Insufficient Dollars and Qualified Personnel to Meet United States Mental Health Needs

Abstract

The American populace currently supports the need for providing additional mental health services for adolescents who frequently express anger and mood instability and maybe are at risk for major psychiatric disorders and behavioral problems; Vietnam, Iraqi, and Afghanistan veterans or military personnel still on duty diagnosed with posttraumatic stress disorder, depression, or other similar combat-related disabilities; the approximately 1 million prisoners currently incarcerated primarily because of substance abuse and needing medically related rehabilitative services; and senior citizens who experience dementia and depression and require improved therapeutics. The problems outlined herein are as follows: far too limited monies are being spent for mental health services (5.6% of total US expenditures for health or roughly one fifth of what is consumed for hospital care); effective therapies are often lacking; and there is a shortage of qualified mental health personnel except in upscale urban and suburban areas. Unfortunately, these problems are so immense that, even with enhanced prioritization of our available resources, they are still not entirely solvable. The American public may continue to impart lip service when attempting to respond to our nation's mental health needs or may decide to spend vastly more money for such care. The latter choice may not be forthcoming in the near future for various cultural-societal-clinical-fiscal reasons.

The feasibility, acceptability, and outcomes of PRIME-D: A novel mobile intervention treatment for depression

“…A digital system of care may help circumvent the challenges of limited access to high quality mental health care in the U.S. For instance, in this study, when participants endorsed experiences with depression, they were directly given access to a mobile treatment, whereas in traditional care settings, initial appointments may take up to three months(Kaplan, Lopez, McGinnis, & Institute of Medicine (U.S.), 2015). Another challenge we are seeing in the U.S. healthcare system pertains to the limited supply of mental health care providers relative to those seeking care(Collins et al, 2004; Weil, 2015). In this study, mental health coaches spent on average, 2 hours per week, delivering treatment to 10 individuals with depression.…”

“…While there are many effective behavioral and pharmacological treatments available, many people do not have access to those treatments(Collins, Westra, Dozois, & Burns, 2004). Poor access to care is in part due to time demands that most traditional treatments place on consumers, the “bricks and mortar” delivery system, and the limited supply of treatment providers relative to those seeking care(Collins et al, 2004; Weil, 2015). Recent efforts to overcome poor access and to make care more efficient include using technology platforms to deliver evidence-based treatment (EBT), such as Internet-based and mobile app platforms.…”

Empirical redefinition of comprehensive health and well-being in the older adults of the United States

“…A list of "diagnostic codes," embodied in the ICD-10 system used to bill for health services, is emblematic of this approach. One consequence is that health policy neglects important aspects of health, such as mental health (50) and medical training for managing comorbidities in geriatric populations (51). By using the WHO definition of health, we have shown how expanding health dimensions and domains and incorporating positive aspects of health reveal six unique, replicable constellations of disease and health, including two previously unrecognized classes not apparent in the organ disease-focused MM.…”

Innovations in healthcare delivery and policy: Implications for the role of the psychologist in preventing and treating diabetes.

“…For example, CMS has approved reimbursement for intensive behavioral counseling and behavioral therapy for weight loss, but limited this only to "primary care" providers, which it defines as a primary care physician, a clinical nurse specialist, a nurse practitioner, or a physician assistant; psychologists were explicitly excluded, despite the fact that identity issues vis-à-vis other mental health professionals rather than embracing the many opportunities for psychology in integrated patient-centered care. Perhaps most serious is the fact that psychology's current training programs are not producing sufficient numbers of psychologists trained in patientcentered integrated care to meet the need (Weil, 2015). …”