More Than 500,000 Americans Denied Care for Mental Health

The scale of Americans still going untreated for mental illnesses but wanting help reached more than half a million last year despite intended protections in the Affordable Care Act (ACA), a new study has found. Nearly 570,000 adults ages 18 through 64 diagnosed with a mental illness, serious psychological stress or substance use disorder reported that they wanted treatment for their mental conditions last year but lacked resources or eligibility in Medicaid. That’s because they lived in the 24 states that didn’t expand Medicaid eligibility under Congress’ ACA, also called Obamacare. Released in April, the report was produced by the American Mental Health Counselors Association (AMHCA) — a national trade group whose 7,000 members are licensed clinicians who diagnose and treat mental disorders, including addiction.

More Than Half the States Paid for Mental Health Treatment

In the 26 states, and the District of Columbia that did expand coverage of Medicaid, some 352,00 residents with the same serious mental health struggles got treatment because it was paid for by the state-federal health insurance for low-income adults. “The take-away point is we have hundreds of thousands of people who have serious mental disorders whose needs are not being met, because of the failure to expand Medicaid into those states,” James K. Finley, AMHCA’s associate executive director, and director of public policy, said in an interview. Finley said a handful of states in the past year have expanded Medicaid, which is more than originally did following Congressional passage of the historic ACA. But “the federal government would have paid 100 percent of the treatment costs; the monies were already included in the federal budget,” the report states. “The comprehensive study also highlights that 458,000 fewer people would have avoided a depressive disorder mainly by securing health insurance through the Medicaid Expansion Program.”

Costs for the Care Are Paid Elsewhere

The AMHCA study is drawn from government data, notably from the National Survey of Drug Use and Health, the federal government’s chief statistical source regarding substance abuse and other mental illness. The survey conducts in-person interviews with about 70,000 randomly chosen Americans. Most of the folks who wanted treatment for their substantial mental illness — including substance use disorders — were notably young, between 18 and 34 years old. You can see a state-by-state map of which have expanded Medicaid on the website of the non-profit news and research organization, Pew Charitable Trusts. Those with untreated mental illness addictions often end up on the streets or in jail, so they cost state and local taxpayers, said Bill Lindsey, executive director South Carolina chapter of the National Alliance on Mental Illness. Lindsey told Pew that this been true in South Carolina, one of the 24 states that haven’t taken advantage of the Medicaid expansion. “Right here in Richland County, where the capital is located, the local jail has about 1,000 inmates a night, and 300 of them are on psychotropic drugs, which the government pays for,” Lindsey told Pew.

Who’s the Study Audience?

The new study results are meant for policymakers, advocates, providers, family members of the mentally ill and consumers. “It’s information for action,” Finley said. “We are trying to mobilize our chapters to get them engaged in this need for change. “People need healthcare, that’s our message, and behavioral treatment and medical treatment are integrally related,” Finley said. “We can’t have a half million people needing serious help. But because of the ACA increasing coverage to more people, improving care and expanding mental health and addiction services coverage to millions of people, it’s a huge step in the right direction.” By Nancy Wride Follow Nancy on Twitter at @NWride

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