On Facebook, the moderator of The Thinking Project Podcast asked "Tell me the questions you have on your mind today? I bet we can figure it out!"
One person wrote: "Why isn’t help for mental health accessible? I personally had to spend 600 dollars for a diagnosis I already knew I had but had to have someone else tell me before I could get help. And I can afford that but how about the people who can’t?"
Money in healthcare creates some perverse incentives (as well as positive incentives), so I decided to respond.
In thinking about your question, I think that our history of dealing with what is now called "mental health" is troubling and systemically flawed. While our scientists and doctors have excelled in mending broken bones and vaccinating against viruses, our history with mental health is pretty broken. The last ice pick lobotomy was in my lifetime. For a great historical perspective I would suggest "Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness", by Anne Harrington. Basically, there aren't any clear biological markers for most of what we call mental illness.
The DSM (Diagnostic and Statistical Manual) that leads to every lay diagnosis of every divorced spouse everywhere was basically a bunch of guys (not being sexist, they were almost all men) getting in a room and voting. The vote in 1973 is why homosexuality is no longer a mental illness. Now, entire identity groups have grown up around these diagnosis and we are told to celebrate embracing their labels -- labels created by guys in a room voting. (https://www.labeledfest.org/ lest you think I'm making this up.) Like I've told The Thinking Project the two times I've managed to sneak on his podcast -- follow the money. Who profits from our mental health distress?
The remedies for a troubled mind run counter to our techno-consumer culture. If nothing else, the pandemic has shown us that, forcing us to live with our own thoughts without the constant distractions and pleasures of consuming.
I'd say the biggest reason mental health assistance isn't accessible is that the things we need for mental health -- uninterrupted time with loved ones or friends, movement of our bodies (alone and together), relief from economic stress, healthy food, and lots of rest, by and large don't generate any income for the gaping economic maw that is devouring our minds wholesale with Prime Delivery. No cash for it, why should they deliver peace of mind?
I should note that I'm not discounting mental distress, nor the fact that biological elements can play a huge role. I am also very sorry that you have suffered. I am saying the labels and diagnosis of mental health issues are convenient fictions that can block out other remedies and create more unintended consequences, because a diagnosis is a two edged sword. It can help, but once the label is affixed, it can cut out other possible options for healing.
Neuropsychiatric disorders were the number one leading cause of disability in the United States in 2010 and just behind musculoskeletal system and connective tissue disability in 2019. We are so dysfunctional in this area of health care that our population is incapacitated by mental health issues.
I hope that you have found the financial and medical relief you need for your health
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