\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> Alright. And have you already requested a credentialing application?\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Horowitz:\u003c/strong> Yes.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Insurance company:\u003c/strong> Sorry could you repeat that.\u003c/em>\u003c/p>\n\u003cp>These experiences did not bode well from Horowitz' perspective.\u003c/p>\n\u003cp>“Honestly, I got a really bad feeling about it,” he says.\u003c/p>\n\u003cp>He figured, if this is what it’s like just finding out if he’s in the network, how’s it going to be when he has a problem with a claim and can’t get paid?\u003c/p>\n\u003cp>“I could just see that getting out of hand really quickly,” he says. “So at that point we just said, do we really even want to do this?”\u003c/p>\n\u003cp>Not just that. The reimbursement rate was even lower than he expected, and the billing was so complicated that he was going to have to hire someone to do it. He says he couldn’t afford that.\u003c/p>\n\u003cp>“We made the decision that we’re just going to cancel the contract and continue to go with cash,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Easier said than done. Horowitz hasn’t been able to get through to anyone on the phone to cancel the contract. In the meantime, prospective patients are finding his name on the directory and are calling for appointments. Horowitz says he just has to say no.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/185843/just-like-patients-therapists-also-battle-insurance-red-tape","authors":["3205"],"series":["stateofhealth_2768"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_68","stateofhealth_2713","stateofhealth_2519"],"featImg":"stateofhealth_187863","label":"stateofhealth_2768"},"stateofhealth_166706":{"type":"posts","id":"stateofhealth_166706","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"166706","score":null,"sort":[1459450014000]},"guestAuthors":[],"slug":"a-decade-later-obama-advances-mental-health-parity","title":"A Decade Later, Obama Advances 'Mental Health Parity'","publishDate":1459450014,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Tucked in \u003ca href=\"http://www.11alive.com/news/full-transcript-president-obama-at-atlanta-heroin-summit/108944462\" target=\"_blank\">remarks\u003c/a> the president made Tuesday on the opioid epidemic was his announcement of a new \u003ca href=\"https://www.whitehouse.gov/the-press-office/2016/03/29/presidential-memorandum-mental-health-and-substance-use-disorder-parity\" target=\"_blank\">task force on mental health parity\u003c/a> — aimed at ensuring that people with mental illnesses and substance abuse problems don’t face discrimination in the health care system.\u003c/p>\n\u003caside class=\"pullquote alignright\">Advocates say parity has long been an 'empty phrase' and it has taken the administration far too long to address the problem.\u003c/aside>\n\u003cp>Despite a landmark \u003ca href=\"https://www.cms.gov/Regulations-and-Guidance/Health-Insurance-Reform/HealthInsReformforConsume/downloads/MHPAEA.pdf\" target=\"_blank\">2008 law\u003c/a> intended to do just that, enforcement has been paltry, and advocates say discrimination has continued.\u003c/p>\n\u003cp>“The goal of the task force is to essentially develop a set of tools, guidelines, mechanisms so that it’s actually enforced, that the concept is not just a phrase — an empty phrase,” President Obama said during a panel discussion at the National Prescription Drug Abuse and Heroin Summit in Atlanta, Georgia. “We’ve got to let the insurance carriers know that we’re serious about this.”\u003c/p>\n\u003cp>Advocates say parity has long been an “empty phrase” and it has taken the administration far too long to address the problem. They say insurers have been subverting the law in subtle ways, and the government has not aggressively acted to stop them.\u003c/p>\n\u003cp>“It’s better late than never, and you can’t not be grateful for the fact that we’re finally implementing a law that was passed nearly a decade ago,” said former congressman Patrick Kennedy, one of the authors of the parity law. “But it’s troubling that it’s occurring in the last year of the presidency, and that it took the administration this long to address a problem that’s been with us for many years.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In \u003ca href=\"http://www.nami.org/About-NAMI/Publications-Reports/Public-Policy-Reports/A-Long-Road-Ahead/2015-ALongRoadAhead.pdf\" target=\"_blank\">a 2015 survey\u003c/a> by the National Alliance on Mental Illness, an advocacy group for people with mental illness and their families, many patients said they were denied payment because treatment was deemed “not medically necessary” twice as often for mental health as for other medical conditions. Only \u003ca href=\"http://khn.org/news/achieving-mental-health-parity-slow-going-even-in-pace-car-state/\" target=\"_blank\">a handful of states, including California\u003c/a> and New York, have been investigating whether insurers are complying with the parity law. Meanwhile, the federal government has taken few if any public enforcement actions, as \u003ca href=\"http://khn.org/news/advocates-say-mental-health-parity-law-is-not-fulfilling-its-promise/\" target=\"_blank\">Kaiser Health News reported\u003c/a> last year.