Mental health treatment has become an issue requiring attention in the U.S. as Obamacare, which provides for mental health services, gradually rolls itself out. Mental health treatment still seems to lag behind other services, however, especially for veterans suffering from post-traumatic stress disorder (PTSD) and depression.

Recently, Vice President Joe Biden announced that U.S. mental health funding would receive a $100 million boost; others have emphasized the importance of mental health parity, or allowing affordable mental health care to be available to everyone. Last month, Virginia state Sen.Creigh Deeds vowed to improve mental health services after his son killed himself.

In light of the discussion about the importance of mental health care, researchers who conducted a recent study found that about half of psychiatrists took private insurance, whereas nearly 90 percent of other doctors accepted it, between 2009 and 2010.

“It’s a very big difference,” Dr. Tara Bishop, assistant professor at Weill Cornell Medical College in New York and the study’s lead author, told Reuters. “It seemed to fit in well with my personal experience of referring patients to psychiatrists and stories that I’ve heard from other doctors.”

Dr. Bishop and her team reviewed U.S. government data between 2005 and 2010, surveying some 1,250 doctors every year, 6 percent of whom were psychiatrists. They found that the number of psychiatrists accepting private insurance actually decreased significantly over the period of time, from 72 percent in 2005 to 55 percent in 2009-2010. The researchers also found that fewer psychiatrists accepted Medicare and Medicaid than did their other medical counterparts.

Dr. Bishop says the study doesn’t reveal what the trends were like in 2011 or 2012, and it doesn’t help them necessarily come to a conclusion about why psychiatrists are accepting private insurance less than other doctors. It could be because insurance doesn’t cover the amount of extra time psychiatrists spend on patients in comparison to other doctors — but this is just speculation, the authors note.

“Many doctors can’t afford to accept insurance because (insurance companies) don’t pay them for the time,” Dr. Jeffrey Lieberman, president of the American Psychiatric Association, told Reuters Health. “It involves taking more time with the patient and often treating them with psychotherapy.”

Writing for The New York Times in 2011, Gardiner Harris said that “Medicine is rapidly changing in the [U.S.] from a cottage industry to one dominated by large hospital groups and corporations, but the new efficiencies can be accompanied by a telling loss of intimacy between doctors and patients. And no specialty has suffered this loss more profoundly than psychiatry.” Harris goes on to state that many talk therapists turned to drug therapy instead to make money, leaving psychiatrists with thousands of brief, 15-minute interviews with patients aimed only to keep them functional rather than help them maneuver their psychological lives. “I miss the mystery and intrigue of psychotherapy,” Dr. Donald Levin, a psychiatrist in Pennsylvania, told The New York Times. “Now I feel like a good Volkswagen mechanic.”

Earlier this week, Vice President Joe Biden announced that mental health funding would receive a $100 million boost in light of the one year anniversary of Sandy Hook Elementary School in Newtown, Conn. After a 20-year-old Adam Lanza murdered 20 first graders and several faculty members, he shot himself. The horrific incident raised a debate on two major fronts: gun laws and mental health treatment in the U.S.

Likewise, Kathleen Sebelius, Secretary at the Department of Health and Human Services (HHS), announced last month that HHS would take steps to improve its enforcement of the 2008 Mental Health Parity Act, which would make mental health services on par with both medical and surgical services.

 

Source: Bishop T, Press M, Keyhani S, Pincus H, et al. “Acceptance of Insurance by Psychiatrists and the Implications for Access to Mental Health Care.” JAMA Psychiatry. 2013.