If Connecticut is desperate to provide better access to mental health resources, why have so many pediatricians, school counselors and social workers closed the door to therapists and coaches whose services are not accepted by insurers?
Simply put, we live in an insurance-driven and contentious era with standards seen as non-negotiable. This is to the real detriment of people who need and want help – and who deserve full access to a much wider range of professionals. This wider range can help them make more informed decisions when selecting the type of practice and wellness professionals that are best for them or their child.
Whether it’s expressive arts therapy, therapeutic coaching or otherwise, there are many successful practices without insurance company approval. Practitioners who accept insurance typically see patients for six to eight sessions before reaching a conclusive diagnosis or solution for the patient. No costs for the client, no worries for the therapists. He keeps overbooked appointment books for months, no questions asked. This format, however, does not necessarily meet the needs of the individual or the demand of the community. Local reference lists are biased and limiting, excluding anyone who does not meet the qualifications set by insurers.
Today we are more aware of the mental health crisis. Demand has increased and so have diagnoses, especially for children. Suddenly, families and children are accepting that they are “suffering” from pathological anxiety, a chronic condition that needs to be “managed”, rather than experiencing an anxiety produced by the changing situation. Stress often leads to the insurable diagnosis code for “anxiety”. Check the billing code, collect a copayment, write the prescription, see you next time. No sweat, no questions by either party.
Diagnosers of clinical depression or anxiety usually offer psychopharmaceutical solutions. Sometimes exclusively. Especially for overbooked providers, knowing that patients “feel better” when they leave with something tangible (a prescription) gives hope. He must make the rendezvous on all sides more acceptable. When I see someone who says, “My therapist gave me medicine but doesn’t really know me and didn’t help me,” I get sickened and irritated by the limitations of the system.
When people see their stress or situation as unmanageable, but know that they themselves are whole and fundamentally healthy, what’s the point? They need immediate support, practical guidelines and an action plan to feel better and change their circumstances or coping mechanisms, not a brief encounter with an overworked provider ticking the right box, the prescription pad and computer information.
At a time when identities are being formed, self-esteem is under pressure, and the realities of everyday life are difficult, the application of the diagnosis of pathological anxiety or depression is particularly impactful for young adults, children and their families.
These labels carry deep and internalized stigmata. They may feel like a permanent “pass,” even if it isn’t earned. If stress, life transitions, identity issues, or communication failure in relationships are viewed only through the lens of a licensed provider and prescriptions for certifiable mental illness, it can certainly decrease a person’s motivation and empowerment to change their behavior or environment as much as possible. For teens and tweens, and 20+ year olds, it’s murky water.
Of course, in some cases the problems are truly pathological. Situational triggers, however, are just that – normal people in abnormal situations that shouldn’t require a life sentence just because they’re easily handled by doctors, insurers, pharmacies, society. and, unfortunately, the person wearing the tag.
The goal is for individuals to be happy, independent and resilient. The current system does not support this very well assuming that there is always an inherent personal deficit.
By limiting options only to counselors, healers, therapists, and trainers who have been approved by people of similar ilk and training, all of whom have been given a stamp of approval by insurance boards, Connecticut institutions, and physicians made a preemptive, limiting decision for patients, students and clientele.
So who loses? The patients.
Let’s get more help, to more people, sooner, by expanding those referral lists and perspectives, and dissolving traditional biases about licensing, doctors, educators, and insurance.
Allison B. Spitzer, Therapeutic Coach, provides practical, short-term emotional support to children, teens, and young adults to clarify difficult relationships and situations at home, school, and work. She can be reached at 203-218-2200.
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