MONEY VS. MENTAL HEALTH

Despite legislation meant to address the issue, a new study by North Shore Child & Family Guidance Center in Roslyn Heights, Long Island, has found that it’s increasingly difficult to find mental and addiction healthcare specialists who accept commercial insurance. The organization’s executive director Andrew Malekoff and social worker Kerry Lynn Eller are here to talk about “Project Access” which is exploring the challenges of providing timely affordable mental health treatment and addiction care.

Aired on February 14, 2018. 

TRANSCRIPT

> A NEW FRONT ON THE BATTLE AGAINST MENTAL HEALTH DISORDERS AND DRUG ADDICTIONS EMERGES.

FEDERAL LAW MANDATES -- HEALTH INSURERS MIGHT NOT BE FOLLOWING THE LAW.

RIGHT HERE IN NEW YORK, A LOCAL NONPROFIT MENTAL HEALTH CARE AGENCY, NORTH SHORE FAMILY GUIDANCE CENTER CONDUCT AT STUDY ON THE ISSUES, THEY'RE FINDING THAT MENTAL HEALTH CARE AND ADDICTION HELP IS GETTING HARDER TO GET.

JOINING US TODAY IS THE CEO OF NORTH SHORE FAMILY DGUIDANCE WHERE THE STUDY WAS CONDUCTED.

FIRST I JUST WANT TO GET AN UNDERSTANDING OF HOW THIS STUDY EVEN CAME INTO EXISTENCE?

JUST TO PROVIDE A LITTLE CON TEXT, IN 2008, THE MENTAL HEALTH PARODY AND ADDICTION EQUITY ACT PASSED, IT WAS A BIPARTISAN BILL SPONSORED BY TWO SENATORS, ARCH CONSERVATIVE AND AN ARCH LIB AREAL.

BOTH HAD EXPERIENCED THE IMPACT OF MENTAL ILLNESS IN THEIR FAMILIES.

SO THIS LAW THAT WAS PASSED IN 2008 MADE IT VERY CLEAR AND PROHIBITED TREATING THE CARE OF PEOPLE WITH MENTAL ILLNESS OR ADDICTIONS DIFFERENTLY THAN PEOPLE WITH PHYSICAL HEALTH PROBLEMS.

AND WHAT THAT MEANS IS THAT THERE WOULD BE A PROHIBITION AGAINST LIMITING THE NUMBER OF VISITS THAT SOMEONE WILL A MENTAL HEALTH ISSUE MIGHT HAVE, PROHIBIT DIFFERENTIALS IN TERMS OF CO-PAYS OR IN TERMS OF DEDUCTIBLES.

AND ANYTHING TO THAT, IT MANDATED THAT INSURANCE CARRIERS WOULD HAVE AN ADEQUATE NUMBER OF PROVIDERS IN THEIR NETWORK FOR PEOPLE SO THAT THEY COULD EASILY ACCESS AFFORDABLE CARE WITHIN THEIR GEOGRAPHIC AREA.INCREDIBL IMPORTANT POINT.

WHAT TIPPED YOU OFF THAT SOMETHING WAS AMISS.

SO ANDY ALLUDED TO THE IDEA THAT YOU CALL YOUR INSURANCE COMPANY, YOU ASK THEM WHO TAKES MY PLAN, WHO IS COVERED BY MY INSURANCE, THEY WILL GIVE YOU A LIST OF NAMES AND YOU CALL THE PROVIDERS AND SOMETIMES THEY'RE NO LONGER IN THE NETWORK OR THEY'RE ONE OF THE FEW PROVIDERS THAT DOES STAY ON THE NETWORK AND SO THEY HAVE LONG WAITS FOR CLIENTS TO BE ABLE TO ACCESS THE CARE.

