In a 2-day substance abuse assessment and intervention course I took last weekend, we were discussing access to good substance abuse and dependence treatment and good mental health treatment. One student, named Steve, made a comment that illustrated the disparity between access to medical care and access to mental health and substance abuse treatment.
“We know exactly where to go for cardiac care and where the best cancer treatment centers are and where to go for all of the medical services we need, but we don’t know that there’s a group home just down the street. Access to mental health services is extremely limited.”
Mental health and substance abuse treatment centers do exist all over the nation, but aren’t used or advertised as frequently as more biomedical settings. In addition, insurance companies are less likely to cover mental health and substance abuse services than other services. Evidenced-based practice is not as much of a factor, we didn’t theorize, as much as the scientific model of the more biomedical treatments. There is a quantitative value to most of these treatments and a predictable, measurable cost and course of treatment. Mental health care stands at a stark contrast. There is not a dose-response relationship with mental health and substance abuse treatment options. No physician can prescribe a set amount of therapy sessions and know that the issue will simply “go away.” Many therapies teach clients to cope with life situations and help to manage and reduce symptoms. Therapy comes in many types with different methods in each type, and each individual responds differently to treatment. Some mental health diagnoses are pervasive and require different types of care throughout the lifespan. These factors make it nearly impossible to create a “dose/response” equation for mental health and substance abuse treatment.
Is mental health care something that you think about often? Do you think access to mental health care is an issue? What would society look like if mental health access were increased, with stigma stripped away? Which would have to change first? Share your opinions and discuss below.
Special thanks to Steve, for letting me use his wise words. Thank you, Steve.
