I can’t control my mind and certainly can’t stop myself from having mental illnesses. Mental health issues don’t appear out of thin air. While many mental illnesses are genetic, it is inaccurate to state that they are simply biological. To me, such statements feel rooted in stigma. It is easier to justify an illness if it’s caused by nature instead of nurture, entirely out of one’s control. But realistically, a person’s life experiences and situations, like trauma, have significant effects on their mental health. This is not to say that a mental illness is anyone’s fault — a mental illness is a body’s reaction to everything that affects the brain. Out of sheer luck, I am equipped to tackle these illnesses in ways many others don’t have the privilege to, because of issues like accessibility, economic inequality and outside support.
Living in poverty increases the risk of mental illness — and these compound each other. It would be disingenuous of me to write about mental illness without ever speaking about the impact of socioeconomic factors. If someone is hungry or homeless, or at risk of being hungry or homeless, both the extreme stress of their situation and inability to access expensive and time-consuming treatment is going to negatively impact their mental health. Attaining basic needs is essential in order to reach a stable baseline and begin working on mental health.
Mental health care should be considered a basic need, but it is unaffordable. I see a therapist who is out of my insurance company network, and the cost adds up quickly. I can receive reimbursements from my insurance company, but many cannot afford the $150 per session cost out-of-pocket to begin with. Even though this expense is a necessity for me, it is still difficult to afford, and seeing that price tag stresses me out every week.
UC Berkeley students are lucky to have access to campus resources like the Tang Center, which offers free short-term therapy to all students and will help you find a long-term therapist. But it takes up to three weeks to get an appointment at the Tang Center, or at most any therapist’s office. Although there are more immediate options on campus, such as Let’s Talk informal consultations and crisis drop-in counseling, many students don’t know about them. There’s options available for students at UC Berkeley if they need to address their basic needs, but they are not readily available. Part of accessibility is being able to access treatment quickly and easily, but demand far outstrips resources that are already hard to access.
I spent six months of freshman year without a therapist because I didn’t know how or where to find one. The few people I did manage to find either had a waitlist, cost $400 a session or weren’t very good practitioners at all.
Insurance companies purposely exacerbate the issue of accessibility. My insurance company has taken over a year to complete my reimbursements — every time I call them, they’ve “forgotten to process the paperwork.” Insurance companies are also well-known to have “ghost networks.” If you’ve ever tried to use your insurance company’s database of in-network providers to find a therapist and haven’t been able to find one who will answer the phone, has open appointments or even exists — you aren’t alone. A study highlighted that 74% of therapists in Blue Cross Blue Shield’s database were not reachable to book appointments. Insurance companies may even keep their databases inaccurate and out-of-date on purpose because they don’t have to pay for your treatment if you can’t find a therapist.
My sister found me my therapist from a Yelp advertisement. Most people find theirs by referrals from friends. To me, one of the problems addressed the least is the energy and time it takes to access these treatments.
When I saw several bad psychiatrists and therapists in a row, I gave up — and it was only at the insistence of my family that I got the treatment I needed. Now, I try to be that voice for my friends who are struggling. I have referred several people to my therapist and have helped others navigate their insurance databases to find a therapist, because it is simply too hard to do alone.
Even though I have many resources and a strong support system, I still struggle to access mental health professionals. The system is difficult to navigate even with insurance and the ability to fund treatment. There are few solutions any individual can have for long wait times and poor-quality care.
All of these issues — from what we think of as basic needs, to accessibility and energy — are interconnected. Many people still suffer from mental illness, even if they possess all of these. I certainly still suffer. These fundamental needs aren’t the only causes of mental illness, but unfulfilled basic needs will certainly worsen a mental illness. But if these needs are fulfilled, more people will get the help they need more easily and get on a path to healing faster than is currently possible.
Salwa Meghjee writes the Thursday column on destigmatizing mental illness. Contact her at [email protected].