AND NORTH SHORE FAMILY GUIDANCE CENTER, WE TURN NO ONE AWAY, SO WE DO HAVE OPEN ACCESS, BUT WHAT WE KNOW IS THAT PEOPLE WITH THESE KIND OF ISSUES, MENTAL ILLNESS AND SUBSTANCE USE T DISORDERS ARE ALSO DEALING WITH STIGMA, WHICH MEANS THAT THEY HAVE A VERY DIFFICULT TIME PICKING UP THE PHONE ASKING FOR HELP, WAITING DAYS, WEEKS AND MONTHS AND SOMETIMES YEARS AND SO WHEN THEY FINALLY PICK UP THE PHONE AND THE PERSON AT THE OTHER END SAYS I NO LONGER ACCEPT YOUR INSURANCE, THAT'S SO DEMORALIZING AND SO DIFFICULT THAT SOMETIMES PEOPLE RETREAT.

THAT'S AN INCREDIBLY IMPORTANT POINT.

I ACTUALLY WANT TO BUILD ON THAT, AND MY QUESTION FOR CRI CARRIE.

I SERVICE ALL NASSAU COUNTY, I SERVICE MANY POPULATIONS THAT HAVE STRUGGLED TO ACCESS MENTAL HEALTH CARE UNTIL THEY FIND THEIR WAY TO NORTH SHORE FAMILY GUIDANCE CENTER.

I'M ALSO A SISTER OF A TEEN WHO STRUGGLED WITH MENTAL HEALTH ISSUES AS WELL AS CHEMICAL DEPENDENCY, AND I CAN ATTEST THAT THE STIGMA ASSOCIATED WITH THAT THAT PEOPLE DON'T WANT TO REACH OUT FOR HELP.

SO THAT WHEN YOU DO, YOU HAVE A SHORT WINDOW TO HELP THESE PATIENTS FEEL COMFORTABLE.

UNFORTUNATELY THAT'S NOT THE CASE WHEN THEY'RE HAVING DIFFICULTY GETTING ACCESS TO GREAT HEALTH CARE IN THEIR --

HOW DOES THAT CHANGE THE DYNAMIC OF PEOPLE'S ACCESS TO MENTAL HEALTH CARE.

IF THEY HAVE MEDICAID, OR IF THAT APPLY FOR A PROGRAM CALLED MENTAL HEALTH PLUS, THOSE WOULD ALLOW THEM TO ACCESS CARE.

THE PROBLEM IS THAT BECAUSE OF SIGNIFICANT CHANGES IN THE LAST 10 YEARS IN NEW YORK STATE, WITH THE WAY THEY FINANCE OUTPATIENT MENTAL HEALTH AGENCIES THAT MANY OF THOSE AGENCIES HAVE TURNED AWAY COMMERCIAL HEALTH INSURERS AND WILL ACCEPT ONLY MEDICAID, NOT UNINSURED AND NEW YORK STATE, MOST OF THE FOCUS FROM THE GOVERNMENT IS ON MEDICAID.

YOU KNOW, I'LL TELL YOU A VERY BRIEF STORY, MANY YEARS AGO I WAS IN THE OCEAN, I LIVE IN LONG BEACH, AND I SAW THREE GIRLS DRIFTING OUT TOWARDS THE JETTY, I SWAM OUT AND I PUT MY ARMS OUT TO THEM AND IN A FEW MINUTES THE LIFE GUARDS CAME OUT TO HELP.

CAN YOU IMAGINE THAT REACHING OUT TO THESE GIRLS, THAT I WAS SO CLOSE I COULD SEE THEIR FRECKLES, WHAT IF I STAYED JUST A FEW FEET AWAY FROM THEM AND SAID, HEY, DO YOU HAVE MEDICAID?

IT'S THE WORKING POOR THAT HAVE THE MOST DIFFICULTY TRYING TO ACCESS CARE THROUGH THEIR COMMERCIAL INSURANCE.

I WANT TO THANK YOU FOR THE PROGRAM AND FOR CONDUCTING THE STUDY THAT EVEN ALERTED US TO THE PROBLEM TO BEGIN WITH.

THANK YOU SO MUCH.

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