\u003c/p>\n\u003cp>For years, Kennedy has been traveling the country speaking about the lack of enforcement of the federal mental health parity law he helped create. One problem, he has said repeatedly, is that the administration has been hesitant to enforce a law against insurers, who were a key partner in implementing the Affordable Care Act.\u003c/p>\n\u003cp>“Even this administration, which is pro-consumer and liberal, has a tough time doing anything but dancing around issues of enforcing the law because they’re afraid to step on the insurers’ toes,” Kennedy said.\u003c/p>\n\u003cp>Tuesday’s announcement, he said, was also meager. “If the administration really wanted to be front and center on this they could have done it at the White House at a summit that would have gotten all kind of attention.”\u003c/p>\n\u003cp>Instead, he said, it was buried in an announcement of new programs and funding for opioid addiction. Also announced Tuesday were \u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-03-29.html\" target=\"_blank\">the final parity rules\u003c/a> for patients with coverage under Medicaid and the Children’s Health Insurance Program (CHIP).\u003c/p>\n\u003cp>Despite the complaints of advocates and patients, insurers argue they have long been complying with parity.\u003c/p>\n\u003cp>“Our industry has long supported mental health parity and implementation of those requirements so that consumers have access to care when they need it,” Clare Krusing, a spokesperson for America’s Health Insurance Plans, the industry’s main trade group, said in a written statement. “Suggesting that coverage decisions drive the mental health challenges we face does a disservice to the ongoing efforts to improve the country’s health system for those who need behavioral health care.”\u003c/p>\n\u003cp>The interagency task force, which will be chaired by the White House’s \u003ca href=\"https://www.whitehouse.gov/administration/eop/dpc\" target=\"_blank\">Domestic Policy Council\u003c/a>, will aim to identify and promote best practices for state and federal agencies to ensure that insurers are complying with the parity law. It will consist of heads of the departments of Treasury, Justice, Labor and Health and Human Services, among others, and will be responsible for delivering a report to the President by October 31, 2016.\u003c/p>\n\u003cp>“I think anything the White House does to acknowledge the obstacles to treatment of mental illness is a step in the right direction. But frankly, another task force is a far cry from much-needed enforcement,” said Meiram Bendat, a Los Angeles-based lawyer who has filed several lawsuits against insurers alleging violations of the parity law.\u003c/p>\n\u003cp>People with mental illness and their advocates have long been aware of exactly what the problems are, he said. But rooting them out will require the task force to be “keenly attuned to social and institutional bias against patients with behavioral health problems. And that bias frequently takes the form of insurance companies effectively limiting care only to crisis and refusing to acknowledge the pervasive and long-term nature of these disorders.”\u003c/p>\n\u003cp>Provider groups widely applauded the creation of the task force.\u003c/p>\n\u003cp>“What we’re hoping is that the task force will increase the visibility of the issue and highlight its significance,” said Dr. Renée Binder, president of the American Psychiatric Association, which has identified wide variation in how well insurers are complying with the law.\u003c/p>\n\u003cp>“We would welcome the opportunity to meet with the task force as part of its outreach charge,” she said.\u003c/p>\n\u003cp>But even if parity is successfully implemented, Benjamin Miller, director of the health policy center at the University of Colorado School of Medicine, said it may be “too little, too late.”\u003c/p>\n\u003cp>“It’s simply not enough to have mental health parity – even with this change in law, there will still be access issues for patients.”\u003c/p>\n\u003cp>That’s because mental health providers often don’t have appointments readily available or won’t accept these patients’ insurance coverage, he said.\u003c/p>\n\u003cp>“While mental health parity rights a wrong, it does not change the fundamental delivery of care, which is sorely needed for increasing access to mental health,” Miller said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent project of the Kaiser Family Foundation.