Why mental health care can be hard to find, even with insurance

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by Brittney Melton

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September 1, 2024

Good morning. This week, two men were indicted for allegedly toppling ancient rock formations, a woman used an AirTag to track down thieves stealing her mail, and Mariah Carey announced that her mother and sister recently died on the same day.

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Living with mental health struggles can impact your everyday life. So when it comes to getting the help you need, you don’t want it to be a hassle. Unfortunately, getting mental health care covered by insurance can be tough. ProPublica talked with more than 500 psychologists, psychiatrists and therapists who shared their experiences when it came to joining health insurance networks, which the medical professionals hoped would help those who cannot afford to pay out of pocket.

Woman named Melissa Todd sits at a desk in her office in Eugene, Oregon.

Tony Luong for ProPublica

Although federal law requires insurers to provide the same access to mental and physical health care, they have been caught, time and again, shortchanging customers with mental illness. This can be in the form of restricting coverage or delaying or even denying treatment. Industry insiders told ProPublica that patients whose disorders can be chronic and costly are bad for business. And although almost all Americans are insured, about half of people with mental illness are unable to get treatment.

The consequences can be devastating. Often the insurers, not the therapists, determine who can get treatment, what kind they can get and for how long. To understand the issue at its core, reporters spoke to hundreds of therapists who left their insurance networks to find out why.

In addition, ProPublica reporters delved into ‌laws across all 50 states to chart new ways to secure mental health care access. Many new protections are just starting to be enforced, but a few states have already begun punishing companies for violations and forcing them into compliance.

Insurers generally face few limitations on how they define what mental health care is medically necessary, often creating their own internal standards instead of relying on ones developed by nonprofit professional medical societies. The internal standards can then be used to challenge diagnoses or treatment plans.

In California, the law requires insurers to follow generally accepted standards of care for mental health and substance use conditions, and bars insurers from covering only short-term or acute conditions. Last October, the state found health care organization Kaiser Permanente in violation of the new state law and other health care regulations, resulting in a multi-million-dollar settlement. Here’s a closer look at where your state stands when it comes to laws protecting patients.

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Minnesota Gov. Tim Walz famously used the term “weird” against Republicans even before becoming Vice President Harris’ running mate. Now, during the presidential campaign, the descriptor is inescapable, from speeches to merch to artwork. NPR went to the Minnesota State Fair and learned that in the Midwest, "weird" is a loaded term.

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A package with 16 bricks of suspected cocaine was discovered by guests on a beach in the Florida Keys this week. It wasn’t the first time. Earlier this month, more than 100 pounds of cocaine worth $1 million washed up on a Florida Keys beach in the aftermath of Hurricane Debby. And, near Everglades City, boaters alerted deputies to a package with over half a million dollars worth of cocaine floating in the mangroves off Panther Key. Why does this keep happening? Here’s the answer, and the reason it harms wildlife.

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Podcast Picks

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LifeKit: Everyone needs a little help being a human. From better sleep to saving money to parenting and more, host Marielle Segarra talks to experts to get the best advice out there.

🎧 Today's teens struggle with perfectionism and mood swings, and their parents struggle to have hard conversations with them, according to a recent survey. Teen psychologist Lisa Damour explains how parents can better support their kids as a new school year begins.

MindShift, from KQED: Listeners will be introduced to educators, researchers, parents and students who are developing effective ways to improve how kids learn.

🎧 This episode revisits the pioneering initiatives of the Black Panthers, who used a community school approach when they opened a first-of-its-kind school in East Oakland in 1973.

Throughline: Each episode takes the listener beyond the headlines to answer the question, "How did we get here?" using sound and stories to bring history to life, putting you into the middle of it.

🎧 What does it mean to do the greatest good for the greatest number? When the Los Angeles Aqueduct opened in 1913, it rerouted the Owens River from its natural path through an Eastern California valley hundreds of miles south to LA, enabling a dusty town to grow into a global city. But of course, there was a price. This episode dives into greed, glory, and obsession; what the water made possible, and at what cost.

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