Payment Plan for Mental Health

Some believe when children head off to college, the worry lessens.

It does, in many ways.

Yet we live with the vast unknown when it comes to the pressures they’re under, how they’re handling them, partying that may spin out of control, and careless choices that may affect their health.

We don’t know what they’re doing. We don’t know who they’re doing it with. We remember what it’s like to be 17 or 20 or 22, feeling indestructible, and consequently we know our worries to be justified – even if we feel helpless to make a difference once they’ve flown the nest.

Sure, we can fall back on “I did the best I could to instill good values and judgment.” But we nonetheless worry about drinking, prescription pills, illegal drugs, and depression which, in my opinion, continues to hold more stigma in our culture than substance abuse.

As I send my sons back to their respective university environments at this time of year, I can only assume that like many parents, I worry about everything I don’t know, and likely never will.

Addressing Mental Health and Addiction

Earlier this week I read an article entitled “The Case to Fund Addiction Treatment Right Now.” It addresses the financial and societal impacts of mental health and addiction treatment options, how they may play out under the Affordable Care Act, and placing the associated problems squarely in terms of a “pay me now or pay me later” framework.

As I’m still trying to wade through what healthcare reform will actually mean – (aren’t we all?) – I was intrigued.

Likening preventative and early treatment in mental health to use of vaccines to prevent disease, psychologist Dr. Richard Juman writes:

The early treatment of addictive disorders is one of the most cost-effective investments in medicine—since the costs of not treating these illnesses are immense, and only magnify over time.

Consider the reciprocal relationship between substance use disorders and poverty; the connection between unemployment and addictive disorders; the links with homelessness, domestic violence and child abuse.

He notes:

Treatment of substance use disorders is falling victim to short-term pressures on a staggering scale—and our failure to pay now will have a tragic impact.

Teenagers, Drugs, Depression, and Worse

As a parent, I paid particular attention when reading this:

… the alarming rise in teen substance abuse that we’re seeing in the US, to add to all the other pressures kids face. Sadly, it’s become all too common to hear in the media that another teenager has committed suicide…

… it’s getting harder and harder to pay for programs that might help prevent it [teen suicide] — like screening, early intervention and treatment.

The article does not address reforms that may be required in terms of mental health or addiction treatment systems; that’s not its purpose.

The focus is financial and social – enumerating the far-reaching impacts of mental health conditions and addiction, and whether or not we will face them head-on.

Our Quick-Fix Pill Popping Society

The extent to which the Affordable Care Act will mean good news for addressing mental health concerns remains fuzzy, at least to me. But the value of preventing or limiting problems through early treatment is hardly rocket science.

Shouldn’t all health care be designed to do exactly that?

In my own experience of visiting a doctor’s office with specific physical complaints, on more than one occasion, I was sent off with dismissive remarks and packets of sample antidepressants. In each of these instances, I set aside the pointless pills and tried other care givers until I found someone to test and diagnose – at which point clear, easily addressed causes were pinpointed and treated.

How often are women, especially, dispensed anxiety or depression medications as a quick fix to any problem?

How often do they become “dependent” as a result, perhaps unnecessarily?

How many women dare to say no to a physician? How many co-pays (or full pays) can we afford, going from doctor to doctor until one actually listens?

On that note, I will mention another article which caught my attention. In “Not an Addict, Just Addicted,” writer Maria Diaz explores her own struggles with legally prescribed pills she was given for panic attacks. Whether or not she views herself as an addict seems less the point than this reality:

Most shrinks are careful to tell you that there is a difference between addiction and dependence, but the body doesn’t care. Withdrawal is withdrawal even if you were a good girl who didn’t “abuse” her medication.

So where does that leave those who are hooked on meds thanks to a prescription, when they try to lessen or eliminate the dependence?

The Problems are Complex; We Treat the Symptoms

There’s no doubt that I am touching (superficially) on a variety of interrelated issues, each of which deserves thorough discussion. These are complex problems with complex origins and no simple solutions, but as I read, learn, and question – I’m hungry for dialog and additional interpretations.

As for the Affordable Care Act (and the extent to which states will control available services), I’m still trying to sort through it. Do you find yourself in the same position?

I am also reminded that when we see pain we want to treat it; when we see dysfunction we want to improve it. But addressing symptoms isn’t sufficient. We need to chip away at the core problems – familial, economic, institutional.

As a parent, I would like to think that affordable healthcare coverage would be available to any child, teenager, or adult, and that we could encourage them to seek help – before things get out of hand. And regardless of what state they reside in.

To me, “pay now” is a No-Brainer in health care, just as it is in education. I have no illusions about the difficulty of shifting the current cultural “mindset” which is entirely short-term oriented. But perhaps if we all thought as parents – about our larger communities – the longer view might make more sense.