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"A landmark 2008 law aimed at ensuring people with mental illnesses didn't face discrimination in health care, but enforcement has been paltry.","status":"publish","parent":0,"modified":1459450094,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1105},"headData":{"title":"A Decade Later, Obama Advances 'Mental Health Parity' | KQED","description":"A landmark 2008 law aimed at ensuring people with mental illnesses didn't face discrimination in health care, but enforcement has been paltry.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"166706 http://ww2.kqed.org/stateofhealth/?p=166706","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/03/31/a-decade-later-obama-advances-mental-health-parity/","disqusTitle":"A Decade Later, Obama Advances 'Mental Health Parity'","nprByline":"Jenny Gold\u003cbr />\u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>","path":"/stateofhealth/166706/a-decade-later-obama-advances-mental-health-parity","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tucked in \u003ca href=\"http://www.11alive.com/news/full-transcript-president-obama-at-atlanta-heroin-summit/108944462\" target=\"_blank\">remarks\u003c/a> the president made Tuesday on the opioid epidemic was his announcement of a new \u003ca href=\"https://www.whitehouse.gov/the-press-office/2016/03/29/presidential-memorandum-mental-health-and-substance-use-disorder-parity\" target=\"_blank\">task force on mental health parity\u003c/a> — aimed at ensuring that people with mental illnesses and substance abuse problems don’t face discrimination in the health care system.\u003c/p>\n\u003caside class=\"pullquote alignright\">Advocates say parity has long been an 'empty phrase' and it has taken the administration far too long to address the problem.\u003c/aside>\n\u003cp>Despite a landmark \u003ca href=\"https://www.cms.gov/Regulations-and-Guidance/Health-Insurance-Reform/HealthInsReformforConsume/downloads/MHPAEA.pdf\" target=\"_blank\">2008 law\u003c/a> intended to do just that, enforcement has been paltry, and advocates say discrimination has continued.\u003c/p>\n\u003cp>“The goal of the task force is to essentially develop a set of tools, guidelines, mechanisms so that it’s actually enforced, that the concept is not just a phrase — an empty phrase,” President Obama said during a panel discussion at the National Prescription Drug Abuse and Heroin Summit in Atlanta, Georgia. “We’ve got to let the insurance carriers know that we’re serious about this.”\u003c/p>\n\u003cp>Advocates say parity has long been an “empty phrase” and it has taken the administration far too long to address the problem. They say insurers have been subverting the law in subtle ways, and the government has not aggressively acted to stop them.\u003c/p>\n\u003cp>“It’s better late than never, and you can’t not be grateful for the fact that we’re finally implementing a law that was passed nearly a decade ago,” said former congressman Patrick Kennedy, one of the authors of the parity law. “But it’s troubling that it’s occurring in the last year of the presidency, and that it took the administration this long to address a problem that’s been with us for many years.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In \u003ca href=\"http://www.nami.org/About-NAMI/Publications-Reports/Public-Policy-Reports/A-Long-Road-Ahead/2015-ALongRoadAhead.pdf\" target=\"_blank\">a 2015 survey\u003c/a> by the National Alliance on Mental Illness, an advocacy group for people with mental illness and their families, many patients said they were denied payment because treatment was deemed “not medically necessary” twice as often for mental health as for other medical conditions. Only \u003ca href=\"http://khn.org/news/achieving-mental-health-parity-slow-going-even-in-pace-car-state/\" target=\"_blank\">a handful of states, including California\u003c/a> and New York, have been investigating whether insurers are complying with the parity law. Meanwhile, the federal government has taken few if any public enforcement actions, as \u003ca href=\"http://khn.org/news/advocates-say-mental-health-parity-law-is-not-fulfilling-its-promise/\" target=\"_blank\">Kaiser Health News reported\u003c/a> last year.\u003c/p>\n\u003cp>For years, Kennedy has been traveling the country speaking about the lack of enforcement of the federal mental health parity law he helped create. One problem, he has said repeatedly, is that the administration has been hesitant to enforce a law against insurers, who were a key partner in implementing the Affordable Care Act.\u003c/p>\n\u003cp>“Even this administration, which is pro-consumer and liberal, has a tough time doing anything but dancing around issues of enforcing the law because they’re afraid to step on the insurers’ toes,” Kennedy said.\u003c/p>\n\u003cp>Tuesday’s announcement, he said, was also meager. “If the administration really wanted to be front and center on this they could have done it at the White House at a summit that would have gotten all kind of attention.”