America Becoming Divided Nation of Have-more and Have-less Mental Health Care?


The Washington Post discussed a report and national map from the American Mental Health Counselors Association that showed data on which US states have been implementing new federal Medicaid provisions that increase mental health care access, and which states have been opting out. Could a formal study of the consequences follow?

“The grey states have accepted the expanded Medicaid funds, so the numbers there represent the estimated number of mentally ill patients that were treated,” stated the Washington Post in reference to the map. “An estimated 350,000 people with mental illness received treatment for their conditions, including prescription drugs and regular health visits in 26 states and D.C., which did expand Medicaid in 2014.”

“The green states opted out of the Medicaid expansion, meaning the numbers represent the patients that would have been treated, but weren’t,” reported the Post. “As the map shows, an estimated 66,723 patients in Florida and 62,400 patients in Texas would have received treatment in 2014.”

The Post did not discuss the possibility, but the data suggested that a formal study could soon be done comparing grey and green states and evaluating the positive or negative impacts of expanding America’s mental health care system.

These states leave the most mentally ill adults untreated. Guess what else they have in common. (Washington Post, April 14, 2015)

AMHCA Releases ‘Access Denied’ Report (AMHCA press release, April 6, 2015) (Full report)


  1. “People who don’t get treatment for mental illness can end up in jail or homeless; past research has found that about 30 percent of the chronically homeless in the U.S. are mentally ill. They are also more likely to fail out of school, lose their jobs or end up in the emergency room.” Way to demean and stigmatize the so called “mentally ill,” Washington Post. And it appears according to the actual medical evidence that it may be treatment, rather than “lack of treatment leads to more hospitalizations, suicides and suffering for the mentally ill and their families.”

    “Many of these beneficiaries are young adults between the age of 18 and 34. Some are veterans: Roughly 175,000 uninsured veterans with mental illness live below the federal poverty line, the report says. The expansion would also have an impact on children, the AMHCA argues, since research suggests that parents who obtain health insurance are more likely to get coverage for their children.”

    And, yes, the youth, children and veterans are prime targets of the psycho / pharmaceutical industrial complex – no doubt the psycho / pharmaceutical industries are unhappy they are unable to profit off drugging so many children and veterans. Since it is so very profitable turning unsuspecting children into bipolar / schizophrenics with their antidepressants, ADHD stimulants, and antipsychotics. And getting the veterans to commit suicide on the psych drugs has been very success for the psycho / pharmaceutical industries, as well.

    “The Post did not discuss the possibility, but the data suggested that a formal study could soon be done comparing grey and green states and evaluating the positive or negative impacts of expanding America’s mental health care system.” Excellent idea, I look forward to seeing the outcome of such a study.

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      • We have to hope, at least I do, that real human being’s consciences, and the actually medical evidence, will some day convince the psycho / pharmaceutical industries that they were wrong. And the truth will prevail.

        I do still want to believe many, or at least some or a few of the psychiatrists went into the medical profession to actually help people. So honesty will some day prevail. I’m quite certain most psychiatrists were deluded, by their educations and the pharmaceutical industry. But I do understand way too many are completely unethical and driven only by money, power, and ego.

        But some top psychiatric practitioners do now seem to be at least morally torn, like Thomas Insel and Allen Frances. And there do seem to be more and more ethical psychiatrists joining the MiA conversations, which is great. Let’s try to have hope. And I am very grateful to those psychiatric practitioners who have been honest all along, and have and are being inappropriately ostracized and harassed for their desire to actually help patients.

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    • Btw, these stats are pulled out of psychiatry’s a**. 30%? Given that the DSM labels are based on circular thinking it should be 100% and also according to some of their own estimates 25-50% of all people are “mentally ill” so it’s like a representative sample of general public. It’s all bs.

      “Excellent idea, I look forward to seeing the outcome of such a study.”

      The outcome of this study would be dismissed and buried since it’s likely to show what all the others so far – that “treatment” does more harm than good.

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      • “It’s all bs.” And that’s why we’re here to point this out. The DSM is a book of stigmatizations based upon the psychiatric industry’s myopic and deluded view of the iatrogenic illnesses their drugs create, but provides no insight into those who recovered from adverse life experiences and escaped the “disempowering system” that psychiatry has set up, for profit.

