The midterm elections are on the horizon, the war in Ukraine shows little sign of cooling down, we’re in approximately the billionth straight month of Covid, and Nichelle Nichols just died. So it’s little surprise that Americans are in serious need of therapy: four in 10 U.S. adults recently reported symptoms of anxiety or depressive disorder, up from just one in 10 before the pandemic.
Unfortunately, this uptick in the number of people with mental health issues has only worsened yet another bleak fact of contemporary life: Americans can’t get help with their mental health issues. As John Oliver pointed out during Sunday’s Last Week Tonight, 65 percent of psychologists recently said they have no capacity for accepting new patients, and more than half of people who are in need of mental health care do not receive it (the number is even higher in minority populations).
This dearth of availability should, by law, not really be allowed. The 2008 Mental Health Parity and Addiction Equity Act required big insurance providers to cover mental health the same way they cover other healthcare, and Obamacare later expanded those requirements. But as anyone who’s ever so much as driven past a hospital knows, the American healthcare system doesn’t, in technical terms, “work.” Because there are not enough therapists period, and because many therapists decline to accept health insurance because of the bureaucratic nightmare they must endure in order to get paid a fraction of what they should, those seeking help are often left to cold-call a list of mental health providers their insurance companies provide — lists that have been shown to include providers who aren’t accepting new patients, providers who don’t accept that insurance, and even providers who are dead. Then they’re left to hope that, against the odds, they’ll get called back.
“That is distressing for a number of reasons, not least of which is it forces someone into the appalling position of actually wanting to be called back on the phone,” Oliver said. “Which is just horrifying. The best phone call is a text, the second-best is an email, and the third-best phone call is two traded voicemails. Everything else is a complete nightmare.”
Those who are able to secure care worry about whether their insurance company will terminate payment because an employee in a cubicle reviewing paperwork decides treatment is no longer necessary. Providers who do manage to get paid by insurance companies often receive a relative pittance for their work, which is not only prompting more and more of them to stop taking insurance altogether, but also driving providers out of the industry entirely.
The government effectively does nothing to investigate and punish insurance companies for this atrocious behavior. Why? Because health insurance providers spend tens of millions of dollars a year on political lobbyists.
The shit storm kicked up by the broken mental healthcare system has kicked up a relatively new shit storm in the form of mental health apps. There are currently more than 10,000 of them, and the level of care many of them provide is… dubious. Oliver gleefully described Woebot, a free app that allows users to chat with a “mental health ally… powered by AI.” Journalists have repeatedly shown that the chatbot’s responses to mental health issues can be at best nonsensical and at worst retraumatizing.
Other telehealth apps have been shown to overprescribe meds and pair patients in genuine distress with providers who don’t have little to no medical training. As Oliver pointed out, this Silicon Valley disruption of mental healthcare — or whatever tech bros like to call it — winds up treating potentially life-and-death situations like the purchase of a burger and fries.
“There is basically no scenario where mental health services should be acting like fast food restaurants,” Oliver said. “In fact, the only idea that they should maybe be stealing from them is the concept of giving out toys. Because admit it, therapy would feel a lot better if you left each session with a little Minion in a wig.”