\u003c/p>\n\u003cp>Instead, he said, it was buried in an announcement of new programs and funding for opioid addiction. Also announced Tuesday were \u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-03-29.html\" target=\"_blank\">the final parity rules\u003c/a> for patients with coverage under Medicaid and the Children’s Health Insurance Program (CHIP).\u003c/p>\n\u003cp>Despite the complaints of advocates and patients, insurers argue they have long been complying with parity.\u003c/p>\n\u003cp>“Our industry has long supported mental health parity and implementation of those requirements so that consumers have access to care when they need it,” Clare Krusing, a spokesperson for America’s Health Insurance Plans, the industry’s main trade group, said in a written statement. “Suggesting that coverage decisions drive the mental health challenges we face does a disservice to the ongoing efforts to improve the country’s health system for those who need behavioral health care.”\u003c/p>\n\u003cp>The interagency task force, which will be chaired by the White House’s \u003ca href=\"https://www.whitehouse.gov/administration/eop/dpc\" target=\"_blank\">Domestic Policy Council\u003c/a>, will aim to identify and promote best practices for state and federal agencies to ensure that insurers are complying with the parity law. It will consist of heads of the departments of Treasury, Justice, Labor and Health and Human Services, among others, and will be responsible for delivering a report to the President by October 31, 2016.\u003c/p>\n\u003cp>“I think anything the White House does to acknowledge the obstacles to treatment of mental illness is a step in the right direction. But frankly, another task force is a far cry from much-needed enforcement,” said Meiram Bendat, a Los Angeles-based lawyer who has filed several lawsuits against insurers alleging violations of the parity law.\u003c/p>\n\u003cp>People with mental illness and their advocates have long been aware of exactly what the problems are, he said. But rooting them out will require the task force to be “keenly attuned to social and institutional bias against patients with behavioral health problems. And that bias frequently takes the form of insurance companies effectively limiting care only to crisis and refusing to acknowledge the pervasive and long-term nature of these disorders.”\u003c/p>\n\u003cp>Provider groups widely applauded the creation of the task force.\u003c/p>\n\u003cp>“What we’re hoping is that the task force will increase the visibility of the issue and highlight its significance,” said Dr. Renée Binder, president of the American Psychiatric Association, which has identified wide variation in how well insurers are complying with the law.\u003c/p>\n\u003cp>“We would welcome the opportunity to meet with the task force as part of its outreach charge,” she said.\u003c/p>\n\u003cp>But even if parity is successfully implemented, Benjamin Miller, director of the health policy center at the University of Colorado School of Medicine, said it may be “too little, too late.”\u003c/p>\n\u003cp>“It’s simply not enough to have mental health parity – even with this change in law, there will still be access issues for patients.”\u003c/p>\n\u003cp>That’s because mental health providers often don’t have appointments readily available or won’t accept these patients’ insurance coverage, he said.\u003c/p>\n\u003cp>“While mental health parity rights a wrong, it does not change the fundamental delivery of care, which is sorely needed for increasing access to mental health,” Miller said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent project of the Kaiser Family Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/166706/a-decade-later-obama-advances-mental-health-parity","authors":["byline_stateofhealth_166706"],"categories":["stateofhealth_2442","stateofhealth_14"],"tags":["stateofhealth_2713","stateofhealth_274","stateofhealth_2519"],"featImg":"stateofhealth_166724","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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And we take a step back in history to understand how psychotherapy became a \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/05/24/how-therapy-became-a-hobby-of-the-wealthy-rather-than-a-necessity-for-the-mentally-ill/\" target=\"_blank\">hobby of the wealthy\u003c/a> rather than a critical service for those in need.","featImg":"https://ww2.kqed.org/app/uploads/sites/27/2016/08/RS20817_State-of-Mind-qut.jpg","headData":{"title":"State of Mind Archives | KQED Arts","description":"Sorry, The Therapist Can't See You -- Not Now, Not Anytime Soon More than 43 million Americans have depression, anxiety, or another mental health condition. But more than half never get help. Recent laws were supposed to make it easier for Californians to access treatment, but many still face roadblocks, even with insurance. In this special series by KQED's The California Report and State of Health we travel across the state to find out why it’s so difficult to get mental health care. 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