        We need to hope for common decency some day. If you believe, you will achieve.

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  2. In other news, the psychopharmaceutical industrial complex has determined that since it knows what is best for the U.S. population, “treatment” will be required for every citizen until each one is sufficiently docile, compliant and subservient. Comrades, we are very fortunate indeed to have such benevolent dictators to rule over us. Sieg heil to the therapeutic state!

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    • And, unfortunately your comic relief speaks to the truth, which isn’t actually funny. We do now seem to have the evil bankers and corporations our founding fathers warned us of, in charge:

      “If the American people ever allow private banks to control the issue of their currency, first by inflation, then by deflation, the banks and corporations that will grow up around them will deprive the people of all property until their children wake up homeless on the continent their Fathers conquered…I believe that banking institutions are more dangerous to our liberties than standing armies… The issuing power should be taken from the banks and restored to the people, to whom it properly belongs.” Thomas Jefferson quote.

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  3. The consequence for the lack of treatment is the same as the consequence for the lack of income. Many businesses have a preference in employment for people without mental health issues and screen out applicants with the telltale gaps in employment history. Since treatment is often accompanied by a disability check to take care of basic expenses, the individual loses the incentive to undertake illegal activities to make ends meet. This is what reduces homelessness and incarceration, not the intoxication with profitable pharmaceuticals.

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    • I’m still waiting to see any actual data to prove that mental health treatment “reduces homelessness and incarceration”. So far the only data I’ve seen can be attributed to the other aspects such as subsidized housing and as you mention benefits.

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  4. As others have said, articles like this beg the question about whether so-called “treatment” helps. The presumption in expanding Medicaid (or other insurance services) is that by granting “more access” people are better off. But the care they are accessing is awful, harmful, and probably decreasing their mental health. As such, I suspect not expanding Medicaid is HELPING people get mentally healthier. We obviously need major changes in care so we can provide good services to the people who need it.

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    • Decades ago I wondered why “street men” who looked dissociative or “schizophrenic” walked oddly.

      I wondered why those conditions affected gait.

      Now I know. Thorazine. (A symptom of a co-morbid condition, usually incurable, called “diagnosis.”)

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      • I had the same experience. I thought the odd expressions and movements and vocalizations were a result of “schizophrenia.” Once I learned about Tardive Dyskinesia, the scales fell from my eyes. In fact, I was in a bus station on the way back from the training and saw a person waiting who was making all these grimaces and twitches, and I thought, “Tardive Dyskinesia! There it is!” Apparently it was quite common but I had no idea what I was looking at before that training.

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      • It drives my mom crazy that I now sway with the music when I join her at her church. When I was a child she pointed out movement disorders in church as a sign of the mentally ill. I tell her she should have protected me from the psychiatric industry, rather than believing their bull shit defamation of me.

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        • By the way, it’s not just the movement disorders that are adverse effects of the neuroleptics, it’s also the psychosis (symptoms of schizophrenia) itself. Proof from

          “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

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  5. I agree with B – I hope they do the study, and won’t they be surprised to find that the people receiving LESS mental health “treatment” do BETTER over the long run? This is perhaps the only benefit of states refusing to implement expanded medicaid – less clients for the mill!

    — Steve

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  6. The US Southern States remain hold-outs stubborn to the Southern mentality and understanding culturally that a Church-based system of care provides for those truly in need. If you look at the map (in the article below), you can easily see the territorial and regional markers holding in place their Secede the US trends practically. Texas ranked 53rd in the US in mental health services care and attention (including the 3 US Territories) when I left it to join Georgia to work and learn rural public community health services. Georgia, however, deeply Southern and proud of it, continues to rely on suits to pay for itself. The South prides itself on being resourceful and responds in kind as long as it’s their idea to do it. The CMS and US pressures will hold nothing to their potentially entering status a Medicaid Expansion state in the union. The Confederacy flag still waves prominently throughout Georgia. The last time I visited Columbia, South Carolina, the flag waved over its’ very own Capitol building. My recommendation at this time is for policy makers to meet in the South on their terms and on their ground. A cultural understanding is required in order for there to be any type of education and pursuading, in fact. The US South are also the last hold-outs for other cultural phenomenons (e.g., Marriage). The only way the South will move its’ firm stance is to have the South want to do it, themselves.

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