Decades of disinformation and funding restrictions have devastated mental health services and wrecked lives. For more than thirty years, organized medicine has engaged in a concerted effort to severely restrict the practice of psychotherapy. In the early ‘80s, faced with competition for patients from psychologists and social workers, the American Psychiatric Association began colluding with pharmaceutical companies to eliminate the competition for their mutual economic benefit. Specifically, they began promoting a theory that had, and still has, no basis in science, that mental illness is the result of a chemical imbalance in the brain that can be corrected by the administration of drugs. This fraudulent theory was used as justification to restrict the use of psychotherapy.
Health insurance companies joined in this effort by severely restricting the number and frequency of psychotherapy sessions, imposing higher co-pays and burdensome preauthorization requirements. Despite the passage of federal mental health parity legislation in 2008 which outlawed these practices, most health insurance companies continue to require preauthorization of mental health care in violation of the law. In addition, most insurance companies have not increased the fees paid to psychotherapy providers in over 30 years, which has resulted in an inflation-adjusted reduction in fees of more than 70%. This has forced many psychotherapy providers to go out of business, discouraged new providers from entering the field and eroded the quality of care.
The latest assault against psychotherapy has come as a result of procedure code billing changes implemented by the American Medical Association for psychotherapy services that took effect on January 1, 2013. There are between 8000 and 9000 billing codes for medical procedures and changes are made every year. Now, insurance companies are claiming that changes to 30 psychotherapy billing codes are beyond the capacity of their computer systems to handle and it may take up to six months to fix the problem and pay providers. Many mental health providers will be forced to go out of business if they are not paid for months. In addition, insurance companies are using the changes in procedure codes to further reduce fees for psychotherapy.
As of 2000, over half of the counties in the U.S. did not have a single mental health provider of any kind. Other areas have severe shortages. As a result, many people in great emotional distress due to trauma or overwhelming life circumstances get prescriptions for pills instead of the compassionate help they need to develop effective coping strategies.
The Newtown massacre has prompted many to be concerned about the inadequate treatment of the mentally ill. The emphasis on drugs rather than psychotherapy as a treatment modality actually has made some mentally ill people more dangerous. Many of the most widely prescribed psychiatric drugs, including antidepressants, antipsychotics and stimulants, increase the chances of violence and suicide, according to recent studies. Numerous studies also show that the benefits of long term psychotherapy far exceed the benefits of medication and that psychiatric medication increases the likelihood that a mental illness will become chronic. Psychiatric illnesses are the leading cause of disability and reduced productivity in the U.S and worldwide.
Studies have also shown that about 90% of visits to doctors’ offices are related to stress. Studies in the 1950s showed that emotionally distressed patients could be identified by the weight of their medical chart and that even one targeted session of psychotherapy could reduce medical utilization for up to five years. Many subsequent studies have shown that psychotherapy is cost effective in that it reduces medical utilization and overall medical costs. And, unlike many medications used to treat chronic pain, high blood pressure, migraine headaches, ulcers and other stress related medical conditions, psychotherapy has no negative side effects. Reduced psychotherapy services have been one of the driving forces behind the huge increases in medical costs.
I’ve started the petition “Congress and President Obama: End the war against psychotherapy and expand mental health services“. The petition calls on Congress to hold hearings on this issue and to pass legislative remedies and calls on the President to use his executive powers to remedy this situation.
Will you take 30 seconds to sign my petition and help end the war against psychotherapy?
Thanks so much.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.