Comparative analysis has shown that the United States has one of the highest costs of health care in the world. Yearly average spending per individual was as high as $12,900 in 2021. Despite the high cost of health care, research has shown that the American health care system still has worse outcomes than other developed nations. While this often is explored within the context of general medicine, this article will briefly explore Mental Health Care in the United States.
Accessibility and Affordability:
Accessibility to care is one of the most important factors when judging a health care system. After all, what good is a robust care system if most have no ability to access it. Unfortunately, one of the primary concerns in American mental health care is the lack of affordability. Many Americans are left with two expensive options: pay out of pocket or pay high insurance premiums. In contrast, countries like Canada, the United Kingdom, and Australia have implemented universal health care systems that include mental health services, providing more equitable access to care. America has taken steps towards improving accessibility and affordability in recent years. This can be seen in mental health parity laws that ensure that mental health care is included within insurance coverage.
Research and Innovation:
The United States has been at the forefront of mental health research and evidence-based practice development. The US houses numerous prestigious institutions leading the way in psychiatric advancements. Such therapies as CBT, REBT, Humanistic Psychology, and ACT were all developed from individuals working within American institutions, albeit many of the researchers were themselves European. The focus on research and training keeps America on the cutting edge of providing its citizens evidence-based care.
Mental Illness is not only painful but in some instances can lead to psychiatric crises. While crises vary, some examples include suicidal ideation, homicidal ideation, psychosis, or other loss of connection to collective reality. In some instances these can threaten the safety of the individual or those An effective mental health care system needs to be able to care for and keep safe individuals experiencing psychiatric crises within their communities.
The United States has agencies who are put into place to support individuals in crisis including mobile crisis units, community support partners, and crisis hotlines. However, funding and use of these services continues to be limited. This leaves the American mental health care system primarily relying on law enforcement to handle mental health crises. Most law enforcement offices have limited or no training in understanding or de-escalating a mental health crisis. Sending untrained law enforcement into situations involving mental health crises has led to many devastating and even fatal outcomes. A research study reported that individuals with untreated mental illness are 16 times more likely to be killed by law enforcement. This is an alarming statistic that shows the need for significant reform.
While the United States has made notable contributions to mental health care through research and innovation, it has significant shortcomings in ensuring accessibility, affordability, and crisis services. Comparatively many other high income countries have utilized socialized health care to decrease cost barriers and better fund crisis services, providing lessons that can inform the improvement of American